Name of Supplier

Product Name: Date:

Name of supplier Address of supplier Issue date

Confidential Fragrance Product Information Form

Please complete the following: General Fragrance Information, Regulatory Status, Hazard Identification, Transportation, Fragrance Specific Information, Supplier Guarantee and TSE/BSE/SARS certification. Also, Fragrance Information checklist.

This product is acceptable for fragrance use: Yes No If no – do not continue sign and return to sender.

1. General Information Supplier Product code number: ______Supplier Product name: ______Common name: Chemical name: Type of product: select one (natural, etc.) INCI name: CAS number: FEMA GRAS number: FDA GRAS citation: Molecular formula: Molecular weight: Generic chemical class: select one select one Purity %

Country of Origin - NAFTA eligible: Yes No (If yes, attach NAFTA Form 434) Harmonized Tariff Code: Country of production:

FDA Bioterrorism The facility where this product is manufactured is registered with FDA under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (the Bioterrorism Act): Yes No

Source Information This product or any of its ingredients are derived from: Animal Yes No If yes, see attached TSE/BSE/SARS certification Plant Yes No If yes, see GMO Statement (below) Synthetic Yes No Petroleum Yes No Mineral Yes No

GMO Statement This product or any of its ingredients are derived from genetically modified organism (GMO) material: Yes No If yes, the specific source of the GMO is: The country of origin of the GMO material is: This product or any of its ingredients contain genetically modified material: Yes No

Fragrance Product Information Form Version 2.5 - Page 1 of 18 07/11/2011 Product Name: Date:

Organic Status This product is suitable for use in a product bearing a claim of “Organic”, or “made with organic” as defined by 7 CRF Part 205 under the U.S. National Organic Program: Yes No

Organic certified (100% organic) Yes No Organic (95% organic) Yes No Made with organic (>70% organic) Yes No

Impurities: Impurities that are to be expected in the final product (e.g. residual solvents, residual monomers, reagents intermediate synthesis phases, heavy metals, etc) Impurities/residues/heavy metals Percentage or ppm select one select one select one

2. Regulatory status of ingredient(s) USA Ingredient(s) registered in compliance with section 5, TSCA Yes No Contains any ingredient(s) subject to rules 4, 5, 6, 7 and 12b under TSCA Yes No If yes: Chemical name CAS number Percentage Rule/order number

Contains any ingredient(s) listed under EPCRA Extremely Hazardous Substances (SARA 302) Yes No If yes: Chemical name CAS number Percentage

SARA 311/312 Hazard Categories: Acute health hazard select one Chronic health hazard select one Fire select one Sudden Release of Pressure select one Reactivity select one

Contains any ingredient(s) listed under SARA 313 Yes No If yes: Chemical name CAS number Percentage

Contains any ingredient(s) listed under EPA Hazardous Air Pollutants (HAPs) Yes No If yes:

Chemical name CAS number Percentage

Contains any ingredient(s) listed under EPA CERCLA Yes No If yes: Chemical name CAS number Percentage

Contains ingredient(s) that are forbidden for use in cosmetics under US FDA Yes No If yes: Chemical name CAS number Percentage

Contains US DEA List I or II chemical(s) Yes No If yes: Chemical name CAS number Percentage DEA code number

Contains material(s) or any component thereof on California Proposition 65 list Yes No If yes: Chemical name CAS number Percentage

Contains chemical(s) identified in California SB 484 (California Safe Cosmetics Act of 2005) as causing cancer or reproductive toxicity Yes No If yes: Chemical name CAS number Percentage

Contains any ingredient(s) listed under State Right-to-Know lists (MA, NJ, PA) Yes No If yes: Chemical name CAS number Percentage State RTK list(s)

Europe Ingredient(s) listed on: EINECS (number) Yes No

ELINCS (number) Yes No Limited <1,000kg/yr or Full >1,000 kg/yr notification REACH Contains chemical(s) identified in Substance of Very High Concern (SVHC) Yes No If yes: Chemical name CAS number Percentage

Cosmetic Directive number 76/768/EEC Substance(s) which are mentioned in Annex II to IV of the EU Cosmetic Directive (other than preservatives, dyes, UV filters, fragrance allergens, which are listed in the fragrance section): Chemical name Annex Percentage

Volatile Organic Chemicals according to Swiss VOC-legislation (dated 12.11.1197 / 9.2.1999) Chemical name CAS number Percentage

Canada Ingredient(s) listed on: DSL Yes No NDSL Yes No Contains substances notified under CEPA Yes No For bases or compounds: percentage on DSL: percentage on NDSL:

Contains chemical(s) identified in Canadian Cosmetic Hot List Yes No If yes: Chemical name CAS number Percentage

Japan Ingredient(s) listed on Existing and New Chemical Substances (ENCS) Yes No ENCS number: Registered low volume <1 ton/year Yes No Registered low volume <10 ton/year Yes No

Ingredient(s) listed on Industrial Safety & Health Law (ISHL) Inventory Yes No ISHL number:

Contains ingredient(s) listed on the Poisonous and Deleterious Substances Control Law: Yes No If yes: Chemical name CAS number Percentage

Cyanide compounds (i.e. nitriles)

Contains ingredient(s) on the Pollutant Release and Transfer Registry Yes No If yes: Chemical name CAS number Percentage

Australia Ingredient(s) listed on AICS or notified under NICNAS Yes No Low volume notification Yes No

Philippines Ingredient(s) listed or notified on PICCS Yes No Low volume notification Yes No

China Ingredient(s) listed on IECSC Yes No

Republic of South Korea Ingredient(s) listed on ECL Yes No ECL number

New Zealand Ingredient(s) listed on NZIoC Yes No

International Convention on International Trade in Endangered Species (CITES) Contains an ingredient which is, or is an extractive or derivative of, a CITES listed species on Appendix I, II or III Yes No If yes: Species/chemical name CAS number Appendix No. Percentage

3. Hazard identification North America This product is hazardous according to OSHA Hazard Communication Standard: Yes No Hazard classifications (if not present on MSDS): Hazardous Material Information System (HMIS) rating: Health 0* Flammability 0 Reactivity 0 National Fire Protection Association (NFPA) 704 rating: Health 0 Flammability 0 Reactivity 0 Special Carcinogen as defined by NTP, IARC, OSHA or ACGIH: Yes No If yes, present on: NTP select one IARC select one OSHA ACGIH A1 Threshold Limit Value (TLV): Yes No If yes, TLV(s): select one select one select one select one select one select one

This product is hazardous according to Canadian WHMIS: Yes No Canadian WHMIS classification:

European This product is classified as hazardous under EEC Directives 67/548 (substances) or 99/45 (preparations) and its adaptations Yes No Classification of product is (if not present on EU SDS): - Symbol (s) of danger: - Special risk phrases: R - Safety phrases: S CMR as defined in Annex I 67/548/EC and its adaptations (if not present on EU SDS) Dangerous Ingredients Percentage Hazard symbols Risk - phrases

Other dangerous substances classification, according to 67/548/EC and its adaptations (if not present on EU SDS) Dangerous Ingredients Percentage Hazard symbols Risk - phrases

Hydrocarbon total

Total fractional value for each “risk” according to 99/45/EC and its adaptations (if not present on EU SDS): R20 R21 R22 R23 R24 R25 R26 R27 R28 R34 R35 R36 R37 R38 R39/23 R39/24 R39/25 R39/26 R39/27 R39/28 R40 R41 R42 R43 R45 R46 R48/20 R48/21 R48/22 R48/23 R48/24 R48/25 R49 R50 R50/53 R51/53 R52/53 R53 R60 R61 R62 R63 R65 R67 R68 R68/20 R68/21

German Regulation

WGK (Wassergefahrdungsklasse / German legislation) determination Yes No If yes, class select one

Handling and Storage Located on select one: Yes No If NO: Recommended storage conditions: Product shelf-life under these conditions: Recommended packaging:

Technical Information Vapor pressure (mmHg @20ºC), if not on MSDS or specifications: Method: For mixtures, provide the equivalent molecular weight estimate:

4. Transportation This product is hazardous under transportation regulations: Yes No If YES (if not present on MSDS): UN Number: Shipping name: Packing group: Hazard class: Emergency Guide Book Number:

This product is classified as a Marine pollutant: Yes No If yes, identify P or PP Substance CAS number Percentage P or PP select one select one select one select one

5. Fragrance Specific Information

Natural Designation: Natural Product means all the odoriferous ingredients meet a definition of “aromatic natural raw materials” in ISO Standard 9235 or are substances already present in these natural materials and are isolated from them by purely physical means. Percentage Natural If 100% pure and natural, provide type: select one For plant origin, provide botanical species: Nature Identical Synthetic All processes used in production designated are accepted physical means: Yes No

Safety and toxicological information for Fragrances This product has been tested: By RIFM: Yes No If yes, the literature reference is: By our Company: Yes No If yes, information is provided in the following table By other(s): Yes No If yes, specific details are: Date last tested

Test type Method/species Concentration/results Reference Oral LD50

Dermal LD50 Inhalation LC50 Skin irritation Eye irritation Skin sensitization Phototoxicity Photo sensitization Mutagencity Biodegradability Toxicity to aquatic organisms Other

IFRA Certificate This product complies with the current IFRA Standards (46th Amendment): Yes No If yes, attached IFRA Certificate If no, please explain:

Ingredients with limitations by IFRA: None present Ingredient name CAS % % % % number(s) directly indirect indirect Total added from from naturals impurities 5-Acetyl-1,1,2,3,3,6- 15323-35-0 hexamethyl indan (AHMI, Phantolid) Allyl phenoxyacetate (Acetate 7493-74-5 PA) alpha-Amyl cinnamic alcohol 101-85-9 See allergens See allergens See allergens See allergens alpha-Amyl cinnamic aldehyde 122-40-7 See allergens See allergens See allergens See allergens Angelica root oil 8015-64-3 84775-41-7 Anisyl alcohol 1331-81-3 See allergens See allergens See allergens See allergens 105-13-5 cis-and trans-Asarone ((E)- 2883-98-9 and(Z)-2,4,5- 5273-86-9 Trimethoxypropen-1-yl benzene) Benzaldehyde 100-52-7 Benzyl alcohol 100-51-6 See allergens See allergens See allergens See allergens Benzyl benzoate 120-51-4 See allergens See allergens See allergens See allergens Benzyl cinnamate 103-41-3 See allergens See allergens See allergens See allergens Benzyl cyanide 140-29-4 Prohibited Benzyl salicylate 118-58-1 See allergens See allergens See allergens See allergens Bergamot oil expressed 8007-75-8 89957-91-5 Bitter orange peel oil expressed 68916-04-1 72968-50-4 p-tert-Butyl-alpha- 80-54-6 See allergens See allergens See allergens See allergens methylhydrocinnamic aldehyde (BMHCA) alpha-Butylcinnamaldehyde 7492-44-6 p-tert-Butyl 18127-01-0

Ingredient name CAS % % % % number(s) directly indirect indirect Total added from from naturals impurities dihydrocinnamaldehyde (Bourgeonal) Carvone 99-49-0 2244-16-8 6485-40-1 Cedarmoss 68648-41-9 90028-67-4 68917-40-8 Cinnamic alcohol 104-54-1 See allergens See allergens See allergens See allergens Cinnamic aldehyde 104-55-2 See allergens See allergens See allergens See allergens Cinnamic aldehyde dimethyl 4364-06-1 acetal Cinnamyl nitrile 1885-38-7 4360-47-8 Citral (Lemarome) 5392-40-5 See allergens See allergens See allergens See allergens Citronellol 106-22-9 141-25-3 1117-61-9 26489-01-0 6812-78-8 68916-43-8 7540-51-4 Coumarin 91-64-5 See allergens See allergens See allergens See allergens Creosol 93-51-6 Cumin oil 8014-13-9 84775-51-9 Dibenzyl ether 103-50-4 Dihydro safrole 94-58-6 Dimethylcyclohex-3-ene-1- 27939-60-2 carbaldehyde (mixed isomers) 35145-02-9 36635-35-5 67801-65-4 68039-48-5 68039-49-6 68737-61-1 67801-65-4 68084-52-6 1-(5,5-Dimethyl-1-cyclohexen- 56973-85-4 1-yl)pent-4-en-1-one (Dynascone/Galbascone) 2,2-Dimethyl-3-(3- 103694-68-4 methylphenyl) propanol (Majantol) 2-Ethoxy-4-methylphenol 2563-07-7 Estragole (methyl chavicol) 140-67-0 Eugenol 97-53-0 See allergens See allergens See allergens See allergens Farnesol 4602-84-0 See allergens See allergens See allergens See allergens Geraniol 106-24-1 See allergens See allergens See allergens See allergens Grapefruit oil expressed 8016-20-4 90045-43-5

Ingredient name CAS % % % % number(s) directly indirect indirect Total added from from naturals impurities 2-Heptylidene cyclopentan-1- 39189-74-7 one trans-2-Hexenal 6728-26-3 alpha-Hexyl cinnamic aldehyde 101-86-0 See allergens See allergens See allergens See allergens alpha-Hexylidene 17373-89-6 cyclopentanone Hexyl salicylate 6259-76-3 Hydroxycitronellal 107-75-5 See allergens See allergens See allergens See allergens 3 and 4-(4-Hydroxy-4- 31906-04-4 See allergens See allergens See allergens See allergens methylpentyl)-3-cyclohexene-1- 51414-25-6 carboxaldehyde (HMPCC) 130066-44-3 Jasmine absolute 8022-96-6 (Grandiflorum) 8024-43-9 90045-94-6 84776-64-7 Jasmine absolute (Sambac) 91770-14-8 Isobutyl N-methylanthranilate 65505-24-0 p-Isobutyl-alpha-methyl 6658-48-6 hydrocinnamaldehyde (Rhodial/Silvial) Isocyclocitral 1335-66-6 1423-46-7 67634-07-5 Isocyclogeraniol 68527-77-5 Isoeugenol 97-54-1 See allergens See allergens See allergens See allergens Isosafrole 120-58-1 Lemon oil cold pressed 8008-56-8 84929-31-7 Lime oil expressed 8008-26-2 90063-52-8 Melissa oil (genuine Melissa 8014-71-9 officinalis L.) 84082-61-1 para-Menthadiene-1,8-dien-7-al 2111-75-3 (Perilla aldehyde) Menthadienyl-7-methyl formate 68683-20-5 4-Methoxy-αlpha-methyl- 5462-06-6 benzenepropanal (Canthoxal/Fennaldehyde/ Foliaver) o-Methoxycinnamaldehyde 1504-74-1 7-Methoxycoumarin 531-59-9 Prohibited Methoxy dicylopentadiene 86803-90-9 carboxaldehyde (Scentenal) 2-Methoxy-4-methylphenol 93-51-6 alpha-Methyl-1,3-benzodioxole- 1205-17-0 5-propionaldehyde (MMDHCA) alpha-Methyl cinnamic 101-39-3 aldehyde Methyl eugenol 93-15-2

Ingredient name CAS % % % % number(s) directly indirect indirect Total added from from naturals impurities 6-Methyl-3,5-heptadiene-2-one 1604-28-0 (Methyl heptadienone) Methyl heptine carbonate 111-12-6 See allergens See allergens See allergens See allergens Methyl ionone, total mixed 1335-46-2 isomers 127-42-4 127-43-5 127-51-5 7779-30-8 Methyl N-methyl anthranilate 85-91-6 (Dimethyl Anthranilate) Methyl beta-naphthyl ketone 93-08-3 Methyl octine carbonate 111-80-8 See allergens See allergens See allergens See allergens 3-Methyl-2-(pentyloxy) 68922-13-4 cyclopent-2-en-1-one p-Methyltetrahydroquinoline 91-61-2 2-Nonyn-1-al dimethyl acetal 13257-44-8 Oakmoss extracts 9000-50-4 See allergens See allergens See allergens See allergens 90028-68-5 68917-10-2 1-(1,2,3,4,5,6,7,8-Octahydro- 54464-57-2 2,3,8,8-tetramethyl-2- naphthalenyl)ethanone (OTNE) 1-Octen-3-yl acetate (amyl 2442-10-6 vinyl carbinyl acetate) Opoponax 8021-36-1 9000-78-6 1-(2,4,4,5,5-Pentamethyl-1- 13144-88-2 cyclopenten-1-yl)ethan-1-one Peru balsam extracts and 8007-00-9 distillates Petitgrain Mandarin Oil 8014-17-3 93686-22-7 Phenyl acetaldehyde 122-78-1 See allergens See allergens See allergens See allergens (Hyacinthin) 3-Phenylbutanal 16251-77-7 2-Phenylpropionaldehyde 93-53-8 (Hydratropic aldehyde) 3-Propylidene phthalide 17369-59-4 Rose ketones 23696-85-7 23726-91-2 23726-92-3 23726-93-4 23726-94-5 24720-09-0 33673-71-1 35044-68-9 35087-49-1 39872-57-6 43052-87-5 57378-68-4

Ingredient name CAS % % % % number(s) directly indirect indirect Total added from from naturals impurities 70266-48-7 71048-82-3 Rue oil 8014-29-7 84929-47-5 Safrole 94-59-7 Prohibited Styrax extracts and distillates 8024-01-9 (prepared from exudations of 8046-19-3 Liquidambar styraciflua L. var. 94891-27-7 macrophylla or Liquidambar 94891-28-8 orientalis Mill.) Tagetes oil and absolute 8016-84-0 91722-29-1 Tea absolute (Camellia sinensis 84650-60-2 absolute) 1,2,3,4-Tetrahydro-4- 19343-78-3 methylquinoline Treemoss extracts 68648-41-9 See allergens See allergens See allergens See allergens 90028-67-4 68917-40-8 2,6,6-Trimethylcyclohexa-1,3- 116-26-7 dienyl methanal (Safranal) Vanillin 121-33-5 Verbena absolute (Lippia 8024-12-2 citriodora Kunth.) 85116-63-8 Vetiveryl acetate 117-98-6 62563-80-8 68917-34-0 73246-97-6 84082-84-8 Ylang Ylang (various oils and 8006-81-3 extracts) 68606-83-7 83863-30-3 Benzene (indirect) 71-43-2 Prohibited Toluene (indirect) 108-88-3 Prohibited 5-Methoxypsoralen 484-20-8 (Bergaptene) Musk xylene (musk xylol) 81-15-2 Prohibitied Polynuclear aromatic hydrocarbons (PAH) Total chlorine

Ingredients prohibited by IFRA: None present Ingredient name CAS number(s) Present Yes/No Acetyl ethyl tetramethyl tetralin (AETT, Versalide) 88-29-9 select one Acetyl isovaleryl (5-Methyl-2,3-hexanedione) 13706-86-0 select one Allantroot oil (Elecampane oil) 97676-35-2 select one Allyl heptine carbonate 73157-43-4 select one Allylisothiocyanate 57-06-7 select one Amyl cyclopentenone (2-pentyl-2-cyclopenten-1-one) 25564-22-1 select one Anisylidene acetone (4-(4-methoxphenyl)-3-buten-2-one) 943-88-4 select one cis-and trans-Asarone ((E)-and(Z)-2,4,5-Trimethoxypropen-1-yl 2883-98-9/ 5273-86-9 select one benzene) Benzene 71-43-2 select one Benzyl cyanide 140-29-4 select one Benzyildene acetone (4-Phenyl-3-buten-2-one) 122-57-6 select one Birch wood (bark) pyrolysates (oils), crude 8001-88-5/ 84012-15-7/ select one 85940-29-0/ 68917-50-0 Boldo oil 8022-81-9 / 84649-96-7 select one 3-Bromo-1,7,7-trimethylbicylo[2.2.1]heptane-2-one 76-29-9 select one Bromstryene 103-64-0 select one p-tert-Butylphenol 98-54-4 select one Cade oils, crude 8013-10-3/ 90046-02-9 select one Carvone oxide 33204-74-9 select one Chenopodium oil 8006-99-3/ 89997-47-7 select one Cinnamylidene acetone 4173-44-8 select one Colophony 8050-09-7 select one Costus root oil, absolute and concrete 8023-88-9/ 90106-55-1 select one Cyclamen alcohol (3-(4-Isopropylphenyl)-2-methylpropanol) 4756-19-8 select one 2,4-Decadienal 2363-88-4 / 25152-84-5 select one (including all geometric isomers) 1,3-Dibromo-2-methoxy-4-methyl-5-nitrobenzene (Musk KS) 62265-99-0 select one 1,3-Dibromo-4-methoxy-2-methyl-5-nitrobenzene (Musk alpha) select one 2,2-Dichloro-1-methylcyclopropylbenzene 3591-42-2 select one Diethyl maleate 141-05-9 select one Dihydroabietyl alcohol 26266-77-3 select one Dihydrocoumarin (Melilotine) 119-84-6 select one 2,4-Dihydroxy-3-methyl-benzaldehyde 6248-20-0 select one 4,6-Dimethyl-8-t-butyl coumarin (Butolia) 17874-34-9 select one Dimethyl citraconate (cis-Methylbutenedioic acid, dimethyl ester) 617-54-9 select one 3,7-Dimethyl-2-octen-1-ol (6,7-Dihydrogeraniol) 40607-48-5 select one Diphenyl amine 122-39-4 select one Esters of 2-nonynoic acid, except methyl octine carbonate Various select one Esters of 2-octynoic acid, except methyl and allyl heptine Various select one carbonate Ethyl acrylate 140-88-5 select one Ethylene glycol monoethyl ether 110-80-5 select one Ethylene glycol monoethyl ether acetate 111-15-9 select one Ethylene glycol monomethyl ether 109-86-4 select one Ethylene glycol monomethyl ether acetate 110-49-6 select one Fig leaf absolute 68916-52-9/90028-74-3 select one Furfuryl alcohol 98-00-0 select one

Ingredient name CAS number(s) Present Yes/No Furfurylideneacetone 623-15-4 select one Geranyl nitrile 5146-66-7/ 5585-39-7/ select one 31983-27-4 trans-2-Heptenal 18829-55-5 select one 2,4-Heptadienal 5910-85-0 / 4313-03-5 select one (including all geometric isomers) 2,4 Hexadienal 80466-34-8 / 142-83-6 / select one 53398-76-8 (including all geometric isomers) Hexahydrocoumarin 700-82-3 select one trans-2-Hexenal diethyl acetal 67746-30-9 select one trans-2-Hexenal dimethyl acetal 18318-83-7 select one Hydroabietyl alcohol (Abitol) 13393-93-6/ 1333-89-7 select one Hydroquinone monoethylether (4-Ethoxy phenol) 622-62-8 select one Hydroquinone monomethylether (4-Methoxy phenol) 150-76-5 select one Isophorone 78-59-1 select one 6-Isopropyl-2-decalol 34131-99-2 select one Massoia bark oil 85085-26-3 select one Massoia lactone 54814-64-1 select one 7-Methoxycoumarin 531-59-9 select one alpha-Methyl anisylidene acetone (1-(4-Methoxphenyl)-1-penten- 104-27-8 select one 3-one) 6-Methyl coumarin (Toncarine) 92-48-8 select one 7-Methyl coumarin 2445-83-2 select one Methyl crotonate 623-43-8 select one 4-Methyl-7-ethoxycoumarin (Maraniol) 87-05-8 select one p-Methyl hydrocinnamic aldehyde 5406-12-2 select one Methyl methacrylate 80-62-6 select one 3-Methyl-2(3)-nonenenitrile (Citgrenile) 53153-66-5 select one Moskene 116-66-5 select one Musk ambrette 83-66-9 select one Musk xylene (Musk xylol) 81-15-2 select one Musk tibetine 145-39-1 select one Nitrobenzene 98-95-3 select one 2,4-Nonadienal 6750-03-4 / 5910-87-2 select one (including all geometric isomers) 2,4-Octadienal 5577-44-6 / 30361-28-5 select one (including all geometric isomers) Quinoline 91-22-5 select one Pentylidene cyclohexanone 25677-40-1 select one Peru balsam crude (exudation from Myroxylon pereirae (Royle) 8007-00-9 select one Klotzsch) Phenyl acetone (Methyl benzyl ketone) 103-79-7 select one Phenyl benzoate 93-99-2 select one Pseudoionone (2,6-Dimethylundeca-2,6,8-trien-10-one) 141-10-6 select one Pseudomethylionones 1117-41-5 select one 26651-96-7 72968-25-3 Safrole, isosafrole, dihydrosafrole (directly added) 94-59-7/ 120-58-1/ select one

Ingredient name CAS number(s) Present Yes/No 94-58-6 Santolina oil 84961-58-0 select one Styrax gums, crude 8024-01-9/ 8046-19-3/ select one 94891-27-7/ 94891-28-8 Toluene 108-88-3 select one 2,4-Undecadienal 13162-46-4 / 30361-29-6 select one (including all geometric isomers) Verbena oil 8024-12-2/ 85116-63-8 select one

Ingredients which must comply with standards of purity established by IFRA Standards. If present, the ingredient(s) comply with IFRA Standards: Yes No Allyl esters Ionones Nootkatone Savin oil Birch wood pyrolysate Limonene Oakmoss Sclareol Cade oil Linalool Pinacea derivatives Treemoss Cyclamen aldehyde Methylionones Pinacea oils Vetiveryl acetate 2,2-Dimethyl-3-(3-tolyl)propan- Musk ketone 1-ol (Majantol)

EU Fragrance Allergens None present % % % indirect indirect % Ingredient name CAS number(s) direct from from total naturals impurities Amyl cinnamal 122-40-7 Amylcinnamyl alcohol 101-85-9 Anise alcohol 1331-81-3/ 105-13-5 Benzyl alcohol 100-51-6 Benzyl benzoate 120-51-4 Benzyl cinnamate 103-41-3 Benzyl salicylate 118-58-1 Butylphenyl methylpropional 80-54-6 Cinnamal 104-55-2 Cinnamyl alcohol 104-54-1 Citral (Neral+Geranial) 5392-40-5 (106-26-3 + 141-27-5) Citronellol 106-22-9 Coumarin 91-64-5 Eugenol 97-53-0 Farnesol 4602-84-0 Geraniol 106-24-1 Hexyl cinnamal 101-86-0 Hydroxycitronellal 107-75-5 Hydroxyisohexyl 3-cyclohexene 31906-04-4 carboxaldehyde Isoeugenol 97-54-1 alpha-Isomethyl ionone 127-51-5 Limonene 5989-27-5/ 5989-54-8/ 138-86-3 (sum of d, l and dl) Linalool 78-70-6 Methyl 2-octynoate 111-12-6

% % % indirect indirect % Ingredient name CAS number(s) direct from from total naturals impurities Methyl octine carbonate 111-80-8 Phenyl acetaldehyde 122-78-1 Evernia prunastri (oakmoss) 9000-50-4/ 90028-68-5 extract Evernia furfuracea (treemoss) 68648-41-9/ 90028-67-4 extract

Additives None present Ingredient name Percentage Ingredient name Percentage Diluents/solvents Yes No Antioxidants/Stabilizers Yes No Diethyl phthalate BHA Other phthalates: BHT Dibutyl phthalate Tocopherol Dimethyl phthalate

Dipropylene glycol Propylene glycol Emulsifiers Yes No Hexylene glycol Alkyl Phenol Ethoxylates Ethanol Isopropyl myristate Triethyl citrate Carbitol Other glycol ethers: Preservatives Yes No

Hercolyn Other: specify UV filters Yes No

Colors & dyes Yes No if yes, please provide: Name Color Index number Percentage

6. Supplier Guarantee

The answers provided on this document apply to all deliveries from (date):

Signature: ______

Title: Date:

Phone number: Fax number: Email address:

TSE/BSE/SARS CERTIFICATION

Supplier Product code number: ______Supplier Product name: ______

Section I: This product is certified to be obtained from: 1. Fully synthetic source: Yes (go to Section IV) No 2. Botanical source Yes No a. If yes, animal ingredients are used in the process: Yes (go to Section II) No and/or b. Animal derived* ingredients are used: Yes (go to Section II) No 3. Animal source: Yes (go to Section II) No

Section II TSE/BSE to be completed only if answer was Yes to Section I–2a, 2b or 3): 1. Type of animal: Bovine Ovine Caprine Civet (go to Section III) Other Specify 2. Please specify which body part(s) is used: 3. Country of origin: 4. Product is completely free of Specified Risk Material (SRM) as defined in the Annex of Article 1 of 98/16/EC: Yes No OR 5. The process times and conditions used in the production of this product are: a. In accordance with the Annex of Article 1 of 98/16/EC: Yes No b. Other (e.g. CPMP recommendation, etc). Please specify:

*animal derivatives include any of the following materials that may be derived from animal tissue: tallow and tallow derivatives such as fatty acids, fatty acid esters, fatty alcohols fatty amines, fatty amides, soaps, and glycerol.

Section III SARS to be completed only if answer was Civet (Family: Viverridae) in Section II-1: 1. Product derived from Civet (Family: Viverridae) has been properly processed according to the methods (see following) specified by the United States Center for Disease Control (CDC): Yes No a. Heat (heated to an internal temperature of 70°C or placed in boiling water for a minimum of 30 minutes); b. Preservation in 2 percent formaldehyde; c. Chemically treating in acidic or alkaline solutions (soaking in a solution below pH 3.0 or above pH 11.5 for 24 hours); or d. The use of hypertonic salts.

Section IV: This certificate applies to all deliveries from (date):

Signature: ______

Title: Date:

Name of supplier: Address of supplier: Date:

Fragrance Product Information Documentation Checklist

Name of Purchasing Company: Address of Purchasing Company:

Purchasing Company Product code number:

Supplier Product code number: ______Supplier Product name: ______

List of documentation provided for referenced product:

Fragrance Product Information Form

U.S. Material Safety Data Sheet (MSDS)

IFRA Certificate

EU Safety Data Sheet (SDS)

Product Specifications

NAFTA Form 434

TSE/BSE/SARS Certification

Fragrance Product Information Form Version 2.5 - Page 18 of 18 07/11/2011