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Cosmetic Product Safety Report - CPSR Request Form

Variants of a Base Formula

Mandatory Information

Product Name:

Responsible Person:

Address

Street Address

Contact email:

Product Specifications

Appearance:

Scent:

pH:

Viscosity:

Specific Gravity:

Packaging Information:

Final container:

Materials:

Airless Packaging:

Directions of use as they appear on the label (if any)

Base Formula:

Common name OR INCI Name

Weight in %

Weight in Grams / ml

Supplier

Have you performed Stability Test?

Does the formula need Preservation Test (PET or Challenge Test)?

Variant 1:

Variant Name:

Additional ingredients:

Common name OR INCI Name

Weight in %

Weight in Grams / ml

Supplier

Variant 2:

Variant Name:

Additional ingredients:

Common name OR INCI Name

Weight in %

Weight in Grams / ml

Supplier

Variant 3:

Variant Name:

Additional ingredients:

Common name OR INCI Name

Weight in %

Weight in Grams / ml

Supplier

Variant 4:

Variant Name:

Additional ingredients:

Common name OR INCI Name

Weight in %

Weight in Grams / ml

Supplier

Variant 5:

Variant Name:

Additional ingredients:

Common name OR INCI Name

Weight in %

Weight in Grams / ml

Supplier

Name:

Signature

Submit Your CPSR Request Form Today

Cosmetic Product Safety Report - CPSR Request Form

Mandatory Information

Product Specifications

Packaging Information:

Variant 1:

Variant 2:

Variant 3:

Variant 4:

Variant 5:

Believe in Your Vision

Daniel Hughes

Ralph Edwards

Cameron William

Believe in Your Vision

Daniel Hughes

Ralph Edwards

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