Substances of Very High Concern (SVHC) Declaration Form
Please complete this form to declare the presence or absence of SVHCs in your products, parts, or substances.
Product, Part, or Substance Name
*
Product or Part Number / Identifier
*
SVHC Declaration Status
*
Contains SVHC(s)
Does NOT contain SVHC(s)
SVHC Substance Name(s)
SVHC Concentration (% w/w)
CAS or EC Number(s)
Affected Material or Part
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Supplier Contact Name
*
First Name
Last Name
Supplier Contact Email
*
example@example.com
Declaration Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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