\ProvidesFile{ptb-declaration-en.clo}[2018/11/08 v0.1b (ptb-declaration, english)]

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  \begin{center}
    \usekomafont{disposition} \huge Declaration

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  \begin{tabular}{@{}ll@{}}
    To be mailed to: &
    \begin{minipage}[t]{10cm}
      Section 7.54, Vacuum Metrology \\
      Physikalisch-Technische Bundesanstalt \\
      Abbestraße 2--12 \\
      10587 Berlin, Germany
    \end{minipage}
  \end{tabular}

  or email to \vl@myemail{}; may also be sent with instrument.

  \medskip
  \textbf{Subject:}~PTB reference no.:~\vl@myref,~date of confirmation:~\vl@mymail

  \medskip
  This is to certify that the vacuum gauges and/or test leaks (including their
  vacuum components) which we ordered to being calibrated by PTB
  \begin{itemize}
    \item are not contaminated with toxic, corrosive, explosive, radioactive,
    microbiological, carcinogenic or other harmful substances,
    \item were investigated with respect to their operational reliability before
    shipment to PTB,
    \item leave our house in a condition according to the general rules of high
    and ultrahigh vacuum techniques (not applicable for sniffer leaks) and in a
    condition that a contamination of the PTB calibration standards can be
    excluded (e.\,g.\ by oil or other hydrocarbons),
    \item are ready for calibration from the metrological point of view,
    \item obey the general rules of prevention of accidents and the
    acknowledged rules of relevant techniques and
    \item that we have no knowledge of any other indication of obstacles to a 
    calibration.
  \end{itemize}

\bigskip

\fbox{%
\begin{tabular}{@{}ll@{}}
\textbf{Return transport:} \\[1ex]
We wish an insurance of the return transport: & 
  \qquad Yes~\checkBox{}\qquad No~\checkBox{} \\[1ex]
Indication of value or desired sum insured:
\end{tabular}
}

Any costs related to transport, customs clearance, packing material and insurance must be paid by PTB’s
customer.

\textbf{Return address:}

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\begin{tabularx}{\textwidth}{@{}C{.25\textwidth}C{.35\textwidth}Y@{}}
  \hrulefill & \hrulefill & \hrulefill \\
  place, date & purchase order number of the customer &
  \parbox[t]{\linewidth}{\centering institution\,/\,company and \\ 
    legally binding signature}
\end{tabularx}  

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