Customer Declaration Report, Ref.nr.

CD-PT MASSYNDO
GEMILANG-20190815.24411
Below product list of PT MASSYNDO GEMILANG verified on the substances as
requested.

CORIACIDE® BROWN 3J Dermapel Red PBR Melioderm Blue RF

CORIACIDE® BROWN R INODERME® NAVY BNM Melioderm Havana G
EXTRA

Disclaimer: This subjected statement will not be automatically updated. Please request us for the updated version whenever
required. The information submitted in this letter is based upon our current knowledge, information received from our suppliers
and in some cases based upon laboratory tests. In view of many factors, circumstances and aspects that may affect processing
and application, these given data do not release processors from their responsibility of carrying out own tests and experiments;
neither do the data imply any legally binding assurance of certain properties or of suitability for a specific purpose nor of the
legal status of the listed product names. It is the responsibility of those to whom we supply our products to ensure that any
proprietary rights and existing laws and legislation are observed.

Formaldehyde content refers to the free formaldehyde content.

1
Verified substances as such or defined in the Customer Restricted Substances
Lists (RSL).
1. AZO DYES WHICH CAN FORM RESTRICTED SUBSTANCES

Disclaimer: This subjected statement will not be automatically updated. Please request us for the updated version whenever
required. The information submitted in this letter is based upon our current knowledge, information received from our suppliers
and in some cases based upon laboratory tests. In view of many factors, circumstances and aspects that may affect processing
and application, these given data do not release processors from their responsibility of carrying out own tests and experiments;
neither do the data imply any legally binding assurance of certain properties or of suitability for a specific purpose nor of the
legal status of the listed product names. It is the responsibility of those to whom we supply our products to ensure that any
proprietary rights and existing laws and legislation are observed.

Formaldehyde content refers to the free formaldehyde content.

2
The following tables refer to the products showing the substances which match with the listed
substances or Restricted Substances List as given in the previous page. Chosen threshold is >=
0.0001%. Substances are not shown here in case no match is found with the substances to be verified
on or the concentration of the substances to be verified on is < 0,0001%.
Concentrations of substances are reported in w/w%. Heavy metals are reported in ppm.

AZO DYES WHICH CAN FORM RESTRICTED SUBSTANCES

No Substances were found.

Disclaimer: This subjected statement will not be automatically updated. Please request us for the updated version whenever
required. The information submitted in this letter is based upon our current knowledge, information received from our suppliers
and in some cases based upon laboratory tests. In view of many factors, circumstances and aspects that may affect processing
and application, these given data do not release processors from their responsibility of carrying out own tests and experiments;
neither do the data imply any legally binding assurance of certain properties or of suitability for a specific purpose nor of the
legal status of the listed product names. It is the responsibility of those to whom we supply our products to ensure that any
proprietary rights and existing laws and legislation are observed.

Formaldehyde content refers to the free formaldehyde content.