FOR LABORATORY USE ONLY

(Please stick BV sample sticker here)

BureauReviewed
VeritasDate Received:
By:
Consumer Products
Report No.: Services Division
Due Date:
C&A Testing TEST
Sub Cat:REQUEST FORM 申请表
REGULAR 常规 EXPRESS 加快 EMERGENCY 特急
SERVICE REQUIRED: IF NOT:
(5 working days 工作天) (3 working days 工作天) (Next day 下一工作天)
所需服务: (4 working days for Panyu and Hong Kong only) 如非: (40% surcharge 费用加收 40%) (100% surcharge 费用加收 100%)
REQUEST FOR QUOTATION Please kindly attach with quotation copy if provided.
需要报价 (Quotation no. 报价单号码:      )
如已有报价,请附上副本
APPLICANT INFORMATION 申请人资料 * mark refers to mandate information needed for test start * 号表示必须填写该资料方可
开始测试.
*BUYER 买家 (must be filled 提交申请前必须填写)
*SUPPLIER(SUBMITTER) 供应商: submitting for self-reference
Company Name 公司名称: C&A Sourcing Limited
Company Name 公司名称:       Address 地址:
Address 地址:      
Bangladesh      
      Merchandiser 业务员:      
Contact Person 联系人:       Contact Person 联系人:      
Tel 电话:      Tel 电话:      
Email 电邮:       Email 电邮:      
If THIRD PARTY information is required to show as applicant on test report, please advise: 如报告上需要显示第三方信息，请按如下填写：
Company 公司:       Contact Person 联系人:      
Address 地址:      
Local Hub: Bangladesh (BD) Hong Kong (HK) India (IN) Shanghai (SH) Turkey (TK)
Germany (DUS) Belgium (BRU)
Country of Origin: Bangladesh South China North China India Turkey
来源地 Indonesia Vietnam Cambodia Pakistan Sri Lanka
Egypt Myanmar Brazil Mexico
SAMPLE INFORMATION 样品资料 (Below information will state in report unless specified 以下资料将在报告上列出)
Set (Skirt & Shirt)
*Sample Description 样品描述:
*C&A Order No.单号:     
*Style No. 款号: Season-19 Q3
*Application No.: (Supplier no. 供应商号码:       /Fabric Mill no. 布料厂号码: FAB      ):
Material Code / Fabric Code No.: 物料/布料代码      
*USIM No.      
*Age Group 年龄组别: Children 儿童 (size 尺码:      ) Adult 成人
Color 颜色: Ebony
*Product Groups 产品种类:      
*Manufacturer 生产商:      
*Fiber Composition 成份: 100% Cotton Fabric Weight 布料重量:      
Yarn Count 纱支:       Thread Count 经纬密度:      
*Country of Destination 目的地: Europe China (Issue GB report) Brazil Mexico
*Category 类别: Sample Approval Fabric Approval STRM QCC1 Other tests report
Sample Approval Retest (Initial Report No.:       )
Care Instruction:      
Special Finishing:      
Composite Test Requested 需要合并测试, if not 如非: Request Individual 需要單一测试 Return Sample: Not needed 不需退回样品, if not 如非: Need 需要
*TEST REQUEST 要求测试项目
Chemical test package: Physical test package: Safety tests:
Mandatory requested, if not Mandatory & Recommended Mandatory requested, if not Mandatory & Additional Durability of hook & eye fastener
Fabric or Raw materials submitted, if not Garment / Finished Product Garment submitted, if not Fabric Endurance Wash
Press Fastener Peel Strength
Material: Product Groups: Rusting (Corrosion)
Leather Textile (Natural) Woven casual & formal wear Denim clothing Security of Attachment of
Textile (Synthetic & blend) Metal Coats & Rainwear (woven) Circular knits Components
Coating / Print PU Polyurethane Flat knits Lingerie & Underwear Flammability
Plastic / Rubber Paper / Wood / Straw Nightwear & Bathrobes (woven + knitted) Others: Pull Test
Feather Legwear Swimwear & Beachwear
Others: Imitation Leather & Imitation Fur
Performance wear Leather clothing
Linings (woven + knitted) Accessories
Footwear
Others:      
According to the attached eSD form
Other tests:
Billing Information 付款资料: Billing to Applicant 付款者为申请人, if not to 如非为: Buyer 买家 (C&A Sourcing Limited) Below Company 以下之公司
(Please provide details contact information if billing different from applicant/ supplier/ buyer 如付款人和申请人或供应商或买家不相同，请于以下填上详细联络资料):
Payment Method 付款方 法: HKD 港 币 USD 美金 RMB 人民币 Others 其它:      
Company 公司:       Contact Person 联络人:      
Address 地址:      
Tel No.电话:       Email 电邮:      
Please ensure to include page 2 when submitting the signed TRF 提交已签署之申请表时, 请一并付上申请表页二
Date *Authorized Signature and Company Chop
日期:       授权人签署和公司盖章:

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