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Austin Thin Films, Inc.

Phone:

1-512-246-1122

16813 Radholme Ct., Bldg. B

Fax:    

1-512-246-1133

Round Rock, TX 78664

Email:

Sales@Dichro.com

 The undersigned hereby certifies that any merchandise purchased from Austin Thin Films, Inc. is purchased for one or more of the following purposes (check all that apply): 

(   ) Resale as tangible personal property, or resale of a service subject  to tax;
(   ) A component part of an article to be produced for sale by manufacturing, assembly, or processing;
(   ) Use by a tax exempt institution. (A copy of the Tax Exempt Letter must be attached.).

The undersigned further certifies that they will assume liability for payment of tax if the merchandise is used or consumed in such a manner as to render the sales subject to tax and acknowledges that this certification shall remain valid until revoked in writing.

(Please Print)

Sales Tax Registration Number

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Company Name

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Name/Title

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Address

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Address

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City

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State/Province

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Zip/Postal Code

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Country

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Phone

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Email

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Signature and Date

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Fax to 1-512-246-1133    Thank you!