Form No: DOC0078188 (Legacy No: CELQ-033-FORM-27) Rev 20.

0
Reference Document No: DOC0078228

[Supplier Header]
[Address]
[Telephone Number]
[Email Address]

DECLARATION OF COMPLIANCE TO
CELESTICA ENVIRONMENTAL REQUIREMENTS FOR
CHEMICALS AND CONSUMABLES

Product
Celestica PN
Description Supplier PN Identification
(If applicable)
(If applicable)

This is to certify that the part number(s) listed above meets or exceeds all requirements mandated by the
Celestica Environmental Requirements for Chemicals & Consumables Policy DOC # DOC0075099 (Legacy No:
CELQ-033-POL-15), available at:
https://www.celestica.com/suppliers

Celestica intends to use the information contained in this declaration to validate the RoHS compliance of the
stated part number(s), as per the European Union RoHS Directive 2011/65/EU (with Annex II amended by
Commission Delegated Directive (EU) 2015/863) and the Management Methods for Control of Pollution Caused
by Electronic Information Products, Ministry of Information Industry Order #39 (China RoHS).

Celestica therefore requests that the declaration covers IEC 62474 Criteria 1, 2 and 3 sets of Materials (refers to
Appendix 1 & 2 ), expressed in concentration terms of parts per million (ppm), as per stated Reporting Threshold,
where applicable. At minimum, the supplier must complete all required data fields to achieve a negative
declaration, i.e. each substance from Criteria 1, 2 and 3 must be explicitly declared as present or not present
whether it is above or below the threshold. Celestica prefers that the respective concentration be reported for
each substance present in the product.

Materials and Substances

The tables below references IEC62474 Declarable Substances version D26.00 dated 17 Jan 2023 (See
Appendix 1 & 2) , as indicated in the IEC 62474:2018 Material Declaration for Products of and for the
Electrotechnical Industry. This includes the materials defined in Article 4.1 of the European Union RoHS Directive
2011/65/EU on the restriction of the use of certain hazardous substances in electrical and electronic equipment.

SUPPLIER DECLARATION 0
 Form No: DOC0078188 (Legacy No: CELQ-033-FORM-27) Rev 20.0
Reference Document No: DOC0078228

[Supplier Company Name] declares product mentioned in the above

Do not contain any substances listed in the Criteria 1, Criteria 2 and Criteria 3 (Refer to MATERIAL
DECLARATION section- All the substances will automatically declare as "No" and "0")
Contain substances listed in Criteria 1, Criteria 2 and Criteria 3 (PLEASE FILL IN THE MATERIAL
DECLARATION)

ADDITIONAL REQUIREMENTS:

a) Method / Data Source utilized for Declaration:

i) Information from Suppliers Yes / No
ii) In-house / External Testing Yes / No
iii) Others Yes / No
Please specify:

b) Is the product a solder material (bar/paste/wire/ball/pre-form/etc…)? Yes / No

(For determination of RoHS 5-of-6 exemption status)

c) Is RoHS exemption (Refer to RoHS Annex III) applicable to your product? Yes / No
Please specify:

Signature :

Supplier Company Name :

Authorized Representative Name :

Title :

Phone :

Email :

Response Date :

MATERIAL DECLARATION
Criteria 1: Currently Regulated
 Form No: DOC0078188 (Legacy No: CELQ-033-FORM-27) Rev 20.0
Reference Document No: DOC0078228

Report concentration
Intentionally (PPM) if substance
Substance/ Reporting
Added and/or present in the product
Category Name Threshold
Above Threshold *Indicate “0 ” if not
present.
Diarsenic pentoxide
(CAS # 1303-28-2) 0.1 mass% of article

Diarsenic trioxide
(CAS # 1327-53-3) 0.1 mass% of article

Asbestos
(CAS # see Appendix Reference Intentionally added
Substance List)
Azocolourants and azodyes which
form certain aromatic amines 0.003% by weight of
(CAS # see Appendix Reference the finished
Substance List) textile/leather product

Boric Acid
(CAS # 10043-35-3, 11113-50-1) 0.1 mass% of article

Cadmium/Cadmium compounds
(CAS # see Appendix Reference 0.01 mass% of total
Substance List) Cd in homogenous
material

Cadmium/Cadmium compounds
(CAS # see Appendix Reference 0.001% by weight of
Substance List) battery

Chromium (VI) Compounds

(CAS # see Appendix Reference 0.1 mass% of total
Substance List) Cr+6 in homogenous
material

Cobalt dichloride
(CAS # 7646-79-9) 0.1 mass% of article

Dibutyltin (DBT) compounds

(CAS # see Appendix Reference 0.1 mass% of tin in
Substance List) the part

Dioctyltin (DOT) compounds

(CAS # see Appendix Reference 0.1 mass% of tin in
Substance List) the part

Dimethyl Fumarate (DMF) 0.00001 mass% of

(CAS # 624-49-7) the part
Disodium tetraborate, anhydrous
(CAS # see Appendix Reference
Substance List) 0.1 mass% of article
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Fluorinated Greenhouse Gases

(PFC, SF6, HFC)
(CAS # see Appendix Reference Intentionally Added
Substance List)
Formaldehyde 0.0075 mass % of
(CAS # 50-00-0) textile
Hexabromocyclododecane
(HBCDD) and all major
diastereoisomers identified: Alpha-
hexabromocyclododecane Beta-
hexabromocyclododecane Gamma- Intentionally added or
hexabromocyclododecane 0.01 mass% of article
(CAS # see Appendix Reference
Substance List)

Lead/Lead Compounds 0.1 mass% of total Pb

(CAS # see Appendix Reference in homogenous
Substance List) material
Lead/Lead Compounds
(CAS # see Appendix Reference 0.01 mass%
Substance List)
Lead/Lead Compounds 0.009 mass% of
(CAS # see Appendix Reference surface coating
Substance List) material
Lead/Lead Compounds 0.03 mass% of
(CAS # see Appendix Reference surface coating
Substance List) material
Lead/Lead Compounds
(CAS # see Appendix Reference 0.004 mass% of
Substance List) battery

Lead (II) chromate

(CAS # 7758-97-6) 0.1 mass% of article

Lead chromate molybdate sulphate

red (C.I. Pigment Red 104)
(CAS # 12656-85-8) 0.1 mass% of article

Lead sulfochromate yellow (C.I.

Pigment Yellow 34) 0.1 mass% of article
(CAS # 1344-37-2)
Mercury/Mercury Compounds
(CAS # see Appendix Reference Intentionally Added or
Substance List) 0.1 mass% of total Hg
in homogenous
material

Mercury/Mercury Compounds
(CAS # see Appendix Reference Intentionally added or
Substance List) 0.0001 mass% of
battery
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Mercury/Mercury Compounds
(CAS # see Appendix Reference 0.0005 mass% of total
Substance List) Hg in homogenous
material

Nickel/Nickel Compounds
(CAS # see Appendix Reference Intentionally Added
Substance List)
Ozone Depleting Substances
(CFC, Halon, HBFC, HCFC &
others) Intentionally Added
(CAS # see Appendix Reference
Substance List)
Perchlorates
(CAS # see Appendix Reference 6 x 10 ^-7 mass% of
Substance List) battery or product part

2-benzotriazol-2-yl-4,6-di-tert-
butylphenol (UV-320) Intentionally added or
(CAS # 3846-71-7) 0.1 mass% of article

Phthalates, Selected Group 1 0.1 mass% as the

(BBP, DBP, DEHP) sum of the phthalate
(CAS # see Appendix Reference concentrations in
Substance List) plasticized material
Phthalates, Selected Group 2 0.1 mass% as the
(DIDP, DINP, DNOP) sum of the phthalate
(CAS # see Appendix Reference concentrations in
Substance List) plasticized material
Bis (2-ethylhexyl)phthalate (DEHP)
(CAS # 117-81-7) 0.1 mass% in
homogenous material

Dibutyl phthalate (DBP)

(CAS # 84-74-2) 0.1 mass% in
homogenous material

Benzyl butyl phthalate (BBP)

(CAS # 85-68-7) 0.1 mass% in
homogenous material

Diisobutyl phthalate (DIBP)

(CAS # 84-69-5) 0.1 mass% in
homogenous material

1,2-Benzenedicarboxylic acid, di-

C6-8-branched alkyl esters, C7-rich
(DIHP) 0.1 mass% of article
(CAS # 71888-89-6)
1,2-Benzenedicarboxylic acid, di-
C7-11-branched and linear alkyl
esters (DHNUP) 0.1 mass% of article
(CAS # 68515-42-4)
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Polybrominated Biphenyls (PBBs)

(CAS # see Appendix Reference 0.1 mass% in
Substance List) homogenous material

Polybrominated Diphenylethers
(PBDEs) 0.1 mass% in
(CAS # see Appendix Reference homogenous material
Substance List)
Polychlorinated Biphenyls (PCBs)
and specific substitutes
(CAS # see Appendix Reference Intentionally added
Substance List)
Polychlorinated Terphenyls (PCTs)
(CAS # see Appendix Reference 0.005 mass% in
Substance List) material

Polychlorinated Naphthalenes
(PCNs)
(CAS # see Appendix Reference Intentionally added
Substance List)
Radioactive substances
(CAS # see Appendix Reference Intentionally added
Substance List)
Aluminosilicate Refractory Ceramic
Fibres 0.1 mass% of article

Zirconia Aluminosilicate Refractory

Ceramic Fibres 0.1 mass% of article

Alkanes, C10-13, chloro (Short

Chain Chlorinated Paraffins) Intentionally added or
(CAS # see Appendix Reference 0.1 mass% of article
Substance List)
Strontium chromate
(CAS # 7789-06-2) 0.1 mass% of article

Bis(tributyltin) oxide (TBTO)

(CAS # 56-35-9) Intentionally added or
0.1 mass% of article

Tri-substituted organostannic
compounds Intentionally added or
(CAS # see Appendix Reference 0.1 mass% of tin in
Substance List) the part

Tris(2-chloroethyl)phosphate
(CAS # 115-96-8) 0.1 mass% of article

4-(1,1,3,3-tetramethylbutyl)phenol
(CAS # 140-66-9) 0.1 mass% of article

Bis(2-methoxyethyl) ether
(CAS # 111-96-6) 0.1 mass% of article

Bis(2-methoxyethyl) phthalate
0.1 mass% of article
(CAS # 117-82-8)
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Pentazinc chromate octahydroxide

(CAS # 49663-84-5) 0.1 mass% of article

Potassium
hydroxyoctaoxodizincatedichromate
(CAS # 11103-86-9) 0.1 mass% of article

Bis(pentabromophenyl) ether
(decabromodiphenyl ether) Intentionally added or
(DecaBDE) 0.1 mass% of article
(CAS # 1163-19-5)
Sulfurous acid, lead salt, dibasic
(CAS # 62229-08-7) 0.1 mass% of article

1,2-bis(2-methoxyethoxy)ethane
(TEGDME; triglyme)
(CAS # 112-49-2) 0.1 mass% of article

Trilead dioxide phosphonate

(CAS # 12141-20-7) 0.1 mass% of article

1,2-dimethoxyethane; ethylene
glycol dimethyl ether (EGDME)
(CAS # 110-71-4) 0.1 mass% of article

4-Aminoazobenzene
(CAS # 60-09-3) 0.1 mass% of article

Tetralead trioxide sulphate

(CAS # 12202-17-4) 0.1 mass% of article

Orange lead (lead tetroxide)

(CAS # 1314-41-6) 0.1 mass% of article

Pyrochlore, antimony lead yellow

(CAS # 8012-00-8) 0.1 mass% of article

Pentalead tetraoxide sulphate

(CAS # 12065-90-6) 0.1 mass% of article

1,2-Diethoxyethane
(CAS # 629-14-1) 0.1 mass% of article

Diboron trioxide
(CAS # 1303-86-2) 0.1 mass% of article

Dibutyltin dichloride (DBTC)

(CAS # 683-18-1) 0.1 mass% of article

Lead cyanamidate
(CAS # 20837-86-9) 0.1 mass% of article

N,N-dimethylformamide
(CAS # 68-12-2) 0.1 mass% of article
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Silicic acid (H2Si2O5), barium salt

(1:1), lead-doped
(CAS # 68784-75-8) 0.1 mass% of article

1,2-Benzenedicarboxylic acid,
dipentylester, branched and linear
(CAS # 84777-06-0) 0.1 mass% of article

Diisopentylphthalate
(CAS # 605-50-5) 0.1 mass% of article

N-pentyl-isopentylphthalate
(CAS # 776297-69-9) 0.1 mass% of article

Lead titanium trioxide

(CAS # 12060-00-3) 0.1 mass% of article

Lead titanium zirconium oxide

(CAS # 12626-81-2) 0.1 mass% of article

Lead oxide sulfate

(CAS # 12036-76-9) 0.1 mass% of article

[Phthalato(2-)]dioxotrilead
(CAS # 69011-06-9) 0.1 mass% of article

Dioxobis(stearato)trilead
(CAS # 12578-12-0) 0.1 mass% of article

Fatty acids, C16-18, lead salts

(CAS # 91031-62-8) 0.1 mass% of article

Lead dinitrate
(CAS # 10099-74-8) 0.1 mass% of article

Di-isodecyl phthalate (DIDP)

(CAS # 68515-49-1,
26761-40-0) Intentionally added

Di-n-hexyl Phthalate (DnHP)

(CAS # 84-75-3) Intentionally added or
0.1 mass% of article

Hexahydromethylphthalic anhydride
(CAS # see Appendix Reference
Substance List) 0.1 mass% of article

Cadmium
(CAS # 7440-43-9) 0.1 mass% of article

Cadmium oxide
(CAS # 1306-19-0) 0.1 mass% of article

Dipentyl phthalate (DPP)

(CAS # 131-18-0) 0.1 mass% of article
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Pentadecafluorooctanoic acid
(PFOA) 0.1 mass% of article
(CAS # 335-67-1)
Ammonium
pentadecafluorooctanoate (APFO)
(CAS # 3825-26-1) 0.1 mass% of article

4-Nonylphenol, branched and

linear, ethoxylated
(CAS # see Appendix Reference 0.1 mass% of article
Substance List)
Cadmium sulphide
(CAS # 1306-23-6) 0.1 mass% of article

Trixylyl phosphate
(CAS # 25155-23-1) 0.1 mass% of article

Disodium 3,3'-[[1,1'-biphenyl]-4,4'-
diylbis(azo)]bis(4-
aminonaphthalene-1-sulphonate)
(C.I. Direct Red 28) 0.1 mass% of article
(CAS # 573-58-0)

Perfluorooctanoic acid (PFOA) and

individual salts and esters of PFOA
(CAS # see Appendix Reference 1 microgram/m2 (as
Substance List) the sum of PFOA)

Perfluorooctanoic acid (PFOA) and

individual salts and esters of PFOA
(CAS # see Appendix Reference 0.1 mass% of the part
Substance List) (as the sum of PFOA)

Imidazolidine-2-thione; (2-
imidazoline-2-thiol) 0.1 mass% of article
(CAS # 96-45-7)
1,2-Benzenedicarboxylic acid,
dihexyl ester, branched and linear
(CAS # 68515-50-4) 0.1 mass% of article

Diisononyl phthalate (DINP)

(CAS # 28553-12-0, Intentionally added
68515-48-0)
Benzo[a]pyrene
0.0001 mass% of the
(CAS # 50-32-8)
plastic or rubber part
Benzo[e]pyrene
0.0001 mass% of the
(CAS # 192-97-2)
plastic or rubber part
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Benzo[a]anthracene
0.0001 mass% of the
(CAS # 56-55-3)
plastic or rubber part
Chrysen
0.0001 mass% of the
(CAS # 218-01-9)
plastic or rubber part
Benzo[b]fluoranthene
0.0001 mass% of the
(CAS # 205-99-2)
plastic or rubber part
Benzo[j]fluoranthene
0.0001 mass% of the
(CAS # 205-82-3)
plastic or rubber part
Benzo[k]fluoranthene
0.0001 mass% of the
(CAS # 207-08-9)
plastic or rubber part
Dibenzo[a,h]anthracene
0.0001 mass% of the
(CAS # 53-70-3)
plastic or rubber part
Benzo[a]pyrene 0.00005 mass% of the
(CAS # 50-32-8) plastic or rubber part
of toys and childcare
articles
Benzo[e]pyrene 0.00005 mass% of the
(CAS # 192-97-2) plastic or rubber part
of toys and childcare
articles
Benzo[a]anthracene 0.00005 mass% of the
(CAS # 56-55-3) plastic or rubber part
of toys and childcare
articles
Chrysen 0.00005 mass% of the
(CAS # 218-01-9) plastic or rubber part
of toys and childcare
articles
Benzo[b]fluoranthene 0.00005 mass% of the
(CAS # 205-99-2) plastic or rubber part
of toys and childcare
articles
Benzo[j]fluoranthene 0.00005 mass% of the
(CAS # 205-82-3) plastic or rubber part
of toys and childcare
articles
Benzo[k]fluoranthene 0.00005 mass% of the
(CAS # 207-08-9) plastic or rubber part
of toys and childcare
articles
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Dibenzo[a,h]anthracene 0.00005 mass% of the

(CAS # 53-70-3) plastic or rubber part
of toys and childcare
articles
Perfluorooctane sulfonates (PFOS)
(CAS # see Appendix Reference Intentionally added or
Substance List) 1 microgram/m2 of
coated material

Perfluorooctane sulfonates (PFOS)

(CAS # see Appendix Reference Intentionally added or
Substance List) 0.1 mass% of the part
(as the sum of PFOS)

Disodium 4-amino-3-[[4'-[(2,4-
diaminophenyl)azo][1,1'-biphenyl]-
4-yl]azo]-5-hydroxy-6-
(phenylazo)naphthalene-2,7- 0.1 mass% of article
disulphonate (C.I. Direct Black 38)
(CAS # 1937-37-7)

2-ethylhexyl 10-ethyl-4,4-dioctyl-7-
oxo-8-oxa-3,5-dithia-4-
stannatetradecanoate (DOTE) 0.1 mass% of article
(CAS # 15571-58-1)

reaction mass of 2-ethylhexyl 10-

ethyl-4,4-dioctyl-7-oxo-8-oxa-3,5-
dithia-4-stannatetradecanoate and
2-ethylhexyl 10-ethyl-4-[[2-[(2-
ethylhexyl)oxy]-2-oxoethyl]thio]-4- 0.1 mass% of article
octyl-7-oxo-8-oxa-3,5-dithia-4-
stannatetradecanoate (reaction
mass of DOTE and MOTE)

2-(2H-benzotriazol-2-yl)-4,6-
ditertpentylphenol (UV-328) 0.1 mass% of article
(CAS # 25973-55-1)
1,2-benzenedicarboxylic acid, di-
C6-10-alkyl esters; 1,2-
benzenedicarboxylic acid, mixed
decyl and hexyl and octyl diesters
with ≥ 0.3% of dihexyl phthalate 0.1 mass% of article
(EC No. 201-559-5)
(CAS # 68515-51-5,
68648-93-1)

1,3-propanesultone
(CAS # 1120-71-4) 0.1 mass% of article
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2,4-di-tert-butyl-6-(5-
chlorobenzotriazol-2-yl)phenol (UV-
327) 0.1 mass% of article
(CAS # 3864-99-1)
2-(2H-benzotriazol-2-yl)-4-(tert-
butyl)-6-(sec-butyl)phenol (UV-350)
(CAS # 36437-37-3) 0.1 mass% of article

Perfluorononan-1-oic-acid and its

sodium and ammonium salts
(CAS # see Appendix Reference
0.1 mass% of article
Substance List)

Benzo[def]chrysene
(CAS # 50-32-8) 0.1 mass% of article

4,4’-isopropylidenediphenol
(CAS # 80-05-7)
Intentionally added or
0.1 mass% of article

Nonadecafluorodecanoic acid
(PFDA) and its sodium and
ammonium salts 0.1 mass% of article
(CAS # see Appendix Reference
Substance List)
Perfluorohexane-1-sulphonic acid
and its salts
(CAS # see Appendix Reference 0.1 mass% of article
Substance List)
Chrysene
(CAS # 218-01-9; 1719-03-5) 0.1 mass% of article

Benz[a]anthracene
(CAS # 56-55-3; 1718-53-2) 0.1 mass% of article

Cadmium hydroxide
(CAS # 21041-95-2) 0.1 mass% of article

1,6,7,8,9,14,15,16,17,17,18,18-
Dodecachloropentacyclo[12.2.1.16,
9.02,13.05,10]octadeca-7,15-diene
(“Dechlorane Plus”™) 0.1 mass% of article
(CAS # see Appendix Reference
Substance List)

Benzo[ghi]perylene
(CAS # 191-24-2) 0.1 mass% of article

Octamethylcyclotetrasiloxane
(CAS # 556-67-2) 0.1 mass% of article

Decamethylcyclopentasiloxane
(CAS # 541-02-6) 0.1 mass% of article
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Dodecamethylcyclohexasiloxane
(CAS # 540-97-6) 0.1 mass% of article

Disodium octaborate
(CAS # 12008-41-2) 0.1 mass% of article

Terphenyl, hydrogenated
(CAS # 61788-32-7) 0.1 mass% of article

Lead
(CAS # 7439-92-1) 0.1 mass% of article

Dicyclohexyl phthalate
(CAS # 84-61-7) 0.1 mass% of article

2,2-bis(4'-hydroxyphenyl)-4-
methylpentane 0.1 mass% of article
(CAS # 6807-17-6)
Benzo[k]fluoranthene
(CAS # 207-08-9) 0.1 mass% of article

Fluoranthene
(CAS # 206-44-0; 93951-69-0) 0.1 mass% of article

Phenanthrene
(CAS # 85-01-8) 0.1 mass% of article

Pyrene
(CAS # 129-00-0; 1718-52-1) 0.1 mass% of article

Perfluorooctanoic acid and its salts Intentionally added or

(CAS # see Appendix Reference 0.0000025 mass% of
Substance List) PFOA including its
salts in article or
mixture
PFOA-related substances
(CAS # see Appendix Reference Intentionally added or
Substance List) 0.0001 mass% of one
or a combination of
PFOA-related
substances, in article
or mixture

Tris(4-nonylphenyl, branched and

linear) phosphite (TNPP) with ≥
0.1% w/w of 4-nonylphenol,
0.1 mass% of article
branched and linear (4-NP)
(CAS # see Appendix Reference
Substance List)
Tetraboron disodium heptaoxide,
hydrate 0.1 mass% of article
(CAS # 12267-73-1)
Diisohexyl phthalate
0.1 mass% of article
(CAS # 71850-09-4)
Perfluorobutane sulfonic acid
(PFBS) and its salts
0.1 mass% of article
(CAS # see Appendix Reference
Substance List)
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Dibutylbis(pentane-2,4-dionato-
O,O')tin 0.1 mass% of article
(CAS #22673-19-4)
Halogenated Flame Retardants
(CAS # see Appendix Reference Intentionally added
Substance List)

Bis(2-(2-methoxyethoxy)ethyl)ether
(CAS # 143-24-8) 0.1 mass% of article

Dioctyltin dilaurate, stannane,

dioctyl-, bis(coco acyloxy) derivs.,
and any other stannane, dioctyl-,
bis(fatty acyloxy) derivs. wherein
C12 is the predominant carbon 0.1 mass% of article
number of the fatty acyloxy moiety
(CAS # see Appendix Reference
Substance List)

Phenol, Isopropylated Phosphate

(3:1) (PIP (3:1))
(CAS # 68937-41-7) Intentionally added

Cobalt/Cobalt compounds Intentionally added

Neodymium/Neodymium
compounds Intentionally added

4,4'-(1-methylpropylidene)bisphenol
(CAS # 77-40-7) 0.1 mass% of article

PFOA-related compounds
(CAS # see Appendix Reference 0.0001 mass% of one
Substance List) or a combination of
PFOA-related
compounds, in article
or mixture

Medium-chain chlorinated paraffins

(MCCP)
0.1 mass% of article
(CAS # see Appendix Reference
Substance List)
orthoboric acid, sodium salt
(CAS # see Appendix Reference 0.1 mass% of article
Substance List)
6,6'-di-tert-butyl-2,2'-methylenedi-p-
cresol 0.1 mass% of article
(CAS # 119-47-1)
4-Nonylphenol, branched and linear
(CAS # see Appendix Reference
0.1 mass% of article
Substance List)
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C9-C14 PFCAs and their salts

(CAS # see Appendix Reference 0.0000025 mass% for
Substance List) the sum of C9-C14
PFCAs and their salts
in Article or Mixture

C9-C14 PFCA-related substances

0.000026 mass% for
(CAS # see Appendix Reference
the sum of C9-C14
Substance List)
PFCA-related
substances in Article
or Mixture
1,1'-[ethane-1,2-diylbisoxy]bis[2,4,6-
tribromobenzene]
(CAS # 37853-59-1) 0.1 mass% of article

2,2',6,6'-tetrabromo-4,4'-
isopropylidenediphenol 0.1 mass% of article
(CAS # 79-94-7)

4,4'-sulphonyldiphenol
(CAS # 80-09-1) 0.1 mass% of article

Barium diboron tetraoxide

(CAS # 13701-59-2) 0.1 mass% of article

Isobutyl 4-hydroxybenzoate
(CAS # 4247-02-3) 0.1 mass% of article

Melamine
(CAS # 108-78-1) 0.1 mass% of article

reaction mass of 2,2,3,3,5,5,6,6-

octafluoro-4-(1,1,1,2,3,3,3-
heptafluoropropan-2-yl)morpholine
and 2,2,3,3,5,5,6,6-octafluoro-4-
(heptafluoropropyl)morpholine 0.1 mass% of article
(EC number # 473-390-7)

Bis(2-ethylhexyl)
tetrabromophthalate
(CAS # 26040-51-7, CAS # see
Appendix Reference Substance 0.1 mass% of article
List)
 Form No: DOC0078188 (Legacy No: CELQ-033-FORM-27) Rev 20.0
Reference Document No: DOC0078228

Perfluoroheptanoic acid and its

salts
(CAS # 375-85-9,CAS # 20109-59-
5,CAS # 6130-43-4, CAS # 21049-
0.1 mass% of article
36-5,CAS # see Appendix
Reference Substance List)

Per- and poly-fluoroalkyl

substances (PFAS)
(CAS # see Appendix Reference Intentionally added
Substance List)

Criteria 2: For Assessment

Report concentration
Intentionally (PPM) if substance
Substance/ Reporting
Added and/or present in the product
Category Name Threshold
Above Threshold *Indicate “0 ” if not
present.
N/A

Criteria 3: For Information Only

Report concentration
Intentionally (PPM) if substance
Substance/ Reporting
Added and/or present in the product
Category Name Threshold
Above Threshold *Indicate “0 ” if not
present.
Beryllium Oxide
(CAS # 1304-56-9)
0.1 mass%

Brominated flame retardants (other

than PBBs, PBDEs, or HBCDD)
0.09 mass% total
(CAS # see Appendix Reference
bromine content in
Substance List)
laminate
 Form No: DOC0078188 (Legacy No: CELQ-033-FORM-27) Rev 20.0
Reference Document No: DOC0078228

Brominated flame retardants (other

than PBBs, PBDEs, or HBCDD)
(CAS # see Appendix Reference 0.1 mass% of bromine
Substance List) in plastic materials

Chlorinated Flame Retardants

(CFR)
(CAS # see Appendix Reference 0.1 mass% chlorine in
Substance List) plastic materials

Chlorinated Flame Retardants

(CFR)
0.09 mass% total
(CAS # see Appendix Reference
chlorine content in
Substance List)
laminate

APPENDIX

IEC 62474 Declarable Substance List

DeclarableSubstan
ces_vD26.00_2023

IEC 62474 Reference Substance List

ReferenceSubstan
ces_vD26.00_2023