COMMERCIAL USE OF THE STATE SEAL OF TEXAS
MANUFACTURER'S CERTIFICATION OF LICENSE FOR THE COMMERCIAL USE OF THE STATE SEAL 1. Manufacturer's Name: ______________________________________________________ 2. License Number: ___________________________________________________________ 3. Vendor/Reseller's Name:_____________________________________________________ Vendor/Reseller's Address ____________________________________________________
(street address)
_______________________________________________________________________________
(city, state Zip)
4. Type of Product(s) using a representation of the state seal.
________________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________
Number sold to Vendor/Reseller
___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________
BY:___________________________________________ (signature of authorized officer of manufacturer) _______________________________________________ (title) _______________________________________________ (name of manufacturer) _______________________________________________ (date)
FORM #3304