TÜV Rheinland Bangladesh Pvt. Ltd.

Plot 17, Road 113/A, Alauddin Tower (5th-8th

Floor) Gulshan-2, Dhaka-1212, Bangladesh
Tel：+880-2-9894904 Fax: +880-2-9894978
e-mail: info-bd@bd.tuv.com
Internet: www.tuv.com

TEST REQUEST FORM

Service Type Regular Express (40% surcharge) Urgent (100% surcharge)

(4 Working Days) (2 Working Days) (24 Hours)
Note: Nickel Release test takes 9-10 days by its nature of testing
Applicant Baraka Fashions Ltd. Laboratory’s Use Only
Address 6, Shing Bari Road, Boro Dewra, Tongi , Gazipur, Bangladesh. Zip code : 1700
Report. No.:
Contact Person 01937205004, Mobile
Abdul Khaled / Sumon / Maruf
01712807952 Log in Date:
01719977578 Due Date:
Telephone Fax      
E-mail Merchandiser5@barakafashions.com ; maruf@cvsglobalbd.com , Merchandiser1@barakafashions.com

Invoice To : Baraka Fashions Ltd. Contact

Person: Abdul Khaled
Address: 6, Shing Bari Road, Boro Dewra, Tongi , Gazipur, Bangladesh. Zip code : 1700
Tel: 01937205004, 01712807952 Fax:       E-mail: merchandiser3@barakafashions.com
merchandiser5@barakafashions.com
Merchandiser1@barakafashions.com
masud@barakafashions.com
maruf@cvsglobalbd.com
helali@cvsglobalbd.com
mahmudul@cvsglobalbd.com

Sample Information (Please fill in information and tick appropriate boxes)

Buyer Name A.M. LONDON FASHION LTD Agent CVS GLOBAL Manufactu
rer Baraka Fashions Ltd.
Sample Shirt Canada No. of 02 PCS SAMPLE Fibre OUTER:100% COTTON
Description Sample Content
INNER:100% POLYESTER
Style No. Shirt CANADA Article TBMK02831, TBMK02831B, PO No.
No
6620,6721,6722
TBMK02831C
Colour Names Blue Check, Red Check, Navy Check
Fabric / Garment Export to / UK End Use SHACKET
Weight Market of Product
Other Care Instructions:      
Care Symbols:

Test(s) Required: (Please fill/ tick appropriate boxes) Is this a Re-Test? Yes, previous report no. Is      

Chemical Tests: Colour Fastness: Physical Tests: Dimensional Stability (Shrinkage):

Formaldehyde Tear Strength (Woven only) No. of wash 3
Washing Washing
pH Value WASH
Actual Laundering Tensile Strength (Woven only) Dry-clean No. of cycle      
Azo Dyes Dry-clean
Phthalate Seam Properties (Woven only)
Perspiration Seam Slippage (Woven only)
Lead in Surface Coating Appearance Retention:
Lead In Substrates Water Bursting Strength (Knit only) No. of wash 3
After Washing
Cadmium Light (Grade:      ) WASH
Rubbing/ Crocking Pilling Resistance After Dry-clean No. of cycle      
PCP /TeCP
Chlorine bleach Abrasion Resistance Spirality/ Twisting No. of wash      
Heavy metal
PAH’s Non-Chlorine bleach Thread count/ Stitch Density Skew & Bow
Saliva Yarn Count Print Durability No. of wash      
Nickel release
Allergenic dyes Ozone Fabric Weight
Carcinogenic dyes Burn Gas fumes Zipper Strength
Chromium VI Phenolic Yellowing Small Parts
COC Light & Perspiration Sharp point/ Sharp Edge
DMFu/DMFa Saliva & Perspiration Fibre Composition
PFOA/PFOS Chlorinated water Care Label Recommendation
AP/APEO Tension/ Attachment test
PVC Flammability Tests: Snapping/ Un-snapping of Snap
Navy Blue Flammability(16CFR 1610) Fasteners
Corrosion Resistance/ Rust Free Flammability(16CFR1615/1616) Torque test
Button Impact
Stretch & Recovery
Other Tests please mention on below:       Fabric Type: Coating without coating
(Please indicate test method or special request )
Method to be used: ISO/BS/EN AATCC/ASTM AS DIN JIS CAN Other (Please Specify):      
Composite Tests: No Yes (If composite test failed, individual test will be performed and charged separately)
If necessary, some of above tests will be subcontracted to TÜV RHEINLAND OTHER LOCATION Agree Disagree
Return Samples (applicant pays delivery fee): Remain Sample Tested Sample
We request for the above tests and agree that all testing will be carried out subject to TÜV Rheinland Bangladesh Pvt. Ltd’s scale of charges as set forth in their
prevalent price list of which we have seen a copy and upon and subject to the terms and conditions set out hereon and overleaf.
Authorized Signature and Company Chop 0rolr
(P.T.O./ See the next page for General Terms and Conditions )

Revised on 29- Mar-2013

     

Date: 31.08.2020

Notes:
1. To avoid delays, the applicant has to fill the test request form clearly.
2. There is a minimum charge of USD 10.00 + 15% VAT per report issued.
3. The test results for above items will be described in one report.
4. Please dial +880-2-9894904 for free sample pick-up service (only available in Dhaka
City)
5. Please see General terms & conditions (provided separately)

Revised on 29- Mar-2013