Statement of Intended Use of Pyrotechnics

Purchaser intends to use the 1.4G products from Tannerite®. By signing this contract, the purchaser agrees to, and swears under the penalty of perjury that this information is true and accurate. Buyer declares that they are fully competent and allowed to use the pyrotechnics sold. Buyer will use any/all pyrotechnics purchased from Tannerite® in a responsible and professional manner, abiding by any potential local regulations in the location where the end-user resides, contacting local authorities before use, if required. The products may not be sold or given to any person who is not competent in the professional use of pyrotechnics and (if applicable) electronic fire methods. UN0431 Articles may not be sold from any retail stand or sold to consumers. Buyer will provide seller with any pertinent licenses, letterheads, pyrotechnic cards or permits that are required. The purchaser hold Tannerite® Company harmless from the use or misuse of any products sold, and understands the potential inherent hazards with any form of pyrotechnic or explosive item. A copy of buyer’s Driver’s License or ID Card shall be attached, faxed, emailed or mailed to seller.

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Tannerite® Explosives
3633 Valley Rd
Pleasant Hill, OR 97455
541-744-1384 (fax)

For questions Contact:
The Law Offices of John H. Brooke
Brooke Mawhorr Attorneys LLC
112 Eas Gilbert Street
Muncie, Indiana 47305-1734

765-288-7763 (fax)