Guidance
HARMONIZED RAW MATERIAL INFORMATION FORM
Guidance
Introduction:
This form has been created with a view to help capture as much information as possible in one document regarding
the global regulatory, safety and physico-chemical properties of each ingredient or ingredient blend. It is intended to
save time for both the customer and the manufacturer. Once completed, it can serve as the vehicle for information
exchange, eliminating the often tedious process of collating data and documents ad hoc for each individual request.
The form consists of the following required sections:
1. General Information*
2. Regulatory Form*
3. Physical Chemical Properties Form*
4. Safety Form*
The following section is viewed as helpful but not mandatory:
5. Environmental Form
The following sections are to be filled out for relevant materials:
6. Plant Derived Form
7. TSE Certification
This section is intended for Fragrance Materials only:
8. Fragrance Information Form
In addition all materials will require a fully compliant 16 section MSDS and EU SDS with full transportation,
emergency response measures, storage and handling information.
General Comments: The form is housed in EXCEL to facilitate data entry and enable wide use. It is saved as a
template so that the opening of the form automatically creates a new file separate from the original. We suggest
saving the completed form using the trade name of the material being summarized and converting to a Portable
Document File (pdf) to ensure data integrity.
Please Note: If the raw material in question is a fragrance, please go directly to Section 7 of these instruction.
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Guidance
Section 1: General Form
1. Material/Supplier Identification : Basic information regarding the supplier and the subject material/trade name.
2. Trade Name: The unique name used to identify the ingredient/ingredient blend by the supplier and as is noted in
the CTFA Buyer’s Guide or also at
http://www.ctfa-online.org
3. INCI Name : The International Nomenclature for Cosmetic Ingredient designation as noted on the registration of
the Trade Name as maintained by the CTFA (Cosmetic, Toiletry and Fragrance Association; use above link).
4. Material Manufacturer Name : Name of the corporate entity responsible for manufacture of the material.
5. Material Supplier Name : Name of supplier/distributor if other than the manufacturer.
6. Supplier Technical Contact : Name of primary technical person in case of additional questions.
7. Contact Information for person to whom questions should be directed should the need arise.
8. Country of Origin : Country of Manufacture.
9. Harmonized Tariff Code: For tariff treatment of imported goods. The ten digit Code is available at:
Harmonized Tariff Code
For NAFTA Eligible materials the form 434 is available at http://www.cbp.gov/xp/cgov/toolbox/forms/
10. Composition & Material Identification :
11. INCI Name of each individual constituent (see above).
12. CAS #: Chemical Abstracts Service Registry Number is a unique identifier for each chemical substance. Please
avoid using generic CAS #s. For more information see
Chemical Abstracts Service
13. Percent Composition Ranges: Max% & Min% per manufacturing acceptance criteria. Also requested is the
target percentage level for each constituent (ie what is the intended level?).
14. Function & Feedstock Origin : require categorization using a validated data list. Please choose the appropriate
response for each constituent.
15. EINECS/ELINCS #: The EINECS number is a registry number given to each chemical substance commercially
available in the EU between January 1, 1971 and September 18, 1981.
The inventory was created by Directive 67/548/EEC
As of September 19, 1981, the inventory has been replaced by the ELINCS. All "new" substances brought in to the
European market are allocated an ELINCS number after their notification to the European Commission.
16. The following fields have embedded pick lists to direct responses. Please choose from the list.
17. TSCA: The Toxic Substances Control Act (TSCA) became law on October 11, 1976 and took effect on January
1, 1977, except Section 4 (f) became effective two years later. The Act authorized EPA to secure information on all
new and existing chemical substances, and to control any of the substances that were determined to cause
unreasonable risk to public health or the environment. The TSCA is found in United States law at the following site:
15 USC (C. 53) 2601-2692
18. DSL/NDSL: The DSL (Domestic Substance List) is the sole basis for determining whether a substance is new for
the purposes of the Canadian Environmental Protection Act, 1999. Substances not appearing on the DSL are
considered to be new to Canada and are subject to notification under the New Substances Notification Regulations of
CEPA, 1999. The Non-Domestic Substances List (NDSL) specifies substances that are not on the DSL but are in
commercial use internationally. Substances on the NDSL are subject to notification under the Regulations of CEPA,
1999 but may require different information in the New Substance Notification (NSN) packages. The list is available
at:
DSL/NDSL List
19. AICS: Australian Inventory of Chemical Substances. A list of chemical identity data maintained by NICNAS;
legal device that distinguishes new from existing chemicals and lists all industrial chemicals in use in Australia
between January 1, 1977 and February 28, 1990; includes newly assessed chemicals since February 1990. The
Australian Inventory of New and Existing Substances is available at
AICS List
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Guidance
20. IECSC : The People’s Republic of China, SEPA (State Environmental Protection Administration) put forth the
Inventory of Existing Chemical Substances Manufactured or Imported in China (IECSC) for the purpose of
identifying new chemical substances and to master the status of existing chemical substances in China.
21. ENCS : The ENCS is the list of Existing and New Chemical Substances promulgated by the Kashin Act of Japan,
which regulates chemical substances that are either manufactured or imported in Japan: Comprehensive Licensing
Standards [of Cosmetics by Category].
22. ECL : Korean Existing and Evaluated Chemical Substance Inventory
23. Substances or Impurities of Concern : Requires the disclosure of the existence and level of identified chemicals
of general concern. Identify if the materials in question are present and if so at what level. Examples of ingredients
of concern are listed in the following table. The list is not exhaustive.
Name CAS # Name CAS #
Acrylamide 79-06-1 Nitrosamines
Chloroacetic acid, total Phenylacetaldehyde 122-78-1
Dichloro acetic acid 79-43-6 Polycyclic Musks
Monochloro acetic acid 79-11-8 AHTN 15323-35-0
Cyclotetrasiloxane (D4) 556-67-2 HHCB 1222-05-5
Alkanolamines Other Polycyclic Musks
Diethanolamine (DEA) 111-42-2 Tested for Heavy Metals?
Triethanolamine (TEA) 102-71-6 Copper
Phthalates Arsenic
1,4-Dioxane 131151-09-2 Cadmium
Ether Glycols Chromium(VI)
EGBE: 2-butoxyethanol 111-76-2 Cobalt
DEGBE: 2-(2-butoxy ethoxy)ethanol 112-34-5 Lead
DEGEE: 2-(ethoxy ethoxy)ethanol 111-90-0 Mercury
Ethylene Oxide 75-21-8 Nickel
Nitrilotriacetic acid/acetate (residual in Na 2
EDTA) 139-13-9 Zinc
Nitro musks
Musk Ketone 81-14-1
Musk Xylene 81-15-2
Other Nitro Musks
24. Feedstock Origin Clarification : If “Other” is chosen for feedstock origin please explain the nature of the choice.
25. If the Feedstock is Animal: Please fill out the TSE Certification and attach.
Halal Compliance: Further information on compliance with Halal standards is available at: IFANCA-Halal.
Kosher Compliance: Further information on compliance with Kosher standards is available at:
Orthodox Union.
26 . If “vegetable” is chosen please answer the questions regarding Genetically Modified Organisms: A genetically
modified organism (GMO) is an organism whose genetic material has been altered using techniques in genetics
generally known as recombinant DNA technology.
27. LOT Declaration : Certification that all lots that are supplied of this material comply with the data disclosed in
this form.
28. Contact Person to whom questions should be directed should the need arise.
29. Checklist at the end of the general form allows the supplier to denote which forms are attached and which require
special confidentiality precautions.
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Guidance
Section 2: Regulatory Form
1. Trade Name , INCI Name etc., are automatically filled from the previous form.
2. Constituent Name is also filled from the General Form.
NOTE: The questions below and throughout the rest of the addenda refer to each individual constituent.
3. Restriction Limits: For each constituent denoted as a “key ingredient,” please indicate if there exists a restriction
limit for each of the countries indicated. If there are no specified limits (including CIR or SCCP) please indicate
“none.”
4. Compliance Battery : The questions in this section are asked to ascertain compliance with various regulatory
instruments globally and inclusion on various lists. Each question must be answered by choosing yes or no for each
component. An answer of yes will require further specification.
a. The EU Dangerous Substance Directive applies to pure chemicals and to mixtures of chemicals (preparations)
which are placed on the market in the EU, therefore it does not apply directly to substances created purely for
research purposes. The List is found at the following site:
EU Dangerous Substance List
b. The EU Cosmetics Directive applies to cosmetics placed on the market in the EU. Annex II lists chemicals that are
not to be used in the formulation of cosmetics. The full legislation is found at the following link:
EU Cosmetics Directive
c. The International Agency for Research on Cancer publishes monographs to make available the conclusions of their
expert panels. IARC Monographs may be reviewed at the denoted website.
IARC Monographs
d. The Report on Carcinogens is published by the National Toxicology Program and is found at:
NTP/RoC .
e. The US Department of Labor’s Occupational Safety & Health Administration publishes standards for safety in the
workplace. See the link below:
29 CFR Part 1910 Subpart Z
f. California’s Office of Environmental Health & Hazard Assessment publishes the most current list of chemicals at
the following link:
Proposition 65
g. Animal Testing questions attempt to ascertain compliance with the 7th Amendment to the Cosmetic Directive. The
EU position on animal testing may be found at:
5. Volatile Organic Compounds are regulated by the US EPA, California EPA and Switzerland. VOC & ROG
Definitions per the US EPA and CARB are available for review so that the proper classification of each material may
be made (HVOC, MVOC, LVOC, ROG, Exempt VOC) using the pick list provided. The list of exempt VOCs is
available using the link in the template as well as the MIR (Maximum Incremental Reactivity index) of each VOC.
VOC & ROG Regulations
6. Percent (w/w) of each VOC (HVOC, MVOC, LVOC) is required.
7. Contact Person to whom questions should be directed should the need arise.
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Section 3: Physical Chemical Properties Form
1. Trade Name , INCI Name etc., are automatically filled from the previous form.
2. Constituent Name is also filled from the General Form.
3. GMP Certificate: If the titled raw material is manufactured under GMP procedures, then submit suitable
documentation, such as an FDA Facility Registration, Form 2656.
4. Appearance: The Physical Form will determine how to describe the Appearance. For a gas, Color and Odor are
probably sufficient. For a liquid, clear, turbid, opaque, with suspended particles might be useful. For a gel, semisolid,
solid or paste the liquid descriptors plus smooth or lumpy might apply.
5. Particle Size/Range for Powder: Provide the Average Particle Size and the Particle Size Distribution.
6. Density: Be sure to include the measurement units and the temperature for the determination.
7. Viscosity : Include the type of viscosity, the make and model of the viscometer, spindle size, conditions,
temperature and other information to allow the understanding of the measurement supplied.
8. Flash Point : Indicate open or closed cup method, and instrument used.
9. Spectra and Chromatograms : Enclose instrument conditions used to perform the determination.
10. Contact Person to whom questions should be directed should the need arise.
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Section 4: Human Safety Form
1. Trade Name , INCI Name etc., are automatically filled from the previous form.
2. Constituent Name is also filled from the General Form.
3. Toxicological Studies: Standard Toxicological tests are identified. The first set is concerned with the existence of
data. Please check only those tests that have been performed. If the test has been undertaken a summary must be
attached . If the components were tested individually or as a whole please specify.
Acute Oral Toxicity Summary
Subchronic Toxicity Summary
Dermal Irritation
Mucous Membrane Irritation
Percutaneous Absorption
Mutagenicity (Ames)
Genotoxicity
Carcinogenicity
Comedogenicity
Dermal Sensitization
Inhalation Toxicity
Photoirritation
Photosensitization
Phototoxicity
Reproductive Toxicity
Teratogenecity
Toxicokinetics
4. LD 50 : If an LD50 was determined please specify.
5. NOEL: If a No Observed Effect Level has been determined please indicate here.
7. Contact Information for person to whom questions should be directed should the need arise.
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Section 5: Environmental Form
1. Trade Name , INCI Name etc., are automatically filled from the previous form.
2. Constituent Name is also filled from the General Form.
3. US EPA regulated: Information on materials regulated by the US Environmental Protection Agency as described
below:
a. Carcinogenicity: This is covered in the Regulatory tab.
b. SARA: Superfund Amendments and Reauthorization Act of 1986. Title III of SARA authorized the Emergency
Planning and Community Right-to-Know Act.
SARA
c. RCRA: Resource Conservation and Recovery Act. Please note if this raw material must be disposed as hazardous
waste. List the waste code (i.e., D001).
d. OSHA: This is covered in the Regulatory tab.
4. PBT: Persistent, Bioaccumulative or Toxic. Please note which by definition.
a. PBT List b. European Chemicals Bureau
5. vPvBT: Very persistent, very bioaccumulative as determined by the European Chemicals Bureau.
http://ecb.jrc.it/
6. Biodegradable: Per the European Norm EN13432, Japanese Greenpla Standard and the American Society for
Testing and Materials (ASTM International), a material is deemed compostable if it will break down to the extent of
at least 90% to H2O and CO2 and biomass within a period of 6 months. ASTM D6400-99 also imposes a time period
of 6 months.
7. Bioaccumulation: This is covered with the vPvBT question.
8. Water solubility (μg/l): The maximum possible concentration of a chemical compound dissolved in water.
9. Molecular weight (kDa): The sum of the atomic weights of all the atoms in a molecule.
10. Molecular diameter (Ǻ): The diameter of a molecule, assuming it to be spherical.
11. Octanol/water partition, logP: The partition coefficient.
12. Ecological Toxicity Studies: The studies listed are required under the European Union’s REACH
(Registration, Evaluation and Authorization of Chemicals) legislation. It is not expected that all studies have been
completed for a material. Please note if the study is summarized in the Excel spreadsheet, attached, not available or
not conducted.
European Union REACH
13. Contact Person to whom questions should be directed should the need arise.
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Guidance
Section 6: Plant Derived Form
1. Trade Name , INCI Name etc., are automatically filled from the previous form.
2. Constituent Name is also filled from the General Form.
3. Identification of Plant Material: Materials derived from plant extracts must specify plant part used, level of plant
material in raw material (e.g., concentration make up of plant material if a blend, percent solid level), and identify
phylogenetic name of plant material used.
4. Manufacturing Flow Chart: Manufacturing process for plant material needs to be provided.
5. Presence of Pesticides: Materials derived from plant extracts must disclose pesticide residues if present. Were the
pesticide residues directly measured or calculated?
6. Presence of Denatured Alcohol: Indicate whether or not the botanical contains denatured alcohol, and specifiy
the denaturant.
7. Processing Aids: Indicate whether the botanical material in question does not contain the materials listed by using
the checkbox. If the material is in the botanical then specify what percentage is natural source, directly added and
total %.
8. Allergen Disclosure: List includes the 26 allergens identified by the SCCP and regulated by the 7th Amendment
to the Cosmetic Directive. Direct addition, natural source and total content by %
http://ec.europa.eu/enterprise/cosmetics/doc/200315/200315_en.pdf
9. Ingredients of Concern: Indicate whether the botanical material in question does not contain the materials listed
by using the checkbox. If the material is in the botanical then specify what percentage is natural source, directly
added and total %.
10. Contact Information for person to whom questions should be directed should the need arise.
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Guidance
Section 7: TSE Certification
1. Trade Name , INCI Name etc., are automatically filled from the previous form.
2. Constituent Name is also filled from the General Form.
3. The questions contained in this form are geared to gathering information on animal derived ingredients as required
by multiple governments globally.
a. Species Identification: choose from list (Bovine, Caprine, Marine, Ovine, Porcine, Other.
b. Organ source: Please specify the organs harvested to isolate ingredient.
c. Age of Animal: at harvest. Choices are 2 years.
d. BSE Country Status: Indicate GBR level as specified by the European Food Safety Authority
Category rating based on the EU Commission scientific steering committee (SCC) Regulation 999/2001-
Geographical Risk of Spongiform Encephalopathy (GBR) Adopted on January 11, 2002. Updated on August 20,
2004.
4. Contact Person to whom questions should be directed should the need arise.
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Guidance
Section 8: Fragrance Information Form
Introduction
The FMA Fragrance Product Information Form (FPIF) is used for exchanging regulatory and safety information on
fragrance raw materials. Although the FPIF could accompany some simple fragrance bases, it is not intended for
finished fragrances. The FPIF addresses information required to satisfy customer and regulatory requirements
globally.
The FPIF contains the following sections:
1 General Product Information
2. Regulatory Status Information
3. Hazard Identification Information
4. Transportation Information
5. Fragrance Information
6. IFRA Certificate
7. TSE Certification (Please use TSE Certificate Tab in the body of the form).
Please complete all applicable sections and attach all required documents included on the FPIF Documentation
Checklist.
1 General information
This section captures basic information concerning the material.
INCI Name - The International Nomenclature of Cosmetic Ingredients, abbreviated INCI, is a system of names for
waxes, oils, pigments, chemicals, and other ingredients of cosmetics. INCI names are based on scientific names and
other Latin and English words. The INCI dictionary is maintained by the U.S. Cosmetic, Toiletry and Fragrance
Association (CTFA). INCI names are also available in the RIFM/FEMA Database and the CTFA On-Line.
RIFM Home CTFA On-Line
CAS Number - Chemical Abstract Service Registry Number - The CAS Registry covers substances identified in the
scientific literature. Each substance in the Registry is identified by a unique numeric identifier called a CAS Registry
Number. For more information or to locate a CAS Number go to: http://cas.org.
FEMA GRAS Number - Recognition by the Expert Panel of the Flavor and Extract Manufacturers Association
(FEMA) that a flavoring substance is
Definitions
1 "Generally Recognized As Safe" under Section 201 (s) of the U.S. Federal Food, Drug & Cosmetic Act. Since
1965, lists of flavoring substances that have been determined to be GRAS have been published in a series of
publications in the journal Food Technology. A comprehensive list of all the FEMA GRAS flavor ingredients and a
list of (GRAS publications) is available. Please note that the vast majority of the substances listed in the CFR are
FEMA GRAS substances. For more information go to or call 202-293-5800.
www.femaflavor.org
FDA GRAS Number - General recognition of safety under Section 201 (s) of the U.S. Federal Food, Drug &
Cosmetic Act, and 21 CFR § 170.30, and 21 CFR Part 172.
Country of Origin - NAFTA eligible
For purposes of obtaining preferential tariff treatment, Customs and Border Protection (CBP) Form 434 must be
attached. Form 434 is available at:
http://www.customs.gov/xp/cgov/toolbox/forms
Harmonized Tariff Code - The code from the Harmonized Tariff Schedule of the U.S., based on the International
Harmonized System, the global system of nomenclature that is used to describe most world trade goods.
http://www.usitc.gov/tata/hts/index.htm
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Country of Production - The country where the product is produced.
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FDA Bioterrorism - Under the U.S. Public Health Security and Bioterrorism Preparedness and Response Act of
2002, facilities that manufacture, process, pack or hold food intended for consumption in the U.S. must be registered
with the U.S. Food and Drug Administration.
Bioterrorism Act 2002
Source Information - Indicate the origin of the material being used.
GMO Statement - Indicate whether this product or any of its ingredients are derived from genetically modified
organisms.
Organic Status - U.S. organic regulations are found at 7 CFR Part 205 and
National Organic Program
Impurities - Include impurities that are to be expected in the final product (e.g. residual solvents, residual monomers,
reagents intermediate synthesis phases, heavy metals, etc.
Regulatory Status of ingredient (s)
US - TSCA - Toxic Substances Control Act - TSCA regulates the importation, manufacture and distribution of
chemicals in the United States. For information go to:
Toxic Substances Control Act
Any person intending to manufacture or import a chemical substance must first determine whether the substance is
listed on the TSCA Inventory.
TSCA § 4 - This section requires testing of certain chemicals and mixtures.
TSCA § 5 - Manufacturers intending to manufacture or import a new chemical substance must give the U.S. EPA 90
days prior notice. TSCA § 5 authorizes EPA to evaluate and, in certain, instances, to regulate new chemical
substances. Specifically, §5(a)(1) requires a manufacturer (which, by definition, includes an importer) of a new
chemical substance to file a Pre-Market Notification (PMN) at least ninety days prior to the commencement of the
commercial production or importation. 1
Significant New Use Rule (SNUR) - If EPA determines by rule that a particular use of a chemical already on the
Inventory constitutes or would constitute a "significant new use," the Agency can issue a significant new use rule
(SNUR).
TSCA § 6 - This section gives EPA authority to prohibit or limit production and to impose labeling or other
requirements.
TSCA § 7 - This section authorizes EPA to commence a judicial action for seizure of a chemical substance, mixture,
or article containing such a chemical substance or mixture, which EPA has determined is imminently hazardous.
TSCA § 12(b) - This section requires exporters to notify EPA before shipment abroad of any substance for which test
data are required under §§ 4 or 5(b), regulatory action has been proposed or taken under §§ 5 or 6, or an action is
pending or relief has been granted under §§ 5 or 7.
SARA 302 - Section 302 of the Emergency Planning and Community Right-to-Know Act. The list of chemicals may
be reviewed at:
SARA
SARA 311/312 - Sections 311 and 312 are chemical inventory reporting requirements of the Emergency Planning and
Community Right-to-Know Act.
1
McKenna & Cuneo, LLP, TSCA Handbook 55 (3d ed. 1997) EPA TRI: TRI Chemicals
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The list of chemicals may be viewed at:
SARA List
SARA 313 - Toxic Release Inventory (Form R) reporting requirements for Superfund Amendments and
Reauthorization Act, Title 111, Section 313 (SARA 313). The current list of TRI chemicals can be reviewed at:
http://www.epa.gov/tri/chemical/index.htm
EPA Hazardous Air Pollutants (HAPS) - Substances identified as Hazardous Air Pollutants in the U.S. Clean Air
Act Amendments of 1990. For information on EPA Hazardous Air Pollutants go to:
http://www.epa.gov/ttn/atw/188polls.html
EPA CERCLA - Under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA),
the U.S. Environmental Protection Agency (EPA) prepares a list of substances determined to pose the most
significant potential threat to human health due to known or suspected toxicity. The CERCLA priority list is revised
and published every two years. For information and to review the lists go to the Agency for Toxic Substances and
Disease Registry at
http://www.atsdr.cdc.gov/cercla
FDA Prohibited Cosmetic Ingredients - U.S. regulations specifically prohibit or restrict the use of certain
ingredients in cosmetics, see 21 CFR Parts 250.250 and 700.11 through 700.23.
http://www.gpoaccess.gov.
DEA List I or List II Chemicals - Certain chemicals have been specifically designated by the U.S. Drug
Enforcement Administration as listed chemicals subject to the provisions of 21 CFR §§1309, 1313, and 1310.02. This
list of covered chemicals is found in 21 CFR § 1310.02
DEA List
California Prop. 65 - The Safe Drinking Water and Toxic Enforcement Act of 1986, commonly known as
"Proposition 65" (Prop. 65). The updated Prop. 65 list of carcinogens and reproductive toxins is on the website of the
California Office of Environmental Health Hazard Assessment (OEHHA) at:
OEHHA Site
California Safe Cosmetics Act of 2005 , SB-484 - Will require after January 2007, the disclosure of chemicals in
cosmetic products that meet any of the following criteria:
1. Chemicals identified pursuant to regulations under the California Safe Drinking Water and Toxic Enforcement Act
of 1986, also known as "Prop. 65,"
2. Substances listed as known or reasonably anticipated to be a human carcinogen in a National Toxicology Report on
carcinogens,
3. Substances given an overall carcinogenicity evaluation of Group 1, Group 2A, or Group 2B by the International
Agency for Research on Cancer,
4. Substances identified as Group A, Group B1, or Group B2 carcinogen, or as a known or likely carcinogen by the
U.S. Environmental Protection Agency, or
5. Substances identified as having some or clear evidence of adverse developmental, male reproductive, or female
reproductive toxicity effects in a report by an expert panel of the National Toxicology Program's Center for the
Evaluation of Risks to Human Reproduction.
State Right-to-Know Lists
Massachusetts - Include all substances that appear on the Massachusetts Substance List for Right to Know law. This
list consists of toxic and hazardous substances regulated by Massachusetts General Law C.111 F.
Massachusetts RTK
New Jersey - Include any substance found on the New Jersey Right to Know Hazardous Substances list.
New Jersey RTK
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Guidance
Pennsylvania - Include any substance found on the Pennsylvania Right to Know Act Hazardous Substances List.
Pennsylvania RTK
EUROPE
EINECS - The European Inventory of Existing Commercial Substances is a registry number given to each chemical
substance commercially available in the European Union between January 1, 1971 and September 18, 1981. The
inventory was created by Directive 67/548/EEC concerning the labeling of dangerous substances. For more
information go to the European Chemicals Bureau at:
http://ecb.irc.itlexistinQ-chemicals/
ELINCS - The European List of Notified Chemical Substances are substances introduced after the creation of the
EINECS List. For more information go to the European Chemicals Bureau at:
http://ecb.irc.itl
Cosmetic Directive Number 76/768/EEC - Council Directive 76/768/EEC of July 27,1976 sets out a list of
substances which cannot be included in the composition of cosmetic products (Annex II) and a list of substances
which cosmetic products may not contain, outside the restrictions and conditions laid down (Annex III). For more
information go to:
http://europa.eu/scadplus/leg/en/lvb/l21191.htm
Volatile Organic Chemicals in Switzerland - The Swiss VOC ordinance of November 12,1997 (814.018) refers to
two lists, Annexes 1 & 2, of substances that are considered VOCs.
CANADA
DSL- The Domestic Substances List includes substances that were, between January 1, 1984 and December 31,
1986, in Canadian commerce, used for manufacturing purposes, or manufactured in or imported into Canada in a
quantity of 100 kg or more in any calendar year.
NDSL - The Non-domestic Substances List specifies substances that are not on the DSL but are in commercial use
in the United States. As a basis for this list, Environment Canada used the U.S. Toxic Substances Control Act
(TSCA).
The DSL and NDSL are found at: The Substance List
CEPA - Canadian Environmental Protection Act please consult: CEPA Environmental Registry - The Act
JAPAN
ENCS - Existing and New Chemical Substances List
Poisonous and Deleterious Substances Control Law
http://www.nihs.go.jp/law/dokugeki/edokugeki.html
Pollutant Release and Transfer Registry:
http://www.nihs.go.jp/GINC/collabo.html
AUSTRALIA
AICS - The Australian Inventory of Chemical Substances: For more information go to:
AICS List
NICNAS - The National lndustrial Chemicals Notification and Assessment Scheme: For more information go to:
http://www.nicnas.gov.au/
PHILlPPINES
PICCS - Philippine Inventory of Chemicals and Chemical Substances - The PICCS is available for purchase on CD
from the Philippine government and from commercial services.
CHINA
IECS - China chemical inventory
REPUBLlC OF SOUTH KOREA
ECL - Republic of South Korea chemical inventory
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Guidance
Hazard Identification
NORTH AMERICA
OSHA Hazard Communieations Standard - U.S. Occupational Safety, Health and Environment Administration,
Department of Labor: 29CCFR § 1910.1200:
http://www.osha.gov
Hazardous Material lnformation System (HMIS) rating - System developed by the National Paint and Coatings
Association:
http://www.paint.org/hmis/index.cfm
National Fire Protection Association (NFPA) 704 rating - NFPA 704, Standard for the Identification of the Fire
Hazards of Materials for Emergency Response, 2001 Edition. The NFPA 704 ratings are displayed in markings
that are commonly referred to as the "NFPA hazard diamond" :
http://www.nfpa.org
Carcinogens definitions
NTP - National Toxicology Program, Report on Carcinogens (ROC) - The ROC is a congressionally mandated
document prepared by the National Toxicology Program. The ROC is published biennially and the 11th edition was
released on January 31, 2005.
http://ntp.niehs.nih.gov/
IARC - International Agency for Research on Cancer - The IARC program evaluates the carcinogenic risk of
chemicals. The IARC Monograph series publishes independent assessments by international experts of the
carcinogenic risks to humans posed by a variety of chemicals and chemical mixtures.
http://www.iarc.fr/
OSHA - U.S. Occupational Safety and Health Administration - OSHA considers the following sources as
establishing that a chemical is a carcinogen or potential carcinogen for hazard communications purposes:
(i) National Toxicology Program (NTP), Annual Report on Carcinogens (Latest edition):
http://ntp.niehs.nih.gov/
(ii) International Agency for Research on Cancer (IARC), Monographs (Latest edition):
http://www.iarc.fr/
(iii) 29 CFR part 1910, subpart Z, Toxic and Hazardous Substances, OSHA,
http://www.gpoaccess.gov
ACGIH - Threshold Limit Values for Chemical Substances and Physical Agents in the Work Environment, American
Conference of Governmental lndustrial Hygienists (Latest edition):
http://www.acgih.org/home.htm
WHMIS - Workplace Hazardous Materials Information System is Canada's national hazard communication program
for hazardous workplace chemicals:
http://www.hc-sc.gc.ca/
EUROPE
EEC Directive 67/548 - on the approximation of laws, regulations and administrative provisions relating to the
classification, packaging and labeling of dangerous substances:
http://europa.eu.intlcomm/environmentldansub/main67548/indexen.htm
EEC Directive 99/45 - on the approximation of laws, regulations and administrative provisions relating to the
classification, packaging and labeling of dangerous preparations:
http://europa.eu.intleur-lexlpri/en/oi/datl1999/1200/120019990730enOO010068.pdf
GERMANY
WGK - Wassergefahrdungsklasse - The German Federal Water Management Act requires that substances be
evaluated for negative influence on the physical, chemical or biological characteristics of water:
http://www.umweltbundesamt.de/wgs-e/index.htm
WGK hazard classes:
O = not hazardous 1 = slightly hazardous to water 2 = hazardous to water
3 = extremely hazardous to water
RMIF
September 12, 2007 Page 15 of 35
Guidance
Transportation Information
Definitions
Hazardous under transportation regulations - A substance or material that the Secretary of Transportation has
determined is capable of posing an unreasonable risk to health, safety, and property when transported in commerce,
and has designated as hazardous under section 5103 of the Federal Hazardous Materials Transportation law. See 49
CFR § 171.8.
UN Number - UN Numbers or UN IDs are four-digit numbers that identify dangerous goods, hazardous substances
and articles (such as explosives, flammable liquids, toxic substances, etc.) in the framework of international
transportation
Hazard Class or Division - The U.S. DOT divides regulated hazardous materials into nine classes, some of which
are further divided into divisions. Also see 49 CFR Part 172.
Fragrance Information
Natural designation - Association Francaise de Normalization (AFNOR) Huiles essentielles Tome 2 Volume 1,
NFT 75-006 - - "raw material of vegetable, animal or microbiological origin, including the products derived from
this material by enzymatic processes or by traditional procedures of preparation (e.g. drying, torrefaction or
fermentation)."
IFRA Declaration - The Code of Practice of the International Fragrance Association is located at:
http://www.ifraorg.org/GuideLines.asp
Safety and Toxicological lnformation for Fragrances
RIFM - Research Institute for Fragrance Materials. Please indicate if this ingredient has been tested by RIFM or by
your company and provide all requested information.
http://www.rifm.org/
IFRA - The International Fragrance Association, see for information concerning restricted or banned ingredients.
http://www.ifraorg.org
EU Fragrance Allergens - The 7th Amendment to the European Cosmetics Directive - published as Directive
2003/15/EC of the European Parliament and of the Council of 27 February 2003 amending Council Directive
76/768/EEC.
7th Amendment to the Cosmetic Directive
Additives - Ingredients that may be present as part of the fragrance but which are not fragrance ingredients. If present
include concentration.
Colors and Dyes - Ingredients that may be present as part of the fragrance but which are not fragrance ingredients. If
present include color index number and concentration.
IFRA Certificate - This section should be completed and documentation attached to confirm compliance with the
International Fragrance Association Code of Practice.
Supplier Guarantee - This section addresses application of the answers to future shipments.
TSE - Please answer the following questions related to Transmissible Spongiform Encephalopathy (TSE), Bovine
Spongiform Encephalopathy (BSE).
RMIF
September 12, 2007 Page 16 of 35
Acronym Description
AICS Australian Inventory of Chemical Substances
CAS Chemical Abstracts Service Registry Number
CERCLA Comprehensive Environmental Response, Compensation, and Liability Act
CHiPS Chemicals (Hazard Information and Packaging for Supply) Regulations 2002 in the UK
DSL Domestic Substance List (Canada)
ECL Existing and Evaluated Chemical Substance Inventory (Korea)
EINECS European Inventory of Existing Chemical Substances
ELINCS European List of Notified Chemical Substances
ENCS Existing and New Chemical Substances (Japan)
GMO Genetically Modified Organism
HAPS Hazardous Air Pollutants (US EPA)
HMIS Hazardous Material information System (US)
HTC Harmonized Tariff Code
IARC International Agency for Research on Cancer
IECSC Inventory of Existing Chemical Substances Manufactured or Imported in China
IFANCA The Islamic Food and Nutrition Council of America
INCI International Nomenclature for Cosmetic Ingredients
MIR Maximum Incremental Reactivity index for VOCs (US-CA)
NDSL Non Domestic Substance List (Canada)
NFPA National Fire Protection Association (US)
NTP National Toxicology Program (US)
OEHHA Office of Environmental Health & Hazard Assessment (US-CA)
OSHA Occupational Safety & Health administration (US)
OU Orthodox Union (Kosher)
PBT Persistent, Bioaccumulative & Toxic
RCRA Resource Conservation and Recovery Act (US)
RoC Report on Carcinogens
ROG Reactive Organic Gases
SARA Superfund Amendments and Reauthorization Act (US EPA)
TSCA Toxic Substance Control Act (US EPA)
TSE Transmissible Spongiform Encephalopathy
VOC Volatile Organic Chemical
vPvBT very Persistent, very Bioaccumulative & Toxic
GENERAL INFORMATION FORM
Please provide a Specification Sheet, a Material Safety Data Sheet (MSDS) and Certificate Of Analysis (COA) with this completed form.
This form is intended to help in the technical approval and qualification of potential suppliers. As such, the prompt and accurate completion of all sections will facilitate this
process and the data on the form is treated as critical base data for safety and regulatory work. All information will be treated as strictly confidential. If the information being
requested is either unavailable or not applicable, please indicate and explain
MATERIAL / SUPPLIER IDENTIFICATION:
Material Trade Name
Material Chemical Name(s)
Material INCI Name(s)
Color Index Number
Material Manufacturer Name
(If different from Supplier)
Material Supplier Name
Supplier Technical Contact
Supplier E-Mail Address
Harmonized Tariff Code
Supplier Phone / Fax No.
Supplier Address Country of
(address where material is manufactured) Origin:
Is the material a Fragrance? Select If "YES" please proceed to the Fragrance section of this form
COMPOSITION & MATERIAL IDENTIFICATION:
Total target contents of the components should sum up to 100%. List all intentionally-added constituents in this table.
INGREDIENT FUNCTION: (This is intended to identify possible function and is not meant to be limiting in anyway)
Key Ingredients - defined as chemical intended to demonstrate its functionality in finished products.
Carryover Ingredients – defined as chemical intentionally added to material to maintain its quality or stability, such as preservative, anti-oxidant, UV filter, that does not
function in finished product formula.
CONSTITUENT CAS# Min. Target Max. Function * Feedstock Origin
#
(INCI Name) (Avoid generic CAS#) (wt %) (wt %) (wt %) (Select from the pick list) (Select from the pick list)
1 Please Select Select
2 Please Select Select
3 Please Select Select
4 Please Select Select
5 Please Select Select
6 Please Select Select
7 Please Select Select
Total: 0 0 0
*** If you select the Feedstock Origin "Animal", Please use TSE Certificate in this form
Halal Certification? Select
Kosher Certification? Select
*** If you select the Feedstock Origin "Other", please explain:
Is the material Food Grade? GRAS? USP? Other? (Please Specify)
In the table below, Constituent column data is automatically fed from the above table. Please put Inventory Number or Choose status in each column.)
DSL/ICL/
CONSTITUENT EINECS/ TSCA AICS IECSC ENCS ECL PICCS
# NDSL
(INCI Name) ELINCS# (EU) (U.S.) (Australia) (China) (Japan) (Korea) (Philippines)
(Canada)
1 0 Select Select Select Select Select Select Select
2 0 Select Select Select Select Select Select Select
Select
3 0 Select Select Select Select Select Select
4 0 Select Select Select Select Select Select Select
Select Select Select Select Select Select Select
5 0
Select
6 0 Select Select Select Select Select Select
Select Select Select Select Select Select Select
7 0
Impurities/Residues/Catalysts/Monomers/By-Product
An impurity is any chemical substance that is unintentionally present in the new chemical substance. List all CAS # % or ppm Comment
impurities (regardless of weight percent).
Confidential 98b841d8-0592-4e37-81db-95be0e9525c2.xls - General Form 11/4/2011
GENERAL INFORMATION FORM
Material Trade Name
Material Chemical Name(s)
Material INCI Name(s)
Color Index Number
LOT DECLARATION:
Do you certify that all the lots you supply will comply with all the questions until further notice from you? Agree Disagree
Contact Person:
Title
Company Name
E-Mail Address Phone
Date of Completion
CHECK LIST FOR ADDITIONAL INFORMATION REQUIRED
Certificate of Analysis (3 lots if available)
Special document handling requirement
MSDS (US & EU) - please mark if applicable.
Mandatory Specification Sheet
Regulatory Form Restricted Data
Safety Form Restricted Data
Physical-Chemical Properties Form Restricted Data
Provide if available: Environmental Form Restricted Data
If any component origin is Botanical Extract: Botanical Form Restricted Data
If any component origin is Animal derived: TSE Certification Restricted Data
Please submit this form and the additional forms as appropriate for the nature of the material. If information on the attached form(s) would include
confidential data which should be shared only to a pre-identified contact, such condition should be indicated by check mark next to the form and to be sent to
the designated party ONLY. Thank you.
Confidential 98b841d8-0592-4e37-81db-95be0e9525c2.xls - General Form 11/4/2011
REGULATORY FORM
Material Trade Name 0
Material Chemical Name(s) 0
Material INCI Name(s) 0
Color Index Number (If Any) 0
In the table below, Constituent column data is automatically fed from the General Form.
Constituent
INCI Name
0
0
0
0
0
0
0
RESTRICTION LIMITS (If Any): Please respond if the region in question has any restriction limits on the ingredient and if what is the maximum use level allowed.
US Restriction%
CAN Restriction%
EU Restriction%
AUS Restriction%
CHINA Restriction%
JAPAN Restriction%
KOREA Restriction%
Compliance with Regulation (Choose from list) Comments
Is the ingredient a Carcinogen/Mutagen/ Reproductive Select Select Select Select Select Select Select
Toxicant as defined in Annex 1 Directive 67/548/EEC?
Is the ingredient listed in the European Dangerous Substance
Select Select Select Select Select Select Select
Directive (67/548/EEC : 79/831/EEC)?
Is the ingredient in compliance with European Cosmetic Select Select Select Select Select Select Select
Directive (76/768/EEC)?
Information on suitability for Japanese Quasi-Drug use?
Is the ingredient found to be Carcinogenic by IARC? Select Select Select Select Select Select Select
Is the ingredient found to be Carcinogenic by NTP? Select Select Select Select Select Select Select
Is the ingredient found to be Carcinogenic by OSHA? Select Select Select Select Select Select Select
Does this material contain any chemical listed by California's
Proposition 65 inclusive of any impurities, residues, catalysts,
monomers, by-products,?**
Please attach an affidavit attesting to the accuracy of the Proposition 65 Disclosure signed by the appropriate person of authority in the
company.
Animal Testing: see link for further information Europe-Animal Testing If Yes Specify
Select Select Select Select Select Select Select
Are you in compliance with the 7th Amendment of the
European Cosmetic Directive 74/768/EEC on animal testing?
Links: VOC & ROG Definitions Exempt VOC per US EPA
Volatile Organic Compounds
Is the ingredient classified as a VOC or ROG? (Choose from Select Select Select Select Select Select Select
list)
If Yes what is the classification ? (Choose from List) Select Select Select Select Select Select Select
Water is the partial pressure of the material? (mm Hg at ST)
What is the MIR Value? (g O3 formed/g M reacted) MIR Definition
VOC %
Total Raw Material (W/W)
HVOC
MVOC
LVP VOC
ROG
VOC Exempt
If different from the person identified on the General Form:
Contact Person:
Title
Company Name
E-Mail Address Phone
Date of Completion
Confidential 98b841d8-0592-4e37-81db-95be0e9525c2.xls - Regulatory 11/4/2011
PHYSICAL-CHEMICAL PROPERTIES FORM
Material Trade Name 0
Material Chemical Name(s) 0
Material INCI Name(s) 0
Color Index Number 0
In the table below, Constituent column data is automatically fed from the General Form.
Manufacturing Information
GMP Certificate Select
Level of Industrialization Select
Manufacturing Process and/or Flowchart PLEASE ATTACH
CONSTITUENT
(INCI Name)
Material
Technical Tested as
a Single
0 0 0 0 0 0 0 Entity
Appearance
Physical Form Select Select Select Select Select Select Select
Particle Size/Range for Powder Select Select Select Select Select Select Select
Density
Viscosity
Molecular Weight
Color
Odor
If the Material is a Polymer please answer the following questions: Attach GPC
Average Molecular Weight Fraction of material 70% organic)
REGULATORY STATUS OF INGREDIENTS
United States
Ingredients registered in compliance with TSCA Section 5?
YES NO
Ingredients subject to Rules 4, 5 6, 7, or 12(b) under TSCA? YES NO
Name CAS # % Rule #
Contain ingredients listed under EPCRA Extremely Hazardous
YES NO
Substances (SARA 302)?
SARA 311/312 Hazard Categories (choose those that apply)
Acute Health Hazard
Chronic Health Hazard
Fire
Sudden Release of Pressure
Reactivity
Contains any ingredients listed under SARA 313? YES NO
Name CAS # %
Contains any ingredients listed under EPA Hazardous Air Pollutants
YES NO
(HAP)?
Confidential 11/4/2011 Page 29
FRAGRANCE INFORMATION FORM
Name CAS # %
Contains any ingredients listed under EPA CERCLA? YES NO
Name CAS # %
Contains any ingredients forbidden for use in Cosmetics under
YES NO
FDA?
Name CAS # %
Contains any ingredients listed US DEA List I or II? YES NO
Name CAS # %
Contains any ingredients listed on California's Proposition 65? YES NO
Name CAS # %
Contains any ingredients identified California's SB 484 as
carcinogenic or reproductive toxin? YES NO
Name CAS # %
European Union
Ingredients Listed on EINECS? YES NO
Ingredients Listed on ELINCS? YES NO
Limited Full
Name EINECS ELINCS 1000kg/yr
Cosmetic Directive 76/768/EEC: Substances which are mentioned in Annex II - IV of the EU Cosmetic Directive (other
than preservatives, dyes, U filters, fragrance allergens listed in 7th Amendment
Name Annex %
Volatile Organic Chemicals according to the Swiss VOC legislation? YES NO
Name CAS # %
Confidential 11/4/2011 Page 30
FRAGRANCE INFORMATION FORM
Canada DSL ICL NDSL CEPA
Contains ingredients listed on:
For Bases and Compounds: Percentage on
Japan
Listed on Existing and New Chemical Substances (ENCS) YES NO
Low Low
Name ENCS # CAS # % < 1 ton/yr < 10 ton/yr
Listed on Industrial Safety & Health (ISHL) Law Inventory? YES NO
Name ISHL # CAS # %
Australia
Listed on AICS or notified under NICNAS? YES NO
Low Volume Notification? YES NO
Philippines
Listed or notified under PICCS? YES NO
Low Volume Notification? YES NO
China
Listed on IECS? YES NO
Republic of South Korea
Listed on ECL? YES NO
ECL #
Hazard Identification
Attach US MSDS
Attach EU SDS
For this fragrance, please answer the following questions:
Was this fragrance screened for pesticides? Select
Were the pesticide residue levels: Select
Do the pesticide residues present meet the European Pharmacopoeia Select
Guidelines?
Natural Designation: Natural Product means all the odoriferous ingredients meet a definition of "aromatic natural raw materials" in
ISO Standard 9235 or are substances already present in these natural materials and are isolated from them by physical means.
100% pure and natural? YES NO
For plant derived materials please provide the Phylogenetic name:
Are all processes in production accepted physical means? YES NO
Safety & Toxicological Information
This product has been tested: Yes No If yes, the literature reference is:
By RIFM:
Yes No If yes, specified in the following table
By our Company:
Yes No If yes, specific details are:
By other(s):
Date last tested:
Confidential 11/4/2011 Page 31
FRAGRANCE INFORMATION FORM
Test Type Method/species Concentration/ Reference
results
Oral LD50
Dermal LD50
Inhalation LC50
Skin irritation
Eye irritation
Skin sensitization
Phototoxicity
Photo sensitization
Mutagenicity
Biodegradability
Toxicity to Aquatic Organisms
Other
IFRA Certification: YES NO
PLEASE ATTACH CERTIFICATE OF COMPLIANCE
Does the fragrance contain any material restricted by IFRA? YES NO
Name CAS # Percentage
5-Acetyl-1,1,2,3,3,6-hexamethyl indan (AHMI, Phantolid) 15323-35-0
Allyl heptine carbonate 73157-43-4
Amyl cyclopentenone (2-pentyl-2-cyclopenten-1-one) 25564-22-1
Angelica root oil 8015-64-3/84775-41-7
cis-and trans-Asarone ((E)-and(Z)-2,4,5-Trimethoxypropen-1-yl benzene) - 2883-98-9/ 5273-86-9
Benzyl cyanide – indirectly added from naturals 140-29-4
Bergamot oil expressed 8007-75-8/ 89957-91-5
Bitter orange peel oil expressed 68916-04-1/ 72968-50-4
BMHCA (p-t-Butyl-alpha-methylhydrocinnamic aldehyde) 80-54-6 See allergens
p-tert-Butyl dihydrocinnamaldehyde (Bourgeonal) 18127-01-0
Cedarmoss 68648-41-9/ 90028-67-4
Cinnamic alcohol 104-54-1 See allergens
Cinnamic aldehyde 104-55-2 See allergens
Cinnamyl nitrile 1885-38-7/ 4360-47-8
Citral (Lemarome) 5392-40-5 See allergens
Cumin oil 8014-13-9/ 84775-51-9
Eugenol 97-53-0 See allergens
Farnesol 4602-84-0 See allergens
Grapefruit oil expressed 8016-20-4/ 90045-43-5
trans-2-Hexenal – directly added 6728-26-3
trans-2-Hexenal – indirectly added from naturals 6728-26-3
alpha-Hexylidene cyclopentanone 17373-89-6
HMPCC (3 and 4-(4-Hydroxy-4-methylpentyl)-3-cyclohexene-1- 31906-04-4 See allergens
carboxaldehyde)
Hydroxycitronellal 107-75-5 See allergens
Isocyclogeraniol 68527-77-5
Isoeugenol 97-54-1 See allergens
Lemon oil cold pressed 8008-56-8/ 84929-31-7
Lime oil expressed 8008-26-2/ 90063-52-8
Menthadienyl formate 68683-20-5
Methoxy dicylopentadiene carboxaldehyde (Scentenal) 86803-90-9
2-Methoxy-4-methylphenol 93-51-6
Methyl Eugenol – directly added 93-15-2
Methyl Eugenol – indirectly added from naturals 93-15-2
Methyl heptadienone (6-Methyl-3,5-heptadienone) 1604-28-0
Methyl heptine carbonate 111-12-6 See allergens
p-Methyl hydrocinnamic aldehyde 5406-12-2
Confidential 11/4/2011 Page 32
FRAGRANCE INFORMATION FORM
Methyl N-methyl anthranilate - directly added 85-91-6
Methyl N-methyl anthranilate – indirectly added from naturals 85-91-6
Methyl beta-naphthyl ketone 93-08-3
3-Methyl-2(3)-nonenenitrile (Citgrenile) 53153-66-5
Methyl octine carbonate 111-80-8 See allergens
Oakmoss extracts 9000-50-4/ 90028-68-5 See allergens
1-Octen-3-yl acetate (amyl vinyl carbinyl acetate) 198242
Opoponax 8021-36-1/ 9000-78-6
Perilla aldehyde 2111-75-3
Peru balsam extracts and distillates 8007-00-9
Petitgrain Mandarin Oil 8014-17-3/ 93686-22-7
Phenyl acetaldehyde (Hyacinthin) 122-78-1 See allergens
Propylidene phthalide 17369-59-4
Rue oil 8014-29-7/ 84929-47-5
Safrole – indirectly added from naturals 94-59-7
Styrax extracts and distillates (prepared from exudations of Liquidambar 8024-01-9/ 8046-19-3/
styraciflua L. var. macrophylla or Liquidambar orientalis Mill.) 94891-27-7/ 94891-28-8
Tagetes oil and absolute 8016-84-0/ 91722-29-1
Tea absolute (Camellia sinensis absolute) 84650-60-2
Treemoss extracts 68648-41-9/ 90028-67-4 See allergens
2,6,6-Trimethylcyclohexa-1,3-dienyl methanal (Safranal) 116-26-7
1-(Trimethylcyclohexenyl/cyclohexadienyl)-2-buten-1-ones (Rose Various
Verbena absolute 8024-12-2/ 85116-63-8
Benzene (indirect) 71-43-2
Toluene (indirect) 108-88-3
5-Methoxypsoralen (Bergaptene) 484-20-8
Polynuclear aromatic hydrocarbons (PAH)
Does the fragrance contain any material prohibited by IFRA? YES NO
Name CAS # Present?
Acetyl ethyl tetramethyl tetralin (AETT, Versalide) 88-29-9
Acetyl isovaleryl (5-Methyl-2,3-hexanedione) 13706-86-0
Allantroot oil (Elecampane oil) 97676-35-2
Allylisothiocyanate 57-06-7
Anisylidene acetone (4-(4-methoxphenyl)-3-buten-2-one) 943-88-4
cis-and trans-Asarone ((E)-and(Z)-2,4,5-Trimethoxypropen-1-yl benzene) 2883-98-9/ 5273-86-9
Benzene 71-43-2
Benzyl cyanide 140-29-4
Benzyildene acetone (4-Phenyl-3-buten-2-one) 122-57-6
Birch wood (bark) pyrolysates (oils), crude 8001-88-5/ 84012-15-7/
3-Bromo-1,7,7-trimethylbicylo[2.2.1]heptane-2-one 76-29-9
Bromstryene 103-64-0
p-tert-Butylphenol 98-54-4
Cade oils, crude 8013-10-3/ 90046-02-9
Carvone oxide 33204-74-9
Chenopodium oil 8006-99-3/ 89997-47-7
Cinnamylidene acetone 4173-44-8
Colophony 8050-09-7
Costus root oil, absolute and concrete 8023-88-9/ 90106-55-1
Cyclamen alcohol (3-(4-Isopropylphenyl)-2-methylpropanol) 4756-19-8
1,3-Dibromo-2-methoxy-4-methyl-5-nitrobenzene (Musk KS) 62265-99-0
1,3-Dibromo-4-methoxy-2-methyl-5-nitrobenzene (Musk alpha)
2,2-Dichloro-1-methylcyclopropylbenzene 3591-42-2
Diethyl maleate 141-05-9
Dihydroabietyl alcohol 26266-77-3
Dihydrocoumarin (Melilotine) 119-84-6
2,4-Dihydroxy-3-methyl-benzaldehyde 6248-20-0
4,6-Dimethyl-8-t-butyl coumarin (Butolia) 17874-34-9
Dimethyl citraconate (cis-Methylbutenedioic acid, dimethyl ester) 617-54-9
Confidential 11/4/2011 Page 33
FRAGRANCE INFORMATION FORM
3,7-Dimethyl-2-octen-1-ol (6,7-Dihydrogeraniol) 40607-48-5
Diphenyl amine 122-39-4
Esters of 2-nonynoic acid, except methyl octine carbonate Various
Esters of 2-octynoic acid, except methyl and allyl heptine carbonate Various
Ethyl acrylate 140-88-5
Ethylene glycol monoethyl ether 110-80-5
Ethylene glycol monoethyl ether acetate 111-15-9
Ethylene glycol monomethyl ether 109-86-4
Ethylene glycol monomethyl ether acetate 110-49-6
Fig leaf absolute 68916-52-9/90028-74-3
Furfurylideneacetone 623-15-4
trans-2-Heptenal 18829-55-5
Hexahydrocoumarin 700-82-3
trans-2-Hexenal diethyl acetal 67746-30-9
trans-2-Hexenal dimethyl acetal 18318-83-7
Hydroabietyl alcohol (Abitol) 13393-93-6/ 1333-89-7
Hydroquinone monoethylether (4-Ethoxy phenol) 622-62-8
Hydroquinone monomethylether (4-Methoxy phenol) 150-76-5
Isophorone 78-59-1
6-Isopropyl-2-decalol 34131-99-2
Massoia bark oil 85085-26-3
Massoia lactone 54814-64-1
Melissa oil (genuine Melissa officinalis) 8014-71-9/ 84082-61-1
7-Methoxycoumarin 531-59-9
alpha-Methyl anisylidene acetone (1-(4-Methoxphenyl)-1-penten-3-one) 104-27-8
6-Methyl coumarin (Toncarine) 92-48-8
7-Methyl coumarin 2445-83-2
Methyl crotonate 623-43-8
4-Methyl-7-ethoxycoumarin (Maraniol) 87-05-8
Methyl methacrylate 80-62-6
Moskene 116-66-5
Musk ambrette 83-66-9
Musk tibetine 145-39-1
Nitrobenzene 98-95-3
Pentylidene cyclohexanone 25677-40-1
Peru balsam (exudation from Myroxylon pereirae (Royle) Klotzsch) 8007-00-9
Phenyl acetone (Methyl benzyl ketone) 103-79-7
Phenyl benzoate 93-99-2
Pseudoionone (2,6-Dimethylundeca-2,6,8-trien-10-one) 141-10-6
Pseudomethylionones 26651-96-7
Safrole, isosafrole, dihydrosafrole (directly and indirectly added from 94-59-7/ 120-58-1/ 94-58-
naturals) 6
Santolina oil 84961-58-0
Styrax gums, crude 8024-01-9/ 8046-19-3/
Toluene 108-88-3
Verbena oil 8024-12-2/ 85116-63-8
Allergen Disclosure EINECS % Natural % By % Total
INCI Name CAS # # Source Addition Content
Alpha-Isomethyl Ionone 127-51-5 204-846-3
Amyl Cinnamal 122-40-7 204-541-5
Amylcinnamyl Alcohol 101-85-9 202-982-8
Anise Alcohol 105-13-5
Benzyl Alcohol 100-51-6 202-859-9
Benzyl Benzoate 120-51-4 204-402-9
Benzyl Cinnamate 103-41-3 203-109-3
Benzyl Salicylate 118-58-1 204-262-9
Butylphenyl Methylpropional 80-54-6 201-289-8
Cinnamal 104-55-2 203-213-9
Confidential 11/4/2011 Page 34
FRAGRANCE INFORMATION FORM
Cinnamyl Alcohol 104-54-1 203-212-3
Citral 5392-40-5 226-394-6
Citronellol 106-22-9 203-375-0
Coumarin 91-64-5 202-086-7
Eugenol 97-53-0 202-589-1
Evernia Furfuacea (Treemoss) Extract 90028-67-4 289-860-8
Evernia Prunastri (Oakmoss) Extract 90028-68-5 289-861-3
Farnesol 4602-84-0 225-004-1
Geraniol 106-24-1 203-377-1
Hexyl Cinnamal 101-86-0 202-983-3
Hydroxycitronellal 107-75-5 203-518-7
Hydroxyisohexyl 3-Cyclohexene 31906-04-4 250-863-4
Isoeugenol 97-54-1 202-589-1
Limonene 5989-27-5
Linalool 78-70-6 201-134-4
Methyl Octine Carbonate 111-80-8
Phenyl Acetaldehyde 122-78-1
Methyl 2-Octynoate 111-12-6
SOLVENTS USED? YES NO
Name CAS # %
ANTI-OXIDANTS/STABILIZERS? YES NO
Name CAS # %
EMULSIFIERS USED? YES NO
Name CAS # %
COLORANTS/ DYES USED? YES NO
Name CAS # %
Contact Person:
Title
Company Name
E-Mail Address
Date of Completion
Confidential 11/4/2011 Page 35