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Transmittal Form Use this handy form to fill in pertinent information concerning your company and the sample part to be electropolished. Attach your card and mail your sample part. Part Information Part #:_______________________________________________________________________________________ Description:__________________________________________________________________________________ Material:_____________________________________________________________________________________ Last Mfg. Operation:____________________________________________________________________________ Special Tolerances? Yes ___ No ___ If yes, please include a print outlining critical areas. Need A Quote? Yes ____ No, not at present ____ If yes, please indicate: Lot Sizes: _________________________________________________ Annual Volume: ____________________________________________ Please describe the metal surface problem and what your present solution is: __________________________________________________ ___________________________________________ _____________________________________________________________________________________________ Please describe which specific surfaces are most critical to electropolish: ____________________________________________ _________________________________________________ _____________________________________________________________________________________________

Drop the sample part(s) and this form in a box and mail to: Able Electropolishing Co., Inc. 2001 South Kilbourn Ave Chicago, IL 60623-2390 888-868-2900

Please attach your business card or fill in info: Company Name:_________________________ Address:_______________________________ City:_____________ State:___ Zip:__________ ContactName:____________________________ Title: ___________________________________ Telephone:_____________Fax:_______________ Email: __________________________________

©2006 Able Electropolishing All Rights Reserved.

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