TEST MATERIAL INFORMATION SHEET

**PLEASE AFFIX A COPY OF THIS DOCUMENT TO ALL TEST MATERIAL**

Date:

CUSTOMER:

CONTACT:

Customer Address:	Description of Test Material:
Phone:
Email:

Please Ship all test material FREIGHT PREPAID

Shipping Address:

Rapid Granulator, Inc

5217 28^th Ave

Rockford, IL 61109

Attn: Dave Miller