Confirmation for Duty and VAT Free Importation of Samples

(1)

For customs purposes

Document only valid for small samples Date:

Confirmation for Duty and VAT Free Importation of Samples

Paul Scherrer Institute (PSI) is a multi-disciplinary research centre for natural

sciences and technology. We, PSI, VAT Reg No. CHE-116.133.392 MWST, hereby certify that

is autorised to import following research SAMPLES/PROBES for scientific experiments (laboratory testing only) Duty and VAT free according to the Swiss Import Regulations:

I declare that these goods are not restricted, non hazardous, not for therapeutical use, not toxic, not infectious, not flammable or explosive and not radioactive. No drugs.

Security data sheets, if requested, have already been transmitted to the local contact person. This document is only valid with the signature of PSI Import/Export Manager.

I declare that all information in this document is true and correct.

Name of Company Address

City Zip Code

Country Name of Person

Signature of sender PSI VALIDATION

Import/Export Manager Exact description of samples

Local User Contact @ PSI Beamline/ User Facility

Value of goods Value for customs purposes only No commercial value, no invoicing

Import/Export Department OVGA/219

5232 Villigen PSI Switzerland

Phone: +41 (0) 56/ 310 29 13 Fax: +41 (0) 56/ 310 29 14 E-mail: import@psi.ch