Declaration 1
Vendor’s Declaration on Classification, labelling and Packaging (CLP) Regulation
1272/2008
CLP Declaration – For suppliers located in Europe
Wal-Mart Vendor I.D. Number: ________________
Wal-Mart Factory I.D. Number: ________________
WIN Number: ________________
Date:
Company Name:
Address:
Product Name:
Model / Style No.:
Having read and understood the ASDA CLP Policy, our company declares that for the finished
product specified above, we have been submitted the following to your data management system:
Please tick the correct box below:

Our EU Representatives details on official headed paper who completed CLP notifications

You submitted a REACH / CLP compliant safety data sheet for the product

The details of the company that originally notified the substance on official headed paper where
we are using a reimport exemption for chemicals

Having read and understood the ASDA CLP Policy, our company hereby declares that the
chemicals in the product specified above have not been notified and does not comply with the
new EU CLP regulation (1272/2008) and we have not submitted the relevant information
Name and Signature of Authorized Company Representative
Company Chop
Position
E-mail
Issue No.
Issued By:
Authorised By:
Date of Issue
Page No.
Version 2
Dave Lockley
Chemicals Technical Manager
Technical Governance
Liz Cremer-Evans
Head of Technical Governance – Non-Food
Jan 2014
Page 1 of 2
Declaration 2
Vendor’s Declaration on Classification, labelling and Packaging (CLP) Regulation
1272/2008
CLP Declaration - For suppliers located outside of Europe
Wal-Mart Vendor I.D. Number: ________________
Wal-Mart Factory I.D. Number: ________________
WIN Number: ________________
Date:
Company Name:
Address:
Product Name:
Model / Style No.:
Having read and understood the ASDA CLP Policy, our company declares that for the finished
product specified above, we have been submitted the following to your data management system:
Please tick the correct box below:

Our EU Representatives details on official headed paper who completed CLP notifications

You submitted a REACH / CLP compliant safety data sheet for the product

The details of the company that originally notified the substance on official headed paper where
we are using a reimport exemption for chemicals

Having read and understood the ASDA CLP Policy, our company hereby declares that the
chemicals in the product specified above have not been notified and does not comply with the
new EU CLP regulation (1272/2008) and we have not submitted the relevant information
Name and Signature of Authorized Company Representative
Company Chop
Position
E-mail
Issue No.
Issued By:
Authorised By:
Date of Issue
Page No.
Version 2
Dave Lockley
Chemicals Technical Manager
Technical Governance
Liz Cremer-Evans
Head of Technical Governance – Non-Food
Jan 2014
Page 2 of 2