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REACH Compliance Declaration Template

JCB requires its suppliers to provide information on whether any components supplied contain substances of very high concern (SVHC) under the REACH regulation. Wheels India Limited was asked to complete a declaration form indicating if any of the parts it supplies to JCB contain SVHC and to provide details of any such parts. The form collects information on the supplier's REACH obligations, presence of SVHC in parts, and plans for phasing out SVHC if applicable.

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Durai Naidu
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1K views3 pages

REACH Compliance Declaration Template

JCB requires its suppliers to provide information on whether any components supplied contain substances of very high concern (SVHC) under the REACH regulation. Wheels India Limited was asked to complete a declaration form indicating if any of the parts it supplies to JCB contain SVHC and to provide details of any such parts. The form collects information on the supplier's REACH obligations, presence of SVHC in parts, and plans for phasing out SVHC if applicable.

Uploaded by

Durai Naidu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
  • Front Sheet
  • REACH Declarations
  • List of Parts Containing SVHC

REACH Compliance Declaration

In accordance with obligations placed on JCB pursuant to the Regulation (EC) No 1907/2006 of the European
Parliament and of the council on Registration, Evaluations, Authorisation and Restriction of Chemicals
(REACH) JCB is required to seek information from its supplier base on whether controlled substances are
used in the components supplied to JCB.

List of Contents

Sheet 1 Front Sheet


Sheet 2 REACH declaration
Sheet 3 List of parts containing Substances of Very High Concern (SVHC)

*Please populate the boxes below

Company Name Wheels India Limited,Sriperumpudur

Declaration Completed By (Employee Name) Kannan

Employee Job Title Production Manager -Paint shop

Date Completed 07.08.2018

SVHC Present Yes


Version 1 Number of parts affected 0 July 2017
*Please use the drop down options provided to answer questions

Question Answer

We (the supplier) confirm that we understand and


1 fulfil our obligations under REACH (Regulation (EC) Yes
No 1907/2006):

2 Do you supply any products to JCB which contain


SVHC's (Substance of Very High Concern) which are
listed within the European Chemicals Agency
Candidate List or Authorisation List?
Yes
Candidate List
Authorisation List
Restircted List
*Please complete parts list sheet

Under Article 33(1) REACH, you are required to keep


yourself updated about the status of the Candidate List
and to automatically inform your industrial customers We accept responsibility to
when SVHC's are present in products that you supply. keep JCB informed about
3
This incudes all information concerning any SVHC's in the products we
associated Authorisations or Restrictions for usage. supply
Please confirm that you accept your legal
responsibility to keep JCB informed.

Is your company located outside the European Union


4 and does your company export to the European No
Union?

Do you have an “Only Representative” appointed


4a No
within the European Union?

First Name
4b Please provide details for your "Only Representative"
Last Name
Email
Tel No.
*Please populate the list below with all the parts you supply to JCB that contain Substances of Very High Concern (SVHC)

Part Information SVHC Information


Chemical Authorisation Phase Out Plan
JCB Part Name of Abstract Weight by Registration no Applied for Authorisation Authorisation Estimated date Do you plan to Date of phase
Number Part Description SVHC Status substance Service Number weight % Product source of substance authorisation granted number of authorisation phase out? out How do you plan to phase out?
No No

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