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Reading, RG30 1EA, UK
T: 0118 939 8700
F: 0118 939 8701
W: ul.com/consumer-products
Email: qaenquiries@ul.com
For Office Use Only
Sample Submission
Date sample received:
Laboratory number:
Customer Details
Company name:
Address:
Invoice address (if different):
Tel no:
Fax no:
Email address:
Contact name for certificate:
Product Details
Product name for certificate:
Order number:
Product reference for certificate:
Results required by:
Tests required:
NOTE: Testing will be carried out to the current published version of the standard at the date of testing, unless stated
otherwise. When textile testing is required, whenever possible this will be subcontracted to a UL Consumer Products
laboratory. Where necessary, work subcontracted will be carried out by UKAS or UL Consumer Products approved
laboratories.
Any other information:
Do you require emailed or faxed
confirmation of receipt of samples?
(please tick)
Emailed (please ensure email address is shown above)
Faxed (please ensure fax no is shown above)
Not required
Signature (full signature required)
Date:
All samples tested by UL Consumer Products or subcontracted to UKAS/UL Consumer Products approved companies are accepted subject to agreement to
our terms and conditions.
UL Consumer Products Sample Submission Jan 2013