PCG | COSMETIC PRODUCT LISTING FORM

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Cosmetic Product Listing Form

Contact Person

Phone Number

Street Address

State

Company Name

Email

City

Country

Type of document

Initial

Changes to listing

Discontinuation of listing

Abbreviated renewal

Type of business

Manufacturer

Packer

Distributor

Product category

Product name

Is this product for professional use only?

Yes

No

Does this product contain fragrance, flavor or color?

Fragrance

Flavor

Fragrance & Flavor

None

Ingredient Name (Mention the ingredients present in the product)

Is the facility where the product is manufactured or processed exempt from registration (for example because it is a small business)?

Yes

No

Facility FEI

Facility Name

Facility Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country