Defence EXEMPTION APPLICATION FORM

Defence EXEMPTION APPLICATION FORM

1. Industry Partner applicant

Industry Partner / (if applicable)
Address
Contact
Contact Tel / Fax
Email

2. Project Team Applicant

PT
Address
PT Contact
Contact Tel / Fax
Email

3. Chemical Substance Requiring Exemption

Substance Name
Other Name(s)
CAS No.
EC No.
EINECS No.
UK Protective Marking (JSP 440) / Please consult your MOD PT
Annual Tonnage† Manufactured/Imported

† - Please indicate whether you manufacture or import (or both), and in what quantity for each

Classification Elements (delete as appropriate) / R50-53 / CMR 1/2
4. Business Case (continue on extra pages if necessary):

5. Signature

Industry Partner

Signature / Date:
Print Name

For Reach Process Management Office Use Only

ACTION / REMARKS / Date
MOD REACH Reference
Validation and Compliance Check
REWGReview
EPIC Endorsement
SoS Authorisation
Certificate Action
CAR (MOD)
Review

GUIDANCE ON COMPLETING THE APPLICATION FOR A DEFENCE EXEMPTION FROM THE REQUIREMENT TO SUBMIT INFORMATION ON CHEMICAL SUBSTANCES TO THE EUROPEAN CHEMICALS AGENCY UNDER THE REACH REGULATIONS (REGULATION EC NO. 1907/2006)

1. Industry Partner Applicant

Industry Partners should complete these details and submit to their PT for review and submission to DE&S QSEP. This section is not required when a PT is applying directly. Please fill in all the details requested should the Exemption Application Scrutiny Board wish to contact you regarding your application

2. IPT Applicant

PT’s should fill in all the details requested should the Exemption Application Scrutiny Board wish to contact you regarding your application.

3. Chemical Substance Requiring Exemption

Substance Name is the general name of the substance (e.g. hydrochloric acid, sodium hydroxide, etc).

Other Name(s) include trade names and any other synonyms used for the chemical substance.

CAS No. is the “Chemical Abstract Service” number assigned to the chemical. This is a very common reference for chemicals and is required for registration.

EC No. is the “European Commission” inventory number for the substance. This number is not essential if you have supplied the CAS Number for the substance.

EINECS No. is the “European Inventory of Chemical Substances” number assigned to the chemical. This number is not essential if you have supplied the CAS Number for the substance.

UK Protective Marking is the classification assigned to the substance based on the security level of the substance itself, or its use. Generally any chemical substance considered “Official-Sensitive” or above will be considered for Defence Exemption from REACH provided the accompanying business case supports the need for exemption.

Annual Tonnage an PT must indicate the quantity of the chemical substance manufactured, and the quantity imported into the EU. These must be identified separately on the application form.

Classification Elements is the section used to indicate whether the chemical substance requiring exemption is considered “R50-53” (very toxic to the aquatic environment) or “CMR” (Carcinogenic, Mutagenic or toxic to Reproduction). Please delete both if neither classification applies.

4. Business Case

In addition to the substance being “Official-Sensitive” or above according to the protective marking scheme in JSP 440 and the Manual of Protected Security, the business case should be a short supporting statement to clarify why the substance should be considered for Defence Exemption.

5. Additional instructions

Exemption applications should be initiated through the MOD Project Teams (PTs) or equivalent, with assistance from their defence industry partners, to ensure that any contracts are evaluated, and any substances assessed to determine if an exemption is required. Applications submitted through a PT will be scrutinised by an internal DE&S committee.

PTs are to send completed forms to:

QSEP REACH

DE&S Abbey Wood

NH4 Elm 1B #4128

Filton

Bristol

BS34 8JH

REACH / 1 / 17 Aug 2010