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Bedding Registration

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					                                              B UREAU OF O CCUPATIONAL AND INDUSTRIAL S AFETY
                                                              H ARRISBURG, PA 1 7 1 2 0


                                              717-787-6848      Fax: 717-787-6925         www.dli.state.pa.us

                                  APPLICATION FOR REGISTRATION
                                    BEDDING AND UPHOLSTERY
I, or we, hereby make application for registration as:
______ MANUFACTURER
                            ANNUAL FEE — $50.00
______ IMPORTER*                                  plus a Yearly Report must be submitted paying a fee of 2½¢ for each
                                                  article shipped into or sold in the Commonwealth of Pennsylvania.
______ SUPPLIER (Supplies bulk filling material to the trade)

______ VENDOR (Person who brings goods into the state for sale. Example: sales from trucks, etc.)

           NATIONAL UNIFORM REGISTRY NUMBER____________________________________________________
           Manufacturer, Importer, etc., must attach two current Law labels if using a registry number issued by another
           state; also copy of certificate issued by that state.
           List Products ________________________________________________________________________________
           *IMPORTERS NOTE:
           NAME OF FOREIGN MANUFACTURER ________________________________________________________
           COMPLETE ADDRESS _______________________________________________________________________
                                                                                                                (see Section A
           CITY ________________________________________             COUNTRY _________________________________
                                                                                                  on Reverse Side)

           FAX (_____) ___________________           E-MAIL __________________________________________________

______ RENOVATOR
                                                         REGISTRATION & PERMIT FEE — $60.00
______ SECONDHAND                                        (see Section B on Reverse Side)
______ RENTAL
______ AUCTIONEER                 (AUCTIONEERS ONLY) - Dept. of State Auctioneer’s Number AU___________ L
                                      (Name shown below must be same as on Auctioneer’s License)

NAME OF FIRM _____________________________________________________________________________________
ADDRESS __________________________________________________________________________________________
CITY _________________________________________________               STATE ______         ZIP CODE _________________
CONTACT PERSON _________________________________________________________________________________
DATE __________________           SIGNATURE _____________________________________________________________
PHONE (_____) ___________________            PRINT NAME & TITLE ___________________________________________
FAX (_____) ___________________           FEDERAL ID NUMBER ________ - ___________________________________
E-MAIL _____________________________________________________________________________________________

NOTE:      Please make all checks payable to “Dept. of Labor & Industry” (US Funds Only)
           Mail to: Dept. of Labor & Industry, Bedding & Upholstery Section, Room 1619,
                  7th & Forster Streets, Harrisburg, PA USA 17120-0019
LIBU-32 REV 5-01
Section A

The Department has permitted importers to hold Bedding & Upholstery registration on behalf of
foreign manufacturers. However, the Department does not permit an importer to hold a single
registration while importing from multiple foreign manufacturers under the single registration. Penn-
sylvania requires each manufacturer to be separately registered with the Department.

The following options for registration are available to foreign manufacturers:

        1. The manufacturer may register directly with the Department at the foreign manu-
           facturer’s location. This is identical to the requirement for domestic manufacturers, or

        2. An importer may hold a Bedding & Upholstery registration on behalf of each foreign
           manufacturer represented. Please note that the importer is required to hold a separate
           registration for each foreign manufacturer represented. The Department does not per-
           mit “pooling” of registrations.

When an importer holds the registration on behalf of the foreign manufacturer, the Registration
Certificate will show the name of both the importer and the foreign manufacturer.



Section B

Two liquid sprays have been approved by the Industrial Board. They are “MICROBAN X-580 with
Tracer” and “STERI-FAB”. If you intend to employ another method of disinfecting or sterilization
(Section 47.27 of the Regulations), you must contact this office for further information.

				
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