Form sections

Company information

Company policies

Mineral questionnaire

Form certification

 

Conflict Metal Reporting

The purpose of this questionnaire is to collect sourcing information on conflict minerals (defined as tin, tantalum, tungsten and gold) that may be contained in the products/materials your company sells, distributes, or delivers to Telecore, Inc.

The information collected in this questionnaire will be used by Telecore to comply with its reporting and disclosure obligations to our suppliers who MUST report this information under the Dodd Frank Wall Street Reform and Consumer Protection Act, Section 1502.

All Telecore suppliers, distributors, and direct manufacturers MUST complete this form.

All four sections of the form must be completed - follow the prompts to make your way through the form. All fields must be filled in unless indicated otherwise.

Company name
DUNS No        Cage Code
Street address
City       State       Zip code
Country

Description of scope (Only fill in if other than all products supplied and all company divisions)

Authorized Company Representative

First name         Last name
Title
Phone        Email