Toxic Substances Control Act (TSCA) Compliance Declaration Form
Submit this form to declare compliance with TSCA requirements for your chemical or product submission.
Company Name
*
Contact Person Full Name
*
First Name
Last Name
Contact Email Address
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Product or Chemical Name
*
CAS Number
*
Intended Use of Product/Chemical
*
Is the product/chemical listed on the TSCA Inventory?
*
Yes
No
Not Sure
Has the product/chemical been manufactured or imported in compliance with TSCA regulations?
*
Yes
No
Submit Declaration
Should be Empty: