Forms & Instructions
The purpose of these instructions is to assist Tox Tech clients in the completion of the required forms for compliance with regulations to process select agent orders for shipment.
Failure to submit completed correct forms with your select agent order will delay the processing of your order.
The client is responsible for retrieving, completing, and submitting the correct documents, per the following instructions, to Tox Tech with the completed order form so that select agents can be shipped.
Shipping Requirement instructions are applicable to all International and Domestic Select Agents and Hemolysin shipments. The instructions are separated into International (non-U.S.) and Domestic instructions, please follow the appropriate instruction section.
If there are any questions with this process, either call Toxin Technology at (941) 925-2032 or contact us at info@toxintechnology.com.
Downloads
Required Form Instructions
All domestic orders will need to have a completed Intended Use Declaration (IUD) form with each select agent order. This is a CDC requirement for shipments of select agents (Staphylococcal enterotoxins, Abrin, and Ricin).
Intended Use Declaration (IUD) – Declaration of the intended use of the product and the name, address and contact information for the client. (Download Intended Use Declaration Form)
- Name, phone numbers and email addresses are required.
- Multiple orders from the same person or the same company will require each purchase order to have a completed IUD.
The Letter of Assurance (LOA) is required for each order of select agents. (Fill Out and/or Download LOA Form)
This form is to be completed by you, the client, assuring that the product will not be used for bioterrorism or adverse purposes. The provided information is also used to populate the client export license by Tox Tech.
International Transaction Number (ITN or X-Number) Obtained by Tox Tech when individual invoices are greater than $2,500.
NOTE: Please determine whether a BIS-711 document is required. This form is required when the client/recipient is from a country that is checked in column CB2 of Supplement No. 1 to Part 738 – Commerce Country Chart which can be located here: https://www.ecfr.gov/current/title-15/part-738/appendix-Supplement%20No.%201%20to%20Part%20738
BIS-711 (U.S. Department of Commerce – Bureau of Industry and Security)
This is a statement by you, the Ultimate Consignee and Purchaser. (Form can be found on U.S. Department of Commerce website)
This form is required when the client/recipient is from a country that is checked in column CB2 of the Supplement Number 1 to 738 titled “Commerce Control List Overview and the Country Chart”
Form BIS-711 can be located and downloaded here: https://www.bis.doc.gov/index.php/documents/just-licensing-forms/803-bis-711-statement-by-ultimate-consignee-and-purchaser-1/file
It is the client’s responsibility to complete and return this document (when required) with each order to Tox Tech to file with the Export License.
This document:
- Provides the shipping address (end user/recipient)
- Requires that you, the client, provide assurances that the products will not be misused, transferred or reexported in violation of the Export Administration Regulations.
- Provides information that is used by Tox Tech to populate the Export License.
Domestic Select Agent Shipping
These instructions are applicable to all Domestic (within the United States) Select Agents and Hemolysin shipments. Documents must be completed, in their entirety, and submitted with each select agent order to be compliant with regulatory requirements.
All domestic orders require a completed Intended Use Declaration (IUD) form for each select agent order. This is a CDC requirement for select agents (Staphylococcal enterotoxins, Abrin, and Ricin).
The Intended Use Declaration (IUD) contains the intended use of the product and the name, address and contact information for the client.
- Name, phone numbers and email addresses are required.
- Multiple orders from the same person or the same company will require each purchase order to have a completed IUD.
- The client is responsible for retrieving, completing, and submitting the correct documents, per the following instructions, to Tox Tech with the completed order form so that select agents can be shipped.
Before, or at the time you place your order, please download and complete the following pdf.
After you have completed the pdf and signed it, it may be returned to us by either email or fax. We must have a completed IUD prior to completing and shipping your toxin order.
Failure to submit completed correct forms with your select agent order will delay the processing of your order.
If there are any questions with this process, either call Toxin Technology at (941) 925-2032 or contact us at info@toxintechnology.com
Required Documents
Instructions for International Select Agent Shipping
These instructions are applicable to all International (outside of the United States) Select Agents and Hemolysin shipments. Documents must be completed, in their entirety, and submitted with each select agent order to be compliant with regulatory requirements.
The client is responsible for retrieving, completing, and submitting the correct documents, per the following instructions, to Tox Tech with the completed order form so that select agents can be shipped.
International Orders
All orders from outside of the United States must comply with the following:
- Abrin and Ricin cannot be shipped internationally.
- Refer to Table 1 for the required client documents/information needed to accompany the order form to process your order.
| Required document for each shipment of select agents | Required documents when column CB2 is checked on “Commerce Control List Overview and the Country Chart” | Required when US dollar sales per invoice is greater than $2500 | |
|---|---|---|---|
| Letter of Assurance | X | ||
| BIS-711 | X | ||
| International Transaction Number (Tox Tech obtains) | X |
Table 1 - Order Form Required Documents
- The Letter of Assurance (LOA) is required for each order of select agents. (Link to download form)
- This form is to be completed by you, the client, assuring that the product will not be used for bioterrorism or adverse purposes. The provided information is also used to populate the client export license by Tox Tech.
- International Transaction Number (ITN or X-Number) Obtained by Tox Tech when individual invoices are greater than $2,500.
- Consult Supplement Number 1 to 738, titled “Commerce Control List Overview and the Country Chart” to determine if the shipment is to be delivered to a country checked in Chemical and Biological Weapons column CB2. This will establish if a BIS-711 document is needed.
- BIS-711 (U.S. Department of Commerce – Bureau of Industry and Security) – This is a statement by you, the Ultimate Consignee and Purchaser. (Form is found on U.S. Department of Commerce website, link below)
- Required when the client/recipient is from a country that is checked in column CB2 of the Supplement Number 1 to 738 titled “Commerce Control List Overview and the Country Chart”.
- Requires that you, the client, provide assurances that the products will not be misused, transferred or reexported in violation of the Export Administration Regulations.
- Provides information that is used by Tox Tech to populate the Export License.
Failure to submit completed correct forms with your select agent order will delay the processing of your order.
If there are any questions with this process, either call Toxin Technology at (941) 925-2032 or contact us at info@toxintechnology.com.