Toxic Substance Control Act
Date
____________
______ I certify that all chemical substances in this shipment are not
subject to TSCA
_______ I certify that all chemical substances in this shipment comply
will all applicable rules or orders under TSCA and that I am not
offering a chemical substance for entry in violation of TSCA or
any applicable rule or order under TSCA
Company Name
University of Warwick
Address
Department of __________
Gibbet Hill Road
COVENTRY
CV4 7AL
UK
Name
_________________
Signature
_________________
Phone
_________________
Fax
_________________
e-mail
_________________
http://www.warwick.ac.uk/services/postroom/tscaform.doc