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Application form for a joint application for authorisation

Fields marked with an asterisk (*) are mandatory.

Substance(s) applied for

Please note that in accordance with Article 62(3) of REACH Regulation, applications may be made for one or several substances that meet the definition of a group of substances in section 1.5 of Annex XI of REACH. If the application is for several substances, an argumentation for substance grouping must be appended in the Category Rationale field of the IUCLID 5 application file.

* Total number of substances

Use(s) applied for

Please enter, for each use applied for, the use description (in the fields "Use 1", "Use 2" etc.).

The numbering and the descriptions of uses should be identical with the ones in section 3.10 of the IUCLID application for authorisation dossier under the "Use concerned by the request" field.

* Total number of uses

Applicant(s)

* Total number of applicants

* Email of submitting applicant

Please ensure that the email address is correct, as ECHA will communicate important information related to your submission, e.g. the application form in .PDF format, and the submission code or the token.

* Confirm email

I would like to receive the application form file (.PDF format) at the above email address (an email will be automatically sent after clicking on the "Create application form" button). I understand and accept that the email (and its attachments) sent by ECHA will not be encrypted and may therefore be liable to be compromised. ECHA does not, to the extent permitted by law, accept any liability for any external compromise of security and/or confidentiality in relation to transmissions sent by email.
I wish to download myself the application form file (a new screen to allow the download of the application form in PDF format will appear after clicking on the "Create application form" button)

I have read and accepted the following Terms & Conditions