Declaration






Print the declaration out, complete it and send it back on the following address: Organizing Committee on International Carpathian Control Conference ICCC' 2001 Roman Korzeniowski Department of Process Control Faculty of Mechanical Engineering and Robotics University of Mining and Metallurgy Al. Mickiewicza 30 30-059 Kraków Poland

We hereby declare that:
	............................................................................................................. ............................................................................................................. (full name of institution) ............................................................................................................. ............................................................................................................. (address) is / is not * a VAT-payer with the identification number:

We authorize you to make out a *VAT invoice* / an invoice * without our signature for participation in International Carpathian Control Conference ICCC' 2001 the following persons:

1. ........................................................................................................ 2. ........................................................................................................ 3. ........................................................................................................

	Main Accountant

......................................... (signature)		......................................... (stamp and signature)
* cross out unnecessary