*Mandatory Field (Must Be Completed Or Sample Will Be Placed on Hold)

ADULT ACCESSORIES TEST REQUEST FORM

*Mandatory Field (Must be completed or sample will be placed on hold) Submitting For: JDE Number: Nordstrom, Inc. 50607 Submitter: Submitter Contact: Email Address: Phone #: Submitter Address:

Regular (5-7 working Rush+ (3 working Service Requested: Express+ (1 working day) (select one) days) days) +Note: Due to product complexity, sample volume or level of testing, expedited service may not be available. *NPG Contact – Product Developer (Last Name, First Name): *NPS Sourcing Category: Choose an item. Number: If other, please list: *Division: (select one) Department: (select from drop-down) *NPG MEN’S ACCESSORIES Choose an item. Department: If other, please list: WOMEN’S/YC *NPG Choose an item. If other, please list: ACCESSORIES Department: *NPG ACC/WSP Choose an item. Department: If other, please list: *Label Name (E.G. Nordstrom, Halogen, Treasure & Bond etc.): *Nordstrom Style (VPN) Number(s): PO Number(s): (If multiple, please list separately) Ship Date (MM/DD/YY): *Season: Choose an item. *Year (YYYY): *Agent: Choose an item. Agent Contact Name: Agent Email Id: *Manufacturer Name: *Manufacturer RMS Number: *Manufacturer Contact Name: *Manufacturer Email Id: *Factory Name: *Factory RMS Number: *Factory Contact Name: *Factory Email Id: *Factory Address: City: State: Country: Postal Code: Material / Trim Supplier Name: Material / Trim Supplier Article Number:

*Product Description: *End Use: *Submitted Color(s) / Print Name: Size of Socks or Hosiery: Jewelry: Please attach the NPG Component Material Breakdown Form. Testing cannot begin without the completed NPG Component Material Breakdown Form. (note method of g / g / oz / g / linear *Fabric Weight: Momme measurement) M2 pair yd2 yard Product Claims (e.g. RFID, etc.): *Fiber Content Label: *Care Instruction(s):

*Stage of Production Testing: Development

FAILURE TO COMPLETE THIS FORM ACCURATELY WILL RESULT IN RETESTING THE ITEM AT MANUFACTURER/VENDOR’S OWN EXPENSE. NORD-GB-TRFS-GB-ADULT ACCESSORIES-V6 Page 1 of 5 Updated July 2017 ADULT ACCESSORIES TEST REQUEST FORM TEST REQUIRED: Hats, Ear Muffs, Scarves, Wraps, Gloves Critical Test Socks Critical Test Package Package Handbags-Fashion and Basic Critical Test Handbags-Evening Critical Test Package Package Small Leather/Faux Leather Critical Test Belts Critical Test Package Package Sunglasses Critical Test Package Umbrella Critical Test Package Backpacks, Bookbags Critical Test Package Yoga Mats Critical Test Package Watches Critical Test Package Luggage Critical Test Package Jewelry Critical Test Package Note: Wet paint is acceptable for Adult Jewelry. Please submit 50 ml of wet paint (per color) for testing. Jewelry: Please attach the NPG Component Material Breakdown Form. Testing cannot begin without the completed NPG Component Material Breakdown Form. Other: Retest - Previous Report Number: Additional/Reference Information:

Technique(s) used to improve the failure: (Mandatory for all retest submissions)

Return No Yes (shipping and handling charges apply) Sample:

PRODUCT INFORMATION FOR GCC / CPC: Place of Manufacture: (City / Province / Country) Date of Country of Origin: Manufacture: (MM/YYYY)

BILLING INFORMATION: Bill to agent, manufacturer or factory only. If Nordstrom is selected, lab will contact submitter for alternate billing party. Bill to Company: Contact Person: Address: Phone: E-mail: Fax:

FAILURE TO COMPLETE THIS FORM ACCURATELY WILL RESULT IN RETESTING THE ITEM AT MANUFACTURER/VENDOR’S OWN EXPENSE. NORD-GB-TRFS-GB-ADULT ACCESSORIES-V6 Page 2 of 5 Updated July 2017 Date: Authorized Signature:

FAILURE TO COMPLETE THIS FORM ACCURATELY WILL RESULT IN RETESTING THE ITEM AT MANUFACTURER/VENDOR’S OWN EXPENSE. ADULT ACCESSORIES TEST REQUEST FORM

FAILURE TO COMPLETE THIS FORM ACCURATELY WILL RESULT IN RETESTING THE ITEM AT MANUFACTURER/VENDOR’S OWN EXPENSE. NORD-GB-TRFS-GB-ADULT ACCESSORIES-V6 Page 4 of 5 Updated July 2017 FAILURE TO COMPLETE THIS FORM ACCURATELY WILL RESULT IN RETESTING THE ITEM AT MANUFACTURER/VENDOR’S OWN EXPENSE.