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TOYS R US - INTERNATIONAL(1)

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					                                               DISNEY TEST REQUEST FORM

 Website: www.cps.bureauveritas.com
   This form must be completed (including PRR#) in order to avoid submissions being placed on hold.
 PRR#:
 No. Of Testing Samples Submitted:
 Vendor / Mill Company:
 Vendor / Mill Company Address:
 Vendor / Mill Contact Name / Phone:
 Manufacturer:
 Do you need a            No
 CPSIA                    Yes     Place of Manufacture:
 GCC/CPC?
 (US market only)                 Date of Manufacture:
 Invoice Billing Information:
 Report Copy to:
 Sample Information: (Check the appropriate box if applicable)
  Label is supplied by Avery Dennison/Paxar/Advance/Braitrim/Britannia/Clotex approved lab supplier
 approved lab submitted
  Plastic Bag supplier is for shipping only. It is not part of the product packaging given to customers
 RETEST INFORMATION:
 Is this a          No
 retest?            Yes   Previous Lab Report No. & Disney PRR #:
                          Describe
                          Corrective
                          Action taken:

 Service Required:               Regular (5 Days)       Next Two Business Day*      Next Business Day*
                                             *Rush services available at an additional surcharge
 FOR SOFTLINE / TEXTILE TESTING: (Check all that apply)                    Development
   Fabric (Previous test report# _     _)                                  Trim (Previous test report# _     )
   Pre – Prod (Previous test report# _    )                                Production (Previous test report# _     )

 End use:                                                               Submitted Size

 Submitted Color(s)                                                     Ordered Color(s)
 Fiber Content
 Care Instruction
    Proposed
    Labeled

 Sample Return:                Self-collect samples within 5 days after test result               Lab to return failed samples at
                               Lab to return samples after test (at submitter’s expense)       Labs convenience

 We request testing in accordance with the established Disney Product Integrity Testing Program Guidelines



 Date                                         Authorized Signature

This Section For Hardline laboratories Use Only:                                              R / C / M / T / E / L
 Date Rec'd                                         Rec'd By                               Due Date
 Total Qty Rec'd                                                                           Executive
                 (USA:             )      / (CAN:   )     / (EUR:      )   / (AUS:    ) / (JPN:      )
 Labeled Age Grade                                                                Recommended Age Grade
 Distribution  USA                 Canada          Europe              Other (please specify:)
 Sample No.
 This section For Softline laboratories Use Only:
 Distribution:       USA       Canada     Europe        Australia     Japan    Other (please specify):
 Lab No:                                                    Date In:                               Date Due:


 6/6/2012 tp
6/6/2012 tp

				
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