REQUEST FOR PERMIT TO MARK A PRODUCT WITH THE GREEN LABEL

Registered name of manufacturer *

Country *

Number *

Email *

City *

Street *

Fax Number

Name of manager *

Contact person for SII *

Email *

Details of product

Product name *

Details of all models of the product including catalog Number *

Product description *

Is the product or its parts manufactured also at other sites? *

No
Yes

If yes, List the addresses of the additional sites *

Details of main parts of the product, not manufactured by the applicant *

Attached documents describing the product:

Drawings

Attach No file chosen

Product file

Attach No file chosen

Pictures

Attach No file chosen

Justification sheet: What is green in my product - manufacturing process, recycling … (this document is mandatory) *

Attach No file chosen

Catalogs

Attach No file chosen

Standard/specification covering the product

Did the manufacturer previously receive a permit for marking products with the Standards Mark or the Green Label ? *

No
Yes

If yes, what products? *

Is the manufacturer under supervision by The Standards Institution of Israel ? *

No
Yes

If yes, within what framework? *

Did the manufacturer receive an environmental label/approval for the product from a foreign institute ? *

No
Yes

If yes, what institute ? *

Please attach the environmental label/approval for the product

Attach No file chosen

We, the undersigned, hereby request to allow us to place the Green Label on the product described above. We undertake the following:

A. To comply with Israeli Standard SI 14020 - Environmental labels and declarations: General principles.

B. To allow a delegate of the SII Director General to visit the plants and the assembly location of the product, and in other plants producing the product or parts of it or assembling it

C. To permit and assist a delegate of the SII Director General to take samples, without charge, of the product and of the parts and materials used in its manufacture for conducting preliminary tests.

D. Until receipt of the permit from SII, not to publicize in any manner whatsoever that the plant or its products expect to or anticipate being under SII supervision, or are being examined or stand to be examined by them.

E. To assume the expenses related to the handling of this request

Name of applicant *

Date *

Position *

Signature *