CUSTOMER EXPORT CERTIFICATION
The undersigned CUSTOMER of ANADYNE, INC. certifies that it is a U.S. company, with majority ownership by U.S. citizens or permanent U.S. residents. CUSTOMER understands that the logarithmic video amplifier integrated circuit known as the L-17D*M*(hereinafter "L-17D") and provided by ANADYNE, INC. to CUSTOMER under Purchase Order #:_________________may be currently subject to export limitations by the government of the United States.
CUSTOMER understands and agrees that it shall neither export nor re-export, directly or indirectly, the L-17D, products containing the L-17D, or restricted technical information concerning the L-17D, to any country to which such export or re-export is restricted by United States law or regulation. Furthermore, the CUSTOMER hereby certifies that any and all end-user and end-use statements or information provided by the CUSTOMER to ANADYNE, INC. is both true and complete, and has been appropriately verified by the CUSTOMER.
Additionally, the CUSTOMER hereby certifies that if it transfers the L-17D, or any product containing the L-17D, or any restricted technical information concerning the L-17D, to any third party or parties in the United States, the CUSTOMER will advise such third party or parties that the export from the United States of such hardware or restricted information requires a valid export license from the United States government, and will obtain such assurance or certifications as the CUSTOMER deems necessary to assure itself that any such export is properly authorized. Finally, the CUSTOMER hereby recognizes and acknowledges that all the above limitations, restrictions and certifications apply as well to L-2010 die, which are the active components in the L-17D packaged parts.
By signing this Certification, the individual signing also hereby certifies that they understand and agree with the above, and further, certifies that they are authorized by the CUSTOMER to sign this Certification on behalf of the CUSTOMER.
CUSTOMER:	____________________________________________________________
By:	____________________________________________________________ Signature
Name and Title:	____________________________________________________________
Date:	____________________________________________________________
Address:	____________________________________________________________
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