ROHS/REACH/CMRT Request Form | JST Sales America

ROHS/REACH/CMRT Request Form

Requester Information

You are a:*
- Customer
- Distributor
- Representative
- Employee
Name*
Title
Company
Phone Number*
Email*
Email 2 (optional)
Address Line 1*
Address Line 2
Country*
State/Territory
City*
Zip Code
End Customer Information

To expedite your request, we need to know from whom you purchased the products listed below.
Company Name*
Contact Name
Contact Email*
Contact Phone Number*
Application*
Estimated Annual Usage*
Purchased From
Select the documents required:*
- RoHS
- REACH
- CMRT
- Other (Please describe below)
Part Number
*
- I have read and accept the Privacy Policy*
CAPTCHA

48041