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General Carton Requirements
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Invoice and Packing List
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Interim Footwear Information Declaration (IFI)
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Toxic Substance Control Act (TSCA)
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General Certificate of Conformity (GCC)
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Toxic Substance Control Act (TSCA)

Last modified on Apr 2, 2012, 4:36:32 PM CDT

TSCA - Document link

TOXIC SUBSTANCE CONTROL ACT (TSCA)

CERTIFICATION

Date _____________

 

Manufacturer/Shipper ________________________________________________

Address __________________________________________________________

__________________________________________________________

__________________________________________________________

Purchase Order No. ________________________________

Invoice No. ______________________________________

Positive Certification:

______  I certify that all chemical substances in this shipment comply with all applicable rules or orders under TSCA and that I am not offering a chemical substance for entry in violation of TSCA or any applicable rule or order thereunder."

Chemical ingredients contained in controlled substance: (Attach separate sheet if necessary)

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Authorized Name: (type or print)  ___________________________________________

Authorized Signature:  ___________________________________________________

Title:  ________________________________________________________________

If the certifier is unsure if their chemical substance is subject to TSCA compliance, contact the Environmental Protection Agency, TSCA assistance office Washington D.C.

Telephone: 202-554-1404                                    Fax: 202-554-5603