Toy Test Request Form by PUHLP0J7


                                             Toys and Giftware Test Request Form
Name of Applicant (or Report Title):                                                                                     Intertek Taiwan use only
                                                                                                                         Job No.:
Person to Contact:                                E-mail:
Tel:                Ext:                  Fax:
Invoice to:  same as above                                                                                               收件確認(樣品狀態符合測試要求)
                                                                                                                          是    否
Address:                                                                                                                 審查(由 Intertek 客服人員簽章):
Person to Contact:                              E-mail:
Tel:                      Ext:               Fax:
Note: The applicant agrees and promises to be the payer, if the relevant invoices are unable to be settled by the appointed payer.
Sample Description                      Age grading for testing      Item/Style No.                 Number of Sample Submitted

Country of Original :                                                  Goods Exported to :
Special Requirements:                                                  Buyer’s Name:
                                                                       Manufacture’s Name:
Return Sample:        Yes (Delivery fee should be paid by applicant / requester)    No
 US CPSIA (H.R. 4040)                                                               European Toy Directive 2009/48/EC
    Abuse test for accessibility (as received)                                          EN71-1 Physical & Mechanical Hazards
     Lead /coating:       CPSC-CH-E1003(default)               HD-XRF                   EN71-2 Flammability
     Lead /substrate                                                                    EN71-3 Migration of Certain Elements
     Small part (for age under 3)                                                       EN71-6 Graphical Symbol for Age Warning Labeling
     Sharp point      Sharp edge (for age under 8)                                     EN62115 Electric toy safety
     Lead in children’s metal jewelry                                               European Standard
     Phthalate ( Test by products            Material Test)                             EN 60825-1 Class 1 LED Requirement
    Toy Safety Standard ASTM F963 (Please select below)                                 RoHS – Pb/Cd/Hg/Cr6+/PBBs/PBDEs
 US ASTM F963                                                                           Battery Directive (2002/66/EC) - Pb/Cd/Hg
     Physical & Mechanical Hazards                                                      Phthalates (2005/84/EC)
     Flammability ( Solid /    Fabric)                                                  Cadmium content (91/338/EEC)
     Toxic element analysis                                                             Azo dye (2002/61/EC)
     Stuffing Cleanliness                                                              REACH – SVHC Screen Test (7 chemicals)
     Microbial Limits (USP 61)                                                      Australia / New Zealand
     LHAMA (ASTM D4236)                                                                 AS/NZS ISO 8124-1 Physical & Mechanical
 US CPSC Regulation (CFR Title 16)                                                      AS/NZS ISO 8124-2 Flammability
    Physical & Mechanical Hazards                                                      AS/NZS ISO 8124-3 Migration of certain elements
    Flammability ( Solid /      Fabric)                                             Other Tests
    Lead content                                                                        Color fastness to saliva & perspiration (LFGB)
    Lead in crayons and art supplies                                                    BS 7272-1 safety caps
 Canada Hazardous Products (Toys) Regulations                                           BS 7272-2 end Closures
    Physical & Mechanical Hazards                                                       Pencils & graphic instruments regulations (SI 2406)
    Flammability ( Solid /    Fabric)                                                   Pencil hardness (ASTM D3363)
    Toxic element analysis
    Shuttle    24 Hours           (+100% Surcharge)                                 Remark: The promised service of working days is only oral
    Express    2 Working Days (+50% Surcharge)                                      results not including the time of typing, pick- up & delivery or
    Regular 5 Working Days                                                          mailing.
 Remark: Shuttle / Express service is not applicable for all items
 We request for the above tests and agree that all testing will be carried out subject to INTERTEK TESTING SERVICES TAIWAN LTD's scale of charges as set forth
 in their latest price list of which we have seen a copy and upon and subject to the terms and conditions set out hereon and overleaf.
 We also understand the data variation risk of composite test stated above and agree to take up the full legal responsibility.

 Authorized signature or company chop:                                                            Date:

                                                       Intertek Testing Services Taiwan Ltd.
                                                 12F, No. 423, Ruiguang Rd., Neihu District, Taipei City 11492, Taiwan
                                            Tel: (+886-2) 6602-2888 Fax: (+886-2) 6602-2410 Web:
                                                           Professional  Innovative           Reliable
                                                                                                                                      FC04-CS007e Rev 6.1
                                                                                                                                               Page 1 of 2
     Intertek Testing Services Taiwan Ltd.
12F, No. 423, Ruiguang Rd., Neihu District, Taipei City 11492, Taiwan

                                                                        FC04-CS007e Rev 6.1
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