Form 3303-A--General Information (State Seal Statement of Official Use, State Function, or Political Purpose) The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant code provisions. This form and the information provided are not substitutes for the advice and services of an attorney. Commentary Commercial use of the Texas state seal is governed by section 17.08, Texas Business & Commerce Code and the secretary of state's administrative rules found in 1 Texas Administrative Code Chapter 72. Section 17.08 prohibits private or commercial use of the state seal of Texas unless the user applies to the secretary of state. Certain manufacturers and vendors are exempt from the section 17.08 registration requirement. Rule 72.42 exempts manufacturers and vendors producing, selling, or distributing to only state agencies and officials who use the state seal for official uses or state functions or to elected officials who use the state seal for political purposes from the application and fee requirements. Such manufacturers and vendors are encouraged, however, to submit to the secretary of state a certification that the product is not available to the general public (Form 3303) and a signed statement from the agency or official regarding the use of the product. This form may be used for the signed statement of use from the agency or official and would be submitted with the manufacturer/vendor certification. Instructions for Form Identifying Information: Identify the state agency or official signing the statement, as well as the manufacturer or vendor on whose behalf the statement is being signed. Also provide the business address of the manufacturer or vendor for identifying purposes. Statement of Use: Select the appropriate box to complete the statement of use indicating whether the use is by a state agency or official for official use or state functions or by an elected official for political purposes. Execution: A person authorized to sign on behalf of the state agency, officer, or elected official must sign and date the statement. Delivery Instructions: The completed form may be mailed to Registrations Unit, P.O. Box 13550, Austin, Texas 78711-3550; or delivered to the James Earl Rudder Office Building, 1019 Brazos, 5th Floor, Austin, Texas 78701. Revised 09/2015 Form 3303-A 1 American LegalNet, Inc. www.FormsWorkFlow.com Form #3303-A Rev. 09/2015 This space reserved for office use Submit to: SECRETARY OF STATE Registrations Unit P O Box 13550 Austin, TX 78711-3550 512-475-0775 512-475-2815 - Fax Filing Fee: none STATE SEAL STATEMENT OF OFFICIAL USE, STATE FUNCTION, OR POLITICAL PURPOSE Identifying Information Name of State Agency or Official: Name of Manufacturer or Vendor: Business Address: Street City State Zip Statement of Use Products bearing the state seal produced, sold, or distributed by the above-named manufacturer or vendor are: (Select either A or B.) A. B. Date: Signature of authorized representative for agency, official, or officer Printed or typed name of authorized representative used by the above-named state agency or official solely for an official use or for a state function. OR used by the above-named elected official solely for a political purpose. Execution Form 3303-A 2 American LegalNet, Inc. www.FormsWorkFlow.com