TEST REQUEST FORM
Service Required: ☐Regular, × Express* (3 days - 40% Asia/ 50% US surcharge),☐Shuttle* (2 days – 100% surcharge),
☐Emergency* (1 day – 150% surcharge) Available for certain tests only and subject to lab availability. Some tests require additional TAT. Acct Mgr: Stan Ha
Applicant’s Information
Mill Name: CÔNG TY TNHH IN QUANG
PHÁT
Factory Name:
Supplier Name:
Applicant Contact Information
Contact Person: TRẦN ĐÌNH TẤN
Address: 90 LÝ THÁI TỔ - PHƯỜNG AN HÒA-THÀNH PHỐ
HUẾ
Email: [emailprotected]
Telephone: 02343521686-
0903597686
PEI Office : BG BJ GZ HK SH TW ×VN USA Email Address: ☐ ☐ ☐ ☐ ☐ ☐ ☐
Agent Office / Direct Vendor Name: _____________________ Email Address: __________________
VINVOICE TO: (Please check box and enter the email address for Applicant or 3rd party contact) TEST STAMP APPROVAL
PEI GUANGZHOU ACCOUNTING: ☐[emailprotected] /Julier.[emailprotected]
PEI MIAMI ACCOUNTING: ☐[emailprotected] - For International Billing
PEI MIAMI ACCOUNTING: ☐Wilma.Castillo@pery.com - For US Billing
Retest – Bill to Applicant Rush Fees – Bill to Applicant☐ ☐
× Applicant : email address: inquangphat@gmail.com
3☐rd Party, email address:
R PERRY ELLIS INTERNATIONAL *BRAND INFORMATION (please check the appropriate box and fill in information)
AXIST☐
BEN HOGAN☐
☐ CAFE LUNA
× CALLAWAY US
CALLAWAY UK☐
CUBAVERA☐
FARAH☐
FARAH VINTAGE☐
GRAND SLAM☐
HAVANERA☐
JACK NICKLAUS☐
NIKE SWIM☐
OP MAINLINE☐
OP SMU☐
PAC☐
PE AMERICA☐
×PERRY ELLIS
☐ PERRY ELLIS PORTFOLIO
PGA TOUR☐
PRO TOUR☐
RAFAELLA☐
SAVANE☐
OTHER ☐
(Please fill in BRAND name)
Sample Description:
End Use:
Customer: (Please fill in customer name)
OTHER☐
Stage of Testing (please tick appropriate boxes) : Development Bulk Fabric Garment ☐ ☐ ☐
ADULT YOUTH ( Age 16 and under) CHILDREN ( Age 12 and under) ☐ ☐ ☐
*SUPPLIER #:
OEKO-TEX CERTIFIED YES NO☐ ☐
FIBER CONTENT: THREAD COUNT: COUNTRY OF ORIGIN:
*STYLE #:
CGKSE0A6; CGKSE044; CGKSE0A0
*PO#: SU37200,RT27503,
SU3903,SU2353, RT4209,
UG2458, SU2459, SU2460,
RT4209,UG2458,UG2459,
UG2460
*COLOR: 461 MALLARD BLUE;
465 BRITTANY BLUE; 442 LIMPET
SHELL; 032 GRAY DAWN; 052
INFINITY
COUNTRY OF DESTINATION:
× US ☐ EU ☐ CA ☐ UK ☐ ME
FABRIC: REF#: FABRIC WEIGHT:
CONSTRUCTION: FABRIC WIDTH: *SEASON:
VENDOR PROPOSED CARE INSTRUCTION: (Must be filled in below in order for testing to start)
PACKAGE TESTS: ☐ PLAN A ☐ PLAN C ☐ PLAN D ☐ PLAN E ☐ ALTERNATE FABRIC TEST
Fabric Package Tests:
☐Corduroy Fabric
☐ Cotton CVC Fabric
☐Denim Fabric
☐Faux Leather/Suede
☐Genuine Leather
☐Knit Fabric
☐Lined Garment
☐Unlined Garment
☐Knit Lining
☐Linen Fabric
☐Nylon Fabric
☐ Poly CVS Fabric
☐Rayon Fabric
☐Silk Fabric
☐Sweater Fabric
☐Swimwear Knit Fabric
☐Swimwear Woven Fabric
☐Vinyl Rainwear, PVC Fabric
☐Wool/Wool Blends Fabric
☐Woven Lining
☐Pocketing & Waistband Lining
☐Other
Additional Tests (Please mark below):
Abrasion Resistance☐
Analysis of fat☐
CF to Light☐
CF to Perspiration☐
CF to Pool water☐
CF to Sea Water☐
Component Strength☐
Fiber Content☐
Additional Tests continued:
Pilling Random Tumble, 30min☐
Snagging☐
Stretch & Recovery☐
Tear Strength ☐
Dry Clean/Appearance☐
Number of HL_☐ _
Thread Count ☐
Other ☐
Garment Package Tests:
☐CVC-CVS, Silk, Wool, Nylon, PU
Garment
☐Denim Garment
☐Dry Cleaning
☐Knit Garments
☐Sweater Garment
☐Linen Garment
☐Rayon Garment
☐Swimwear
☐Genuine Leather Garment
☐Children’s Garment
☐Socks/Hosiery
☐Other
Accessories Package Tests:
Bags, Backpacks, Portfolios☐
Belts☐
Bottle Coolers☐
Caps and Visors☐
Cufflinks☐
Golf Balls☐
Golf Gloves☐
Special Claims (Please mark below)
Absorbency ☐
Original,☐ # of HL: 3 5 ☐ ☐
Air Permeability ☐
Original,☐ # of HL: 3 5☐ ☐
Anti Fade ☐
Original,☐ # of HL: 5 10 ☐ ☐
Anti Microbial/Anti Bacterial ☐
Original,☐ # of HL: 5☐
Anti Pill ☐
Original,☐ # of HL: 10☐
Breathability ☐
Original,☐ # of HL: 5 10 ☐ ☐
Critical Seam Sealed/Tape ☐
Original,☐ # of HL: 5☐
Crush Proof/Wrinkle Recovery☐
Original,☐ # of HL: 3 5 10 ☐ ☐ ☐
Easy Care: ☐
Original, # of HL: 3 5 ☐ ☐ ☐
Moisture Management ☐
Original, # of HL: 3 5 ☐ ☐ ☐
Moisture Vapor Transmission☐
Original, # of HL: 3 5 ☐ ☐ ☐
No Iron: ☐
Original, # of HL: 5 10☐ ☐ ☐
Odor Resistance ☐
Original, # of HL: 5 10 ☐ ☐ ☐
Oil Repellency: ☐
Original, # of HL: 5 10 ☐ ☐ ☐
Quick Dry ☐
Original,☐ # of HL: 3 5☐ ☐
Stain release☐
Original, # of HL: 5 10 ☐ ☐ ☐
Trim Package Tests
Buttons & Fasteners ☐
Decals, Heat Seals and ☐
Screenprints
Embellishments☐
Small Parts less than 15% ☐
Zippers☐
Feather and Down☐
Other ☐
RSL Testing Category: (Please
mark below)
Azo dyes☐
Flame Retardants☐
Formaldehyde (Quantitative)☐
Formaldehyde (Qualitative)☐
Lead in Paint/Coating☐
Lead in Substrate☐
NP/NPEO☐
Package Material CONEG☐
Notes:
PFOS☐
pH☐
Phthalates☐
Other ☐
Retest: ☐
Previous Report #
Date
31-08-2023
1
