CONG TY TNH VIEN TIE C MOT THANH YANG CONG HOA ...

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CONG TY TNH VIEN TIE C MOT THANH YANG CONG HOA XA H01 CHIINGHIA VItT NAM DOc lap - Ty. do - Haub pluic SO:: 126 / t ve Tour Thira :hien hui , ngay 26 thting 10 nom 2019 Ten thuan Dja chi T Ma s6 thu Del dien: Nguai lien Can cir 1.0 Chinh pith quy dj TNHH MOT TH I. Ten ch THONG BAO THUC HltN 1CHUYEN MAI Kinh girt: Seir CONG THUONG TINH THUA THIEN HUE /Man: CONG TY TNHH MQT THANH TIENG VANG g 5. toe nhit SongDo. 62 Plgun Ngoc Thach, Phuimg 6. Quin 3. TP. 11CM 0309171089 Hoartg Thj Trung Dung Chirc vu: them dale : Nge Queoc C6ng - 0917406262 Email:[email protected] t thuong mai, Nghj dinh so /2018/ND-CP ngay 22 thing 5 nam 2018 cita h chi tiet Luat thuong mpi ve heat dOng xec tien thucmq mui, CONG TY NH VIEN TIENG VANG thong bito chuong trinh khuyen mai nhu sau: g trinh khuyen mai: "Co hOi trai nghiem chain sec t6c vii Dove". 2. Dia hin ii rpham khuyen mai: Tinh Thira ThienIiue 3. Ilinh t khuyen mai: - fling co hOi trai nghiem gOi va chain sec tee mien phi khOng thu tien 4. Thiri gia, khuyen mai: Tir ngay 7 /11/2019 - 9 /11/2019 5. Hang ha*, djch vy khuyenmai: Djch vy chain soc tee gOm gOi va say 6. Hang h . djch vy dung de khuyen mai: djch vy chain sec Mc gOm gpi va say bang San pham dau gOi u Dove trj gia I 5,000/Ifin 7. Khich h ng ciia chmmg trinh khuyen mai (deli tutyng dupe huong khuyen mafl: tat ca khach hang th gia mua sam va Main quan trong khu vrc hoot dOng chtrcmg trinh phat mAti this tren dja bim Ti h Thin Thien Hue 8. Ca eau: ng co 9. Tong gii trj hang hest, djch vy dimg de khuyen mpi: 150.000.000d (MOt tram nam mud trieu diing) 10. Ni du chi tiet ctia chircrng trinh khuyen mai: khach hang di mua sam tai chq sieu thj ve cite khu vc Ian can trim dja ban gin turi thuc hien chuang trinh Ichuyen mai se duce tang I co hoi train iem chain sec talc bang cite . san phim dim goi va dau xa cisa Dove trj gia 15,000. Tong so lu nghiem Ming thin sin phitm la 10.000 lum. 11. CONG Y TNHH MQT THANH VIEN TIENG VANG thong Ma den QuY So va cam ket thvc hie dung va hoan toan chju trach nhiem ye chtrong trinh Ichuyen mei tren thco cite qui dinh cua p luat hien hank. DA.1 DI$N THEO PHAP LILO' CUA THUONG NHAN ci r CONG 'I . x Z * 1.. c : HOANG 4.4.'"06.• UNG DUNG

Transcript of CONG TY TNH VIEN TIE C MOT THANH YANG CONG HOA ...

CONG TY TNH VIEN TIE C

MOT THANH YANG

CONG HOA XA H01 CHIINGHIA VItT NAM DOc lap - Ty. do - Haub pluic

SO:: 126 / t ve Tour Thira :hien hui , ngay 26 thting 10 nom 2019

Ten thuan Dja chi T Ma s6 thu Del dien: Nguai lien Can cir 1.0

Chinh pith quy dj TNHH MOT TH

I. Ten ch

THONG BAO THUC HltN 1CHUYEN MAI Kinh girt: Seir CONG THUONG TINH THUA THIEN HUE

/Man: CONG TY TNHH MQT THANH TIENG VANG g 5. toe nhit SongDo. 62 Plgun Ngoc Thach, Phuimg 6. Quin 3. TP. 11CM

0309171089 Hoartg Thj Trung Dung Chirc vu: them dale : Nge Queoc C6ng - 0917406262 Email:[email protected]

t thuong mai, Nghj dinh so /2018/ND-CP ngay 22 thing 5 nam 2018 cita h chi tiet Luat thuong mpi ve heat dOng xec tien thucmq mui, CONG TY NH VIEN TIENG VANG thong bito chuong trinh khuyen mai nhu sau:

g trinh khuyen mai: "Co hOi trai nghiem chain sec t6c vii Dove". 2. Dia hiniirpham khuyen mai: Tinh Thira ThienIiue 3. Ilinh t khuyen mai: -fling co hOi trai nghiem gOi va chain sec tee mien phi

khOng thu tien 4. Thiri gia, khuyen mai: Tir ngay 7 /11/2019 - 9 /11/2019 5. Hang ha*, djch vy khuyenmai: Djch vy chain soc tee gOm gOi va say 6. Hang h . djch vy dung de khuyen mai: djch vy chain sec Mc gOm gpi va say bang

San pham dau gOi u Dove trj gia I 5,000/Ifin 7. Khich h ng ciia chmmg trinh khuyen mai (deli tutyng dupe huong khuyen mafl: tat

ca khach hang th gia mua sam va Main quan trong khu vrc hoot dOng chtrcmg trinh phat mAti this tren dja bim Ti h Thin Thien Hue

8. Ca eau: ng co 9. Tong gii trj hang hest, djch vy dimg de khuyen mpi: 150.000.000d (MOt tram nam

mud trieu diing) 10. Ni du chi tiet ctia chircrng trinh khuyen mai: khach hang di mua sam tai chq

sieu thj ve cite khu vc Ian can trim dja ban gin turi thuc hien chuang trinh Ichuyen mai se duce tang I co hoi train iem chain sec talc bang cite .san phim dim goi va dau xa cisa Dove trj gia 15,000. Tong so lu nghiem Ming thin sin phitm la 10.000 lum.

11. CONG Y TNHH MQT THANH VIEN TIENG VANG thong Ma den QuY So va cam ket thvc hie dung va hoan toan chju trach nhiem ye chtrong trinh Ichuyen mei tren thco cite qui dinh cua p luat hien hank.

DA.1 DI$N THEO PHAP LILO' CUA THUONG NHAN

ci r CONG 'I . x Z

* 1..

c :

HOANG4.4.'"06.•

UNG DUNG

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CQNG HOA XA HQI CHU NGHIA VICT NAM Dec Lap - Tv Do - Hanh Philc

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Horn nay ngly 31/07/2 9, tai Van Phong Ging ty TNHH Qui< Ti Unilever Viet Nam, chang tai gOm ck bin:

Ben iiy quyen: (sau day i hi "bin A") CONG TY TNHH QUOC TE UNILEVER VIET NAM Van phong giao ich: 156 Nguyen Luang Bing, P.Tin Phu Q7, TP HCM Dien thoai: 028- 54135686 Fax: 028 -54135626 Dai dien ben: P Yin Ren Chic vi): Truern nganh hang cham sec toe.

Ben dirge 4 quyen: (sa day pi la -ben B") CONG TY TNHH MOT THANH V1EN TIENG VANG

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2. GiAy Oy quyen co hi4u Itrc tar ngay ky den het ngay 31/10/2019

3. Gily by quyen nay dtroc lap thanh 4 bin bAng Tiing Viet vi co gia tri nhu nhau. M6i bin gi& 02 ban

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A E D U C 0 V O N C M T

H I E N N

PHIEU CONG BO SAN PHAM MY PHAM TIMPLATE FOR NOTIFICATION OF COSMETIC PRODUCT

Danh dau vao 0 d'ich hop (Tick %%here applicable)

THONG TIN SAN PHAM PARTICULARS OF PRODUCT

I. Ten nhan hang 'a en San pham (Name of brand dC product):

1.1. Nhan hang (Brain d )

D 0 V F.

1.2. Ten san Siam (PI% duct Name)

1.3. Danh sack cac (1a ng hoac mall (List of Variants or Shade). Ten (Names)

- KhOng co.

2. Dung san pliant ( P oduct type(s))

PHAN DANH CHO CO OUAN QUAN LY

(FOR OFFICIAL USE)

Ngay nhan (Date acknowledged): 23 -01. 2319

SO ding b& (Product Notification No.):

000415 /19/CBMP-HCM Phieu ciang b6 co via tri 05 nam ke tir ngay nhanir

:IANI DOC LV DICli VII V

Phan) Thi 'Ranh Buyer)

1'

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D Kern, nhU tuong, gel hoac dau dimg tren da (tay, mat, chart, ....) Creams, emulsion lotions. gels and oils for skin (hands, face, feet, etc.)

O Mat no (chi tris • pham lam bong da nguen g6c hoa hoc) Face masks (with e exception of chemical peeling products)

O Cac chit phi rnau long, nhao, bOt) Tinted bases (liqut s: pastes. powders)

O Phin trang diem, hart dung sau khi tarn, kit ye sixth, .... Make-up powders, after-bath powder, hygienic powders. etc.

❑ Xi phong tam, xi hong khir !mai Toilet soaps. deoavrant soaps. etc

0 Nuere hoa, nuerc t crm &mg ye sinh,.... Perfumes, toilet niters and eau de Cologne

O San phitm dung d tam hoac got (mu& xi phong, dau, gel ) Bath or shower p partitions (salts, foams. oils. gels, etc.)

O San phim tay len Depilatories

0 San pham khir m i vi cheing Deodorants and ii-perspirams

O San pliant cham tic Hair care produc s

- NhuOtn ve ay tee Hair tints • d bleaches

- Uon toc, d 61 tic, gin' nip toc Products ar waving, straightening and fixing,

- Cac sin p dinh ding toe Setting pr, ducts,

- San pham m soch (sera, bet, dau got) Cleansing • oducts (lotions, powders. shampoos).

- San pham ung cap chit dish duerng c'no tic (sart, kern, diu), Conditioni g products (lotions, creams, oils),

- Cac sin p too kieu toc (seta, keo xjt tic, sap) Hairdresst g products (lotions, lacquers. brilliantines)

O San pham dung o tau (kern, xi phemg, sera, ) Shaving product creams, foams. lotions. etc.)

O San pham trang tem va thy trang dung cho mat va mat Products for ma ing-up and removing make-up from the face and the eyes

O San pham dimg ho mei Products intend' for application to the lips

O San pliant de c n s6c rang vi mieng Products for ca _of the teeth and the mouth

O San pham dung e cham sic va td diem cho ming ray, ming chin. Products for na care and make-up

O San phiun dung • e v4 sinh co quan sinh due ngoiti Products for ext rnal intimate hygiene

O San pham chin nang Sunbathing pro• vets

O San phAm lam m da ma kiting can thin nang. Products for to ing without sun.

O San pham lam t da Skin whitening roducts

O San pham chin nhan da Anti-wrinkle pr ducts

U N L E V E R V 1 T N A M

5. Ten nhi sin xuAt (Name of manufacturer):

C O N G Y T N H H Q U O C T

5 6 3 6 5 4 1 3 8 4 8 Fax: 8161 6 4 Tel: 5 4 8 5 3 8 II

❑ Sin ptuim khic (di nghj ghi ri5) Others (please spe• 10:

3. Mix dish sir dung mended use) - Dung de gOi du, gi p lam sack Inc

4. Deng trinh bay (Pr duct prescntation(s))

9 Dang don le (Sing) product) ❑ Mot ahem tic ma (A range of colours) ❑ Bang cac mau tron mat clang sin pham (Palette(s) in a range of one product type)

❑ Cac sin pham phoi hop trong mat bt5 sin phim (Combination products in a single kit)

❑ Clic dang khic (de ghi ghi rt5). Others (please specify)

THONG TIN VE NHA SAN XUAT/ BONG c61

nh such rieng neu nhu co nhieu hon mat tong ty tham gia san xuat/ deng

gel de tao ra mat sin phitn loin chink))

I./km-net LARS OF MAM:FACTVRER iSVASSCNIRLERISI

(Please attach i a separate sheet if there are more than one manufacturer/acsembkr)

Dia chi nhi sin xuAt Oguec san xuat) (Address of manufacturer (state country)):

L 6 A 2 - 3 KHU CONG NGH1CP TAY

BAC GO CH I - XA TAN AN HQ'

HUYCN CO CHI - THAN!! PH6 HO

Cat MINH

Country V1CT NAM

6. Ten ding ty d6ng gel (de nghj dinh dau vio mvc thick hop. CO the danh (tau nhieu ban I a

(Name of assembler ( 'lease tick accordingly. May tick more than one box)):

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ri

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C 6 N

Y T N H H Q U C E

U N I L E V E R V

T N A M

Dja chi cUa cling ty deng g6i (Address of assembler (state country)):

L 6 A 2 . 3 KHU CoNG NCH I F.1) TAY

BAC CU CHI - XA TAN AN H01

HUYtN Cl; CHI - THANH P HO HO

C 11 i mINH

Country V I rf NAM

Tel: 8 4 8 54 1 3 5 6 816

Fax: 8 4 8 5 4 I 3 5 6 3 6

THONG TIN Vt TO cHt:rc, CA NHAN CH1U TRACH NH1CM

DUA SAN PRAM Mt PRAM RA TIll TRUING

PARTICULARS OF LOCAL COMPANY RESPONSIBLE FOR PLACING THE COSMETIC PRODUCT IN THE MARKET

7. Ten Ong ty (Name of company):

C O N C. T N H H Q U O C T E

U N I L E V E It V I T N A M

Dja chi ding ty (Address of company):

L 6 A2 3 KHU CONG NCH' CP TAY

BAC Cl) CH I - XA TAN AN HO 1

HUYCN CU CHI - 4HAN H PII 6 HO

CHI MINH

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SQ giay phep kinh do h/ SQ giAy phep float dOng

Business Registratio Number/License to Operate Number

0 3 0 0 7 6 2 1 5 0

THONG T VE NGUtil DAI DIEN THEO PHAP LU4T CUA CONG TY PARTICUL RS OF PERSON REPRESENTING THE LOCAL COMPANY

8. HQ va ten (N of person):

NGUYEN TH1 BICH VAN

Tel :

8 4

8 - 5 4 I 3 5 6 8 6

Email : N g y n t h

b

V a n n V r

Chtic vu a c6ng ty (Designation in the company):

T O N

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THONG TIN VE CONG TY NI-AP KHAU

PARTICULARS OF IMPORTER

9. Ten cOng ty nhap khan/ Name of Importer:

Dja chi cOng Ty nhap khAu/ Address of 'mponer:

Tel:

Fax:

DANH SACH THANH PHAN

PRODUCT INGREDIENT LIST

ra 0 sau day (Please check the following boxes)

ban sia d6i tir phu lye 11 den phu lye VII cua danh muc cac thanh phAn m9

u dugc cong bo tren ban sira d6i gal) day 'that ciia Hiep dinh m9 phAm

ac nhan rang san phim duqc de cap den trong ban cOng bo nay thong china

han bi cam nao va ding man thti vol danh muc han the va cac dieu kien qui

lye.

e latest revisions of the Annexes 11 to VII of the ASEAN Cosmetic Ingredient

d in the latest amendment of the ASEAN Cosmetic Directive and confirmed

'n this notification does not contain any prohibited substances and is in

e restrictions and conditions stipulated in the Annexes.

ach nhiem tra loi va hqp tae toan dien veri ca quan co thAm quyen ve bat ky

t sau khi ban hang khi co yeti eau boi quan co tham quy8n.

nd to and cooperate fully with the regulatory authority with regard to any

rketing activity initiated by the authority.

plan dAy dti (product full ingredient list)

danh sach thanh pluin vã ti le phAn tram cUa nhimg chat co gidi han ve neng

ung trong m9 pham — To submit ingredient list with percentages of restricted

10. De nghi kiem

O Toi da kiem tr

pham ASEAN

ASEAN. Toi xin

bat dr mOt thanh

djnh trong cac ph

I have examined t

Listing as publish

that the product

compliance with t

• TOi dam nhan

host dOng kiem

I undertake to re

subsequent post-

Danh sach thAnh

(Yeti eau ghi day

dO, ham lugng sir

ingredients)

No Ten day ten kho

Full Ing standard

it thanh phan (ten danh phap milk to hoac sir dung hgc chufin da duge &mg nhan)

lent name (use INCI or approved nomenclature in references)

Ti 18 % cua nhirng chat co gieri hart ve ruing de, ham Itiong

I Water

2 Sodium '—aureth Sulfate

.1 Dimethi ;onol

4 Cocamidopropyl Betaine

Perfume

6 Sodium :.hloricle I

7 Glycerin

g Sodium benzoate 0,49952

9 Glycol Distearate

it irt Ins sTVITAGIIrtki

r I, 17 il. .t. i..._.. 1., et, J.,"

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tt- - is paw-. t igrajjp:

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...WP0-. .2 - 44.1..- ,I,Tt., a I, i,._- _ li it. t -AL.!: 1;1_41.ii -LE II 11 -F!...... :a *-. is. .. - -- 1.14-"Jt1112 47. -..1kIla I It. 11,111 V 'II t 11 1111 fl: T ...trtiiitan :tilb III ivi.injuliA:

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1 St 1 I IrrAistril

• .1.m '701 v:

• - _ -- 77.1 tt. r: 77 -: Eh it 4wimqvat. tun it- Ltd

I ..1411 eat I 1,1 _

' • DI I I=I!!' I: : II 1111r. 1.1Y115-11 IV Is

- - rf

4

I

1-t•- tEP P

10 Carbomer

11 TEA-Dodecylbenzenesulionate 0,24

12 Guar Hydroxypropylirimonium Chloride

13 TEA-Sulfate 0,18

14 Mica

15 Citric acid

16 Cocamide MEA

17 PEG-45 1/44

18 Phenoxyethanol 0,06

19 Cyclotetasiloxane

20 Disodium EDTA

21 Titanium dioxide 0.046

22 Silica

23 Butylene Glycol

24 lodopropynyl Butylcarbamate 0,0003

25 Nonfat Dry Milk

26 BHT

27 Trideceti-9

28 PEG-40 Hydrogenated Castor Oil

29 Nelumbo Nucifera Flower Extract

30 Oryza &Elva (Rice) Bran Extract

31 Oryza Sativa (Rice) Germ Oil

32 Lactic a< id

1

0,000005

33 1.2-Hextnediol

34 Caprylyklycol

35 Potassium sorbatc 0,000002

36 Maltodettnn

CAM KET

(DECLARATION)

ng ty, tOi xin cam ket san pham duct da cap trong don °Ong be nay dat duqc ong 'Wong don M9 pham ASEAN va cac phu lye cna no.

n behalf of my company that the product in the notification meets all the ASEAN Cosmetic Directive, its Annexes and Appendices.

cell nhiem tuan thti cac diau khoan sau day (I undertake to abide by the

s):

de cung cap cac thong tin k9 thuat va tinh an town khi ca quan co thim quyen he sa ve cac san pham da dugc pham phoi de bao coo trong truemg hqp san

oduct's technical and safety information is made readily available to the y concerned ("the Authority") and to keep records of the distribution of the

recall purposes;

gay cho ca quan c6 (ham quyen ve cac tac dung phu nghiem trong gay chat tinh mang trio sari phim bang dien thoai, fax, thu dien tic hoc van ban truce iet thong tin.

ity of fatal or life threatening serious adverse event as soon as possible by e transmission, email or in writing, and in any case, no later than 7 calendar wledge;

boo coo tic dung phu cna san pham (then mkt quy dinh) trong yang 8 ngay (hang bao cho co quan co tham quyen ve nhang tac dung phu nghiem trong

we 2ii nOi tren va cung cap bat cir Meng tin nao then yeti eau cna ca quan co

rse Cosmetic Event Report Form within 8 calendar days from the date of my Authority in para 2ii. above, and to provide any other information as may be uthority;

cho ca quan ea tham quyen va cac pilau img phu nghiem trong miring khans c de doa clan tinh mang ctia san pham va trong bat cti twang hop nao, viec

mau bao coo) ve tac dung pint phai duct tion hanh truac 15 ngay ke sir ngthy ng phu nay.

ority of all other serious adverse events that arc not fatal or life threatening as nd in any case, no later than 15 calendar days after first knowledge, using the Event Report Form;

uan co thAm quyen khi co bat cir sir thay dei nao trong ban cong be nay.

y of any change in the particulars submitIted in this notification;

n ring nhang thong tin duqc dtra ra trong ban cOng be nay la dimg sir that. cac thong tin Ilan quan den nei dung cling 1)6 se dqc cung cap va cac tai lieu

phap hoc sao y ban chinh.

I. Thay mat cho. c tat ca cac you cfiu

I hereby declare requirements of th

2. Toi xin chju t following conditio

i. Dam. bao co sariyeu eau va c6 day phAm phai thu hei

Ensure that the regulatory authori products for prod

ii. Phai thong bao ngueti hoc de do . 7 ngay ke. tir ngay

Notify the Autho telephone, facsitn days after first kn

iii. Phai hoan that lam viec ke tir ng nhu da neu trong tham quyen.

Complete the Ad notification to the requested by the

iv. Thong bao nga gay chat ngtrai h bao coo (sir dung biet ye tic dung d

Report to the Aut soon as possible, Adverse Cosmetic

v. Ging be veil ca

Notlfy the Autho

3.Toi xin cam d Tat ca cac tai lieu dinh kern la ban h

a

I declare that the relevance in relati authentic or true c

particulars given in this notification are true, all data, and information of n to the notification have been supplied and that the documents enclosed are pies.

4. Ini hien rang to.'i cis trach nhiem de dam Ivan tit ea cac In can pham con ehung toi dett dap irng cac yeti au phap lupt. va twin OW tat ca tieu chuin va chi tieu san phalli da duce cong 66 veri co quan c<i ilia it qm en.

I understand that I shall he responsible for ensuring that each consignment of my product continues to meet all the legal requirements. and confirms to all the standards and specifications of the product that I have declared to the Authority.

5. 'len hieti rang ming tuning hop co tranh chAp phap luat. ten khong &roc quyen su dung han ding hn chat [um* san ph: m da duo': co quan en than quyen chap nkan neu san phim cua eking tin khong cac yeu cau ve tieu chuan. chi lieu ma chting till da cong hO.

I understand that cannot place reliance on the acceptance of nn product notification In the authority in any I ;gal proceedings concerning in) product. in the inent that in) product has failed to conform o am of the standards or specifications that I had previously declared to the Authority.

762=.

CY COM TY TN1111

OU6C Tt

* UNILEVE st?,: Vlp NAM,

Cyr tet Tuset Anti

lung Phitng Nghien Ctiu & Trien San Phani - Ngarth Ilang tham Sac ti Nhan

Ten A chat kj cua. ngueri dal dien then phap loot cua cling ty

[Name and Signan re of person representing the local compam

Dau cua ding ly I a 011.9 015

Con puny stampl

NO) I Date)

Nhu dil Jinx Anil out is nuts irons tai ii,u haying tem cho a.ic ennit hat. Coll We Ants phy CL yr phani As dclincd in the l in fk Nianual liw 11w Industr) In /kb crse Ft eat Rep ring 411(1nm:tie% l'tatitteht

1,1 I dab has iron': Ishii 111% I irons tin Inning Jan cue eons 1) ca.. Lie aunt rev cua %in Shins mj ph.im %ct inn in prenth• to the t junk: %Low! fir the Inthettr, on %then.: I %cm lit:porting of Co.inetie. Product.

A E v. K E M X 0 V E 0 N C M M T

N H E N

PHIEU CONG BO SAN PHAM MY PHAM TEMPLATE. FOR NOTIFICATION OF COSMETIC PRODUCT

Danh dau Vac) e thick hop (Tick where applicable)

THONG TIN SAN PHAM PARTICULARS OF PRODUCT

I. Fen nhan hang ^a ten San pham (Name of brand & product):

I.I. Nhan hang CB 'and)

D 0 V

1.2. Ten san phim (Product Name)

1.3. Danh such cat dung hoOe matt (List of Variants or Shade). Ten (Names)

Khong co.

2. Dung san phAm Product type(s))

oit

PHAN DANK CHO CO OUAN OUAN

(FOR OFFICIAL USE)

Ngay nkin (Date acknowledged): 23 -01- na

SO thng b6 (Product Notification No.):

000418 /19/CBMP-HCM PhiOu Ong b6 co gia tri 05 Mm ki to ngay nhOn./7

CLAM DOC

VAN LY DICH YU Y

Phan) Tin Thanh Huyen

• tt° • t

,,Y ;I. I : —

144 1,11-11 ill II F.x f.1N r I VIVI

*". 4 j1. r .141, •

:71 ' t. • t ta.41,• II{ — 14

-

if,

41{9 V/ 1

' I I I I tit

stra, gel hoitc clau dung wen da (tay, mot, than, ....) ns. lotions, gels and oils for skin (hands, face. feet, etc.)

phArn lam bong da again gOc boa hoc) the exception of chemical peeling products)

u (16ng, rth3o, bet) ids, pastes, powders) phi!, dung sau khi bOt ve sinh,

s. after-bath powder, hygienic powders, etc. phi:mg khir mui

dorant soaps. etc thorn dimg ve sinh,.... viers and eau de Cologne

tam hoc g6i (mubi, )(a pheing, dim, gel reparations (salts, foams. oils. gels. etc.)

O Kem, nhit Creams, emulsi

❑ Wit n4 (chi nix Face masks (wit

O Cic chat pH Tinted boses i

O Phil', trang die Make-up powde

0 Xi phOng tam, Toilet soaps. de

❑ Nu& hoa, nut5t Perfumes, toilet

O San pham dung Bath or shower

❑ San phAin ray 16 Depilatories

O San phim kha Deodorants an

0 San pham chain Hair care prod

- NhuOm Hair tints

- U6n t6c, Products

-Cacsa»p Setting p

- San pham Cleansin

- San pharn Condition

- Cac san Hairdress

❑ San pham dimg Shaving produc

O San pham trang Products for ma

O San pham thing Products intend

O San pham de ch Products for ca

❑ San pham dung Products for nat

O San pharn dOng Products for ext

O San phim cher% Sunbathing pro

❑ San pham lam Products for tan

O San phim lam t Skin whiteninf

O Sim phim thong Anti-wrinkle pro

ili va chiang anti-perspirants

tee Is tay toc nd bleaches

u6i toe, gift net) tat or waving, straightening and fixing, Am dinh dung toe ducts,

lam such (s6a, het, dAu 86i) roducts (lotions. powders, shampoos),

cung cap chat dinh du6ng cho toe (s6a. kcm. ditu). ng products (lotions, creams, oils),

m too kieu toe (s0a, keo xit toe, sap) ng products (lotions, lacquers, brilliontines) ao tau (kern, xa phong, sitar •••) (creams, foams, lotions, etc.) km va tay trang dimg cho mitt va mat ing-up and removing make-up from the face and the eyes ho mei d for application to the lips m sec rang vs mieng of the teeth and the mouth chain sec va to diem cho mong tay, nit:mg chan.

care and make-up e ve sinh co quart sinh duc ngoai rnal intimate hygiene nAng cis I

m da ma kitting can tarn nAng. ing without sun. ng da oducts nhan da ducts

1 %it . (tur_ 'At I!•]=a Mil; aig-llinurt ankh 4 -4411' 1 I • •• /VIA. -

ff‘ r 1 -.if .111I - ri .!0! C:fr • t

.74-1k cillwr t_ I e.7. /re :It f -= a.: IS Stir thdrilelt

I 010 W4ATCY/Vlict i - •

Dfialakk, 14 faztl 13414:-0-

it It — -4:I • - t._-V

= IU wiEffitfilett it a n:

I Wil7L:-267;

- Le.

:nit.* • • -_4n-st 7. It I I AI ,o(

J.4 1r1 :4: Mr".

rt.', 24 71 4.0 fl •Nerri as' 11 11 id

r r -5 11• Al It tI = :41

fl .N± I II- c:1= I 1101 = I =NV 1 1 c-44 I

51%I•i• "Iri

i ITO Ki= it I T a-. art li.••••=.114

Alta sa • } . 4 .1 yiali

- ...al At va:l.

= I IT- 1 tt i*Zat

I el: Mt' I: ALT .4 46'

Aret le="1.- . _

JI - I a '. me

•4•4 - 4rIrlifirt

T4417 1

11TI1 -• 1.51 • 40 ill "•:: 4 •:

, a .a. .1

-

8 4 8 5 4 1 3 5 6 86 j l

8 4 8 5 4 1 3 5 6 3 6

0 Bong g6i thin cap Etil Bong g6i chin}

Fax: Tel:

6. Ten wing ty &rig ghi (de nghj clanh dAu yao mvc thich hqp. C6 the &nil dau nhieu hen 1 6 (Name of assembler (Please tick accordingly. May tick more than one box)):

❑ San phim khac (d nghj ghi r5) Others (please spe ify):

3. Muc dish sir dung (Intended use) - Kern xa tic giap t • mem intro

4. Dang trinh bay (

uct presentation(s))

• Dang don 16 (Singe product) O Mqt nhom cac ma (A range of colours) O Bang ck mau tro g mot clang sari pham (Palette(s) in a range of one product type) O Cac san phim p hqp trong mot bq san pham (Combination products in a single kit) O Cac ding khac (d nghj ghi n5). Others (please specify)

THONG TIN VE, NIIA SAN XUAT/ HONG Got

(De nghj dinh kern anh sach ding neu nhu c6 nhieu ban mot citing ty tham gia san xuati dens ghi di tao ra in6t san phim hoan chinh)

PARTICULARS OF MAM'FACTURER ISYASSEMBLERIS)

(Please attac in a separate sheet if there arc more than one manufacturer/assembler)

5. Ten nha san xuAt ame of manufacturer):

Dja chi nha san xui,t (Nueic sin xuit) (Address of manufacturer (sta e country)):

L 6 A2-3 KHU CoNG NCHICP TAY

BAC CU CHI -XA TAN AN HOI

HUYCIs CO CHI -THANH PH6 HO

CHI MINH

Country VICT NAM

C 0 N iT

T N H H Q U 6 C T E

U N' I E V E R V I T N A M

Primary assembler

Secondary assembler

C 6 N

T N H H Q U C T t U N L V R V I T N A M

Dja chi ciao Ding ty ding gel (Address of assembler (state country)):

L6 A2-3 KHU C6NG NGHICP TAY

BAC CO CH1-XA TAN AN HOI

HUY$N CO CHI-THANH PH6 H6

CHI MINH

Counry V1CT NAM

Tel: 8 4 8

4 I 3 5 6 8 6

Fax: 8 4 8 5 4 1 3 5 6 3 6

THONG TIN Vt T6 CHtt, CA NHAN CH[1.1 TRACH NIIISM

MIA SAN PRAM MC PRAM RA THT TRUtiNG

PARTICULARS OF LOCAL COMPANY RESPONSIBLE FOR PLACING THE COSMETIC PRODUCT IN THE MARKET

7. Ten c8ng ty (Name of company):

C a N

T

T N H H Q U a C T

U N I LIb V R V I T N A M

Das chi tong ty (Address of company):

L6 A:-3 KHU CONG NGHICP TAY

BAC CO CHI-XA TAN AN HOI

HUYCN CO CH1-THANHIPH6 H6

CHI MINH

4

Tel: Fax: 8 4 - 8 - 5 4 1 3 5 6 8 6 8 4 - 8 - 5 4 1 3 5 6 3 6

S5 silly phep kinh

S6 gu yp p dOnR

Business Registration Number/License to Operate Number

0 3 0 0 7 6 2 1 5 0

THONG TI PARTICUL

' VIE NGU'UI B31 DWI THEO PHAP LUAT CUA CONG TY RS OF PERSON REPRESENTING THE LOCAL COMPANY

8. Ho vi ten (N of person):

N G U

N T H I B I C H V A N

Tel : 8 4 8

Email : N 8 U y

Chirc cong y (

5 4 1 3 5 6 8 6

t h

b

h V a U U I e V

ignation in the company):

T O N

I A M B O C

THONG TIN Vt CONG TY NHAP KHAU

PARTICULARS OF IMPORTER

9. Ten cling ty n p khiu/ Name of Importer:

Dia chi 05 ty nhep khau/ Address of importer:

Tel:

Fax:

DANH SACH THANH PHAN

PRODUCT INGREDIENT LIST

sau day (Please check the following boxes)

n sins dM to phi loc II den phµ lye VII dui danh moc cac thanh phAn my urge cong b6 hen ban sue din gAn day &At ctia Hiep dinh m9 philm

nhan rang san pham duqc de Op den trong ban cong 1,6 nay khOng chin

n bj cam nao va ding tuan thit vtri danh muc hen the ye cac dieu kien qui

10. De nghj kiem tra

0 Toi da kiem tra

phAm ASEAN nhu

ASEAN. Tdi xin x: bat cir mdt tharth ph

dinh trong cac phi I

atest revisions of the Annexes II to VII of the ASEAN Cosmetic Ingredient

in the latest amendment of the ASEAN Cosmetic Directive and confirmed

this notification does not contain any prohibited substances and is in

cstrictions and conditions stipulated in the Annexes.

h nhiem tra len vi hop tat toan then veri ce quan.ch thAm quyen bat ky

sau khi ban hang khi cd yeti eau boi co quan than) quyen.

1 have examined the

Listing as published

that the product in

compliance with the

0 Ten dam nhAn tr .

hoat Ong kiem soat

I undertake to res

subsequent post-n

Danh midi Minh

(Yeu cAu ghi day di ham lucmg sir d

ingredients)

nd to and cooperate fitlly with the regulatory authority with regard to any

keting activity initiated by the authority.

An dAy du (product full ingredient list)

danh sach thanh phAn Nth ti phan tram clia nh&ng chat cd siert han ve n6ng

ng trong m9 pham - To submit ingredient list with percentages of restricted

No TEn day

ten khoa

Full Ingredient

standard

dii thanh phAn (ten danh phap qu6c to hoc sir dung

hoc chuin da &roc tong nhan)

name (use INCI or approved nomenclature in

references)

Ti le % cfra

nhdng chat cid

gitri han ve nting do, ham lacing

I Water

/ Ceteary Alcohol

3 Dimeth4cone

4 GlyceriA

5 Behentrimonium Chloride 0,9583

6 Perfutn; 1

7 Dipropylene Glycol

8 Steararaidopropyl Dirnethylamine

9 Amodirne1hicone

10 Lactic acid 0,108005

11 Sodium c bride

12 Disodium EDTA

13 PEG-7 Propylheptyl Ether

14 Phenoxyexhanol 0,04286

15 Cetrimon um Chloride 0,04286

16 Cyclotetrssiloxane

17 Magnesium Nitrate

18 Methylchloroisothiazolinone 0,000675

19 Magnesium chloride

20 Butylene Glycol

21 Methylisothiazolinone 0,000225

22 Nonfat Dry Milk

23 Trideceds-9

24 PEG-40 Hydrogenated Castor Oil

25 Acetic acid

26 Nelumbo Nucifera Flower Extract

27 Oryza Saliva (Rice) Bran Extract

28 Oryza Sativa (Rice) Germ Oil

29 Sodium benzoate 0,000005

30 1,2-Hexanediol

31 Caprylil Glycol

1 32 Potassium sorbate 0,000002

33 Maltooextrin

C

CAM KET

(DECLARATION)

ty, tai xin cam ket sin pham &roc de cap trong don tong b6 g Huang din My pham ASEAN vi cat phy lyc ctia no.

behalf of my company that the product in the notification SEAN Cosmetic Directive, its Annexes and Appendices.

nhiern man thii cite dieu 'choir) sau day (I undertake to

I. Thay mat cho con; tat ca die you cat, tro

I hereby declare on requirements of the

nay dat throe

meets all the

abide by the 2. îôì xin chju tr

following conditions :

i. Dam bao c6 s8n CI' cung cap cac thong tin k9 thuat va tinh an toin khi ca quan c6 tharn quyen yett tau va c6 day hei so ye cac san pham d8 dirge phan phOi de bao cao trong trutng hryp sin phim Oat thu hoi.

Ensure that the pro uct's technical and safety information is made readily available to the regulatory authority •oncerned ("the Authority") and to keep records of the distribution of the products for product recall purposes;

ii. Phai thOng bdo n nguai hoc de doa t 7 ngay ke tar ngay b'

ay cho ca quan co tham quyen ye cac the citing phy nghiem trong gay chet h mang cua san pham bang dien thoai, fax, thu dien to hoc van ban twee t thOng tin.

Notify the Authorit of fatal or life threatening serious adverse event as soon as possible by telephone, facsimile transmission, email or in writing, and in any case, no later than 7 calendar days after first kno ledge;

iii. Phii hoin tharth o cao tac dyng phy elm san phiim (theo mitt quy dinh) trong yang 8 ngay lam viec ke tar ngay thong bao cho co quan c6 thim quyen ve nhCing the dyng phy nghiem trong filar di neu trong c 2ii not Tin va cung cap bat cu thOng tin nao theo yeti cat cOa co quan eel 'ham quyen.

Complete the Adve sc Cosmetic Event Report Form within 8 calendar days from the date of my notification to the uthority in para 2ii. above, and to provide any other information as may be requested by the A thority-,

iv. Thong boo ngay cho co quan c6 tham quyen ve cac phan Ung phy nghiem trong nhung khong gay chet ngtrai ho: de doa den tinh mang cua sin pharn va trong bat sir twang hap nit). viec bito cao (sir dyng iu bao cao) ye tac dyng phy phai duce tien hanh tnn' 15 ngay ke tic ngay biet ve tac dyng dy g phy nay.

Report to the Auth soon as possible, a Adverse Cosmetic

rity of all other serious adverse events that arc not fatal or life threatening as in any case, no later than 15 calendar days after first knowledge, using the

vent Report Form;

v. °Ong b6 veri cc uan c6 ttuim quyen khi c6 bat cu sy thay d6i nao trong ban tong b6 nay.

Notify the Authori y of any change in the particulars submitted in this notification;

3..Tei xin cam do rang nhang thong tin dirge duo ra trong ban cling ti6 nay la dimg sy that. Tat ea et Ili lieu, de thong tin lien quan den mai dung ding bo sf dqc cung cap va cac tai lieu dinh kern la bin hi • phip hoac sao y ban chink

declare that the relevance in relati authentic or true c

particulars given in this notification are true, all data, and information of n to the notification have been supplied and that the documents enclosed are pies.

4. *Pi hieu rang toi cc

ting cac yeu cau pha veri co quan en !ham

I understand that 1 continues to meet all of the product that I

5. Tai hieu rang iron ding bO chat luong chung toi khong dot

I understand that I authority in any leg failed to conlbrin to Authority.

co !retch nhiem de dam ban tat ca die 14 snit pham cila chung toi den dap

lust. va wan thti tat ea tieu chuan vi chi tieu san phalli a duce cong bo

ven.

hall be responsible for ensuring that each consignment of my product legal requirements. and conforms to all the standards and specifications

e declared to the Authority.

truimg hop co tranh chap 014 luat. toi khans duce quyen su dung ban

n pham da throe CO quan co tharn quyen chap Man nett san ph5m cua

uot: cite yeu e tieu chuan. chi tieu ma chung till da ding bO.

innot place reliance on the acceptance of my product notification by the I proceedings concerning my product. in the event that my product has iny of the standards or specitications that I had pre% iously declared to the

1) sooN32 ts

CONG Tr T10414

01.16C TE

UNILEVE *

WitAftuytt A g Phong N • hien t'iru & Phil Tritn Sian Phim — Nginh King Chint Sec Nhan

Ten sa cher ky cua ruin dai ditn the° phap luat cua cling t)

IName and Signalu • of person representing the local conipan>

I( i(Al 405

Ngity iDatt: I

DAti cua cong ty

[Company stampl

dr

' Nhu Ja duo.: Anh tli:linett in the (1

I i I ruth hiq Kong ph" Sit:t (lin in %ripcntls

ti.i n1 rang urine In lily hinti: San k-jc cOng t, hat tic Jong pho um till' Stain m5 pltisn

IJc Nlitno.11 few the Intlwast \ kit am: I crit K.:porting oittosnicti.A Protluot pi; I Kong hoinv clto Gie Sing him clio tin' dung ply kna ,an pliant mj phiim

I to thr " the indu`ii, lsi Ad et's: IA col Kellortille Ct'mnetiCs rn411•1 •

A A D F. 0 D U I V B I V T N G N Q U

A N V V N

11) 0 V F

1.2. Ten san pham 'mtluct Name)

1.3. Danh sach cac ding hoAc mau (List of Variants or Shade). 'Ten (Names)

- khiing co.

2. Hang san Pham Product type(s))

PHAN DAM-I CHO CO OUAN QUAN LY

t FOR OFFICIAL USE)

NgA nhan (Date acknowledged): 1 3 -01- 2513

SS cong tx% (Product Notification No.):

0 0 4 1 71191CBMP-HCM Phieu cong b.& có gni Id OS nam ke tit nga> nhan.fr

ei64wciim DOC

G 'iN DICH VI; V *I SO

Y T

Thanh Huyen

- Nhuom vi Hair tints a

- thin tOc, d Products f

- Cie ski Setting pr

- Sin phim Cleansing

- Sin phim Conditions

- Cic sin Hairdressi

❑ Sin phim dung Shaving product

O Sin phim trang Products for ma

❑ Sin phim &mg Products intend

❑ Sin phim dE c Products for car

O Sin phim clang Products for nai

O Sin phim dung Products for ext

❑ Sin phim chOn Sunbathing Jiro

❑ Sin phim lim Products for to

❑ Sin phim lim t Skin whitening l roducts

❑ Sin pan chOn nhin da And-wrinkle pr acts

r waving, straightening and fixing, m dinh dung toe ucts,

I: such (sGa, IDOL diu g0i) roducts (lotions. powders, shampoos). ung cap chit dinh throng cho toe (saa, kern, diu), g products (lotions, creams, oils).

tao kiEu tec (sir& keo xit toe, sip) g products (lotions, lacquers. brilliantines)

rim (kern, xi phang, creams, foams, lotions, etc) sent vi thy trang climg cho mat vi mat 'ng-up and removing make-up from the face and the eyes ho mei for application to the lips sac rang vi mi4g

of the teeth and the mouth chlim sec vi to diim cho mang lay, riving chin.

care and make-up sinh co quan sinh duc agoai

real intimate hygiene nang

ucts 1

m da nta khong cAn tam nang. ing without sun.

g da

y t6c d bleaches i toc, giG nEp toe

❑ Kern, nhO tucmg, s , gel hoc diu dUng tem da (tay. m$t, chin, • • •.) Creams, emulsions lotions, gels and oils for skin (hands, face, feet, etc.)

❑ MAt n4 (chi trir sin pan lam bong da nguem gac hoi hoc) Face masks (with I e exception of chemical peeling products)

❑ Cic chit phi] mitt long, nhio, bOt) Tinted bases Chilli s. pastes, powders)

❑ Pluin trang diem, phin dung sau khi tam, bOt v' sinh, Make-up powders, after-bath powder, hygienic powders, etc.

❑ xi phonic tam, xa thong Toilet soaps, deod rant soaps, etc

❑ Nu& hoa, nuac t dung vet sinh Perfumes, toilet 14, ters and eau de Cologne

❑ Sin phim clUng d tam hoc gOi (muoi, xi phang, diu, gel,....) Bath or shower pr parations (salts, foams, oils. gels, etc.)

❑ Sin phim tay Ion Depilatories

❑ Sin phim khir rn' vi thong Deodorants and a ti-perspirants

O Sin pan chim c t6c Hair care produc

❑ San pham khAc (de Others (please spe

ghi rd)

3. AK dich sir dung ntended use) - Dimg de gOi au, g p lint such tot

4. Dang trinh bay (Pr duct presentation(s))

Pi Dang don le (Sing product) Mn❑ O nhom cat ma (A range of colours)

❑ Bang cac inau tro mOt dang san pham (Palette(s) in a range of one product type) ❑ Cac sin pham phe hop trong in(//t 130 sari pham (Combination products in a single kit) ❑ Cac dang khac ( nghj ghi it). Others (please specify)

THONG TIN VE NHA SAN XUAT/DONG COI

(De nghi dinh kern •anh sach rieng neu nhu co nhieu ban mot cling ty them gia san xuat/ &mg

goi de tao ra inOt san phani hoin chinh)

PART1Ctil ARS OF MANI:FACIA, RER (SWASSEMBIALS)

(Please attach n a separate sheet if there are more than one manufacturer/assembler)

5. Ten nha sin xuAt Name of manufacturer):

C 0 N T TN H H Q U 0 C T t

I U N L EV E V T N A M

Dia chi nha sin xua (Nuoe sin xuet) (Address of manufacturer (sta e country))

L 6 A2-3 KHU CONG NGHICP TAY

BAC CU CHI -XA TAN AN HOI

HUYEN CU CHI -THANH PH6 H 0

CHI MINH

Country V IET NAM

I Fax:

6. Ten cOng ty &mg gel (de nghj danh dau vao muc thich hop. CO the ditch dau nhieu hon I (Name of assembler (Please tick accordingly. May tick more than one box)):

• Deng goi chinh ❑ DOng goi thir cap

Tel: 8 4 8 5 4 I 3 6 8 6 8 4 8 5 4 1 3 5 6 3 6

Primary assembler Secondary assembler

C 0 N G

Y T N H H Q U 6 C T E

U N I L E V E

V I C T N A M

Dia chi ca a cling ty deng gOi (Address of assembler (state country)):

L 6 A2 - 3 KHU CONG NCH! EP TAY

BAC CU CHI - XA TAN AN HO I

HUYEN CU CH I - THANH PHO HO

CHI MINH

County VIET NAM

Tel: 4 8

4 1 3 5 6 8 6

Fax: 8 4 8 S 4 1 3 5 6 3 6

THONG TIN VE TO CHCC, CA NHAN Clip) TRACH NHIEM

DUA SAN PRAM Mf PRAM RA THj TRUONG

PARTICULARS OF LOCAL COMPANY RESPONSIBLE FOR PLACING THE COSMETIC PRODUCT IN THE MARKET

7. Ten cong ty (Name of company):

C 6 N

T

T N H H Q U 6 C T

U N I L V E

V I C T N A M

Dja chi ding ty (Address of company):

LO A;- 3 KHU CONG NGHIEP TAY

BAC CO CHI- XA TAN AN HOI

HUYEN CID CHI -THIANH PH 6 u6

CHI MINH

Tel: Fax: 8 4 - 8 - 514 1 3 5 6 8 6 8 4 - 8 - 5 4 1 3 5 6 3 6

SS gthy phip kinh d gully phep hoat Ong

Business Registratio4 Number/License to Operate Number

0 3 0 0 7 6 2 1 5 0

THONG TI VE NOUN DAI DIEN THEO PHAP LUAT CUA CONG TY PARTICULARS OF PERSON REPRESENTING THE LOCAL COMPANY

8. ha vi ten (N

of person):

NGUYEN TH ri RICH VAN

Tel :

8 4

8

5 4 1 3 5 6 8 6

Email : N g y n

t h

b

h V a n r

Chi= vu 6 ding y (Designation in the company):

6 N

I A M 1:1 6 C

THONG TIN VE CONG TY NHAP KHAU

PARTICULARS OF IMPORTER

9. Ten Ong ty nhgp khAu/ Name of Importer:

Dja chi tong ty nhAp khAu/ Address of importer:

Tel:

Fax: ri

DANH SACH THANH PHAN

PRODUCT INGREDIENT LIST

10. Di nghi kiem tra sau day (Please check the following boxes)

Tai da kiem tra n stilt &Si to phv lye 11 den phv lye VII ctia danh mix cac thanh phin mq phalli ASEAN nhu uqc cong be tren bin site del gin day 'that cue Hiep dinh my* pham

ASEAN. Tai xin xa nh4n rang san pham ducfc de cap den trong ban cling be nay khdng china

bat met thanh p n bj cam nao va aing min thti yr:7i danh mvc hen the va cac dieu kiln qui

djnh trong cac phv I c.

I have examined the test revisions of the Annexes II to VII of the ASEAN Cosmetic Ingredient

Listing as published in the latest amendment of the ASEAN Cosmetic Directive and confirmed

that the product in this notification does not contain any prohibited substances and is in

compliance with the restrictions and conditions stipulated in the Annexes.

EZ! Tin dam nhirt tr h nhiem tra kri va hqp tic coin dien yen co quan co ttuim quyen ve bAt kY 1 boat deng kiem soa sau khi ban hang khi cc) you cau bei co quan co them quyen.

I undertake to re nd to and cooperate fully with the regulatory authority with regard to any

subsequent post-ma keting activity initiated by the authority.

Danh sach thinh in day dti (product full ingredient list)

(You cau ghi day d danh sach thanh phin va ti le phan tram cna nhang chAt co gieri hart ve neng

de, ham broil sir d ng trong tn9 phAin - To submit ingredient list with percentages of restricted

ingredients)

No Tin diy du thanh

chuan da throe cors

Full Ingredient name

references)

phan (tin danh phap quOc to hoac sir dung ten khoa hoc nhon)

(use INCI or approved nomenclature in standard

Ti le % dm nhirng chit co OM hen ve

neng de, ham lucrng

1 Water

2 Sodium Laureth Sulfate

3 Dirnethiconol

4 Cocamidopropyl Betaine

5 Sodium chloride

I 6 Perfume I

7 Glycerin

g Sodium benzoate 0,499525

9 Carbomcr

10 Glycol Distcarate

II TEA-Dodecylbenzesesulfonate 0,24

12 Guar Hydroxypropy1trimonium Chloride

13 TEA-Sulfate 0,18

14 Mica

15 Citric acid

16 Cocamide MEA

17 PEG-45M

I8 Phenoxyethanol 0,06

19 Cyclotetrasiloxane

20 Disodium EDTA

21 Titanium dioxide 0,046

22 Silica

23 lodopropynylButylcarbarnate 0,0003

24 Echinacea Purpurea Extract

25 Camellia Sinensis Leaf Extract

26 BHT

27 Lactic acid 0,000009

28 Potassium sorbate 0,000004

1: Thay mat cho con tat ca cac you tau tro

I hereby declare on requirements of the

2. TOi xin chju tra following conditions

i. Dam boo cei san yeu tau va c6 day d' pliant phai thu

Ensure that the pro regulatory authority products for product

ii. Phai th6ng boo n nguei hoac de doa t 7 ngay Ice tit ngay bi

Notify the Authorit telephone, facsimile days after first know

iii. Phai hoan thanh lam viec ke to ngay nhu da ncu trong mg than.' quyen.

Complete the Adver notification to the A requested by the Aut

iv. Th6ng bag ngay gay chat aginai Ileac bag coo (ski dung m biet ye tae dung dun

Report to the Author soon as possible, an Adverse Cosmetic E

v. ang b6 voi ca qu

CAM KET (DECLARATION)

ty, tai xin cam ket san pham dugc de cap trong don ding be nay dat dirge g Huang clAn My pham ASEAN va cac pltu lye dui no.

behalf of my company that the product in the notification meets all the SEAN Cosmetic Directive, its Annexes and Appendices.

nhiem Man thit cac dieu khoan sau day (I undertake to abide by the

cung cap cac thong tin k? thuat va tinh an town khi co quan co them quyen ho so ye cac salt pham a dirge phan phai de boo coo trong truang hgp san

uct's technical and safety information is made readily available to the oncerned ("the Authority") and to keep records of the distribution of the ccall purposes;

y cho ca quan co them quyen vc cac the dung phy nghiem trong gay chef h mang cith san phalli bang dien thoai, fax, thu dien tir hoac van ban truerc t thong tin.

of fatal or life threatening serious adverse event as soon as possible by ransmission, email or in writing, and in any case, no later than 7 calendar dge;

'o coo the dung phu coa san phial (thco mAu quy djnh) trong \Peng 8 ngay Ong boo cho ca quan ce tham quyon ve nheng the dung Om nghiem trong 2ii not tren va cung cap bAt ca thong till nag then y'eu eau cna ca quan co

Cosmetic Event Report Form within 8 calendar days from the date of my thority in para 2ii. above, and to provide any other information as may be ority;

o ca quan co than quyen ve cac phan Ung phy nghiem gong nhung khOing de doa den Mill mang cua san pham va trong bat cu trutmg hap nix), viec u &to coo) ye the dung phu phai dirge tien hanh truerc 15 ngay ko to ngay phti nay.

ty of all other serious adverse events that are not fatal or life threatening as in any case, no later than 15 calendar days after first knowledge, using the ent Report Form;

n ce them quyen khi co bat cu sir thay dei nao trong ban cong be nay.

Notify the Authority

3..T6i xin cam doan Tat ca cac tai lieu, dinh kern la ban hap

I declare that the p relevance in relation authentic or true cop

f any change in the particulars submitted in this notification:

rind nhung thong tin dirge Qua ra trong ban c6ng be nay dung sir that. c thOng tin lien quan den nei dung cOng be se dot cung cap va cac tai lieu hap hoac sao y ban chink.

rticulars given in this notification arc true, all data, and information of o the notification have been supplied and that the documents enclosed arc s.

I Compa ny stamp)

4. T6i hieu ding tOi ft eh trzich nhiem do dam bno t:it col cae 16 san pham elm chfing tOi dett dap ling cac yeu cau pha, luat. tuan th0 tat ca tieu chuan va chi tieu san pham di duce cong be yen ca quan co tham quyen.

I understand that I shall be responsible for ensuring that each consignment of my product continues to meet all the legal requirements. and conforms to all the standards and specifications of the product that I have declared to the Authority.

5. T6i hieu ring trorig timing hap co tranh chap phap lust. toi.khong duce quyen six dung ban ding b6 chat Itrang ban pham da dace ca quan co tham quyen chap nhan nett san pham cua chting tOi khong duce ale yeti eau ve lieu chuan. chi tieu ma cluing toi di ding 116.

I understand that I ainnot place reliance on the acceptance of my product notification by the authority in any leg; I proceedings concerning my product. in the event that my product has failed to conform to my of the standards or specifications that I had previously declared to the Authority.

-50.01

LONG Tr TNHH

OLI6C TE

UNILEVE VItt NAN/1

Th,

yit A

trrlg Pheng NgPien Cat & Phut Men San Phiim — Nginh Fling Chain S6c CA Shan

Ten vit chi ky cua ngtrai dai din theo phap lust nth cong ty

I Name and Signature of person representing the local company

15

Diiu cua ding ty .1f lcul ticA

Ngay I Datel

I Mu( da dove dint' nghia rang trong tat 14;y huOng ditut chat c;ic cUng 1) C kill {.110 tic dung phu cuu san pham 1115 plum As defined in (iui&k 41anual for the Industr% on Ad% crsc l'Acnt Repining COSInetiCS PrIXIINAS

12) trinh 114 trong phi lw I trong huithtg dan chat talc fling ti hap cao Lie dyng phy cua san pham tn( ph.im Sct out in Appcndix Ito he Guide Manual lir the Industry on A4terse )lien Rcporting of taunt:tic. Producis

A -I 1-

•I II r. - H 4 1 • 1: II 4t 1:4I _1I4 It ..' 'II , Ti

T VT II It I I /111.1=1 ligDol I_

• II . 14

-14 a-

¶1

I

I -I I

ALiller, • a-.

41•1

- -4 1-4 1, -• 4 -4-

{ •

N Lt DICH VII

x E A K E M D 0 V B Q U V T N N

)1,1 A C V CI N

PHIEU LONG BO SAN PHAM Mt PHAM T :MPLATE FOR NOTIFICATION OF COSMETIC PRODUCT

IMnh deu sic) 6 i kh km (Tick where applicable)

0 V E

1.2. Ten san phem (Iinx1uct Name)

1.3. Danh sach cat: ditty hoc mati (List of Variants or Shade). Ten (Names)

- KIM~ng cu.

2. D?ng san phini(product pe( s))

oy

PHAN DANH CHO CO OUAN OUAN IS

(FOR OFFICIAL USE)

Navy nhin (Date acknowledged): 23 -01- 2313

Se tong be (Product Notification No.):

0°0416 /19/CBMP-HCM Phieu tong be co gia trj 05 nem ke Us ngity nhon.Ar

IA NI D6C

Pham l hi Thant' 11u4 ii

gel hoac dlu dimg wen da (Lay, mit, chin, ....) lotions, gels and oils for skin (hands, face, feet. etc.) phArn lam bong da ngu6n wot hod hpc) e exception of chemical peeling products) long, nhio, WO s, pastes, powders)

n dung sau khi tarn, bat ve sinh, fier-bath powder, hygienic powders, etc hong kha mai,..... rant soaps, etc in dung ye sinh,....

ters and eau de Cologne tiim hoac gPi (man, xi phong, dau, gel ) 'orations (salts, foams. oils. gels, etc.)

O Kern, nhil Creams, emulsion

El Mit nu (chi tra sa Face masks (with

O Cac chit pha mats Tinted bases giqui

❑ Phan trang di8m, Make-up powders.

O Xi phong tam, xi Toilet soaps, deod

O NuOp hoa, nut t Perfumes. toilet H .

O Sin phim dung de Bath or shower pr .

❑ Sin pham lay ;Ong Depilatories

❑ Sin phim khir mu Deodorants and a

El Sin phAnn cham Hair care product

- Nhuom vit t Hair tints a

- Lon t6c, d Products fo

- Cac sin phi Setting pro

- Sin phain la Cleansing p

- Sin phArn c Conditionin

- Cac sin phii Hairdressin

ID San pham dung c Shaving product (

O Sin pham trang di Productts for mak

O San phim thing c Product? intended

O Sin pham de char Products for care

❑ Sin pham dung de Products for nail c

❑ Sin pham clang de Products for extert

O Sin pharn thong Sunbathing produ

O Sin phim lam sun Products for Lanni

❑ Sin pham lam Ira Skin whitening pro

❑ Sin pham thong n Anti-wrinkle prods

vi ch6ng mai. ti-perspirants

tOe

y 16c bleaches

i t6c, gia nip toc Having, straightening and fixing. OM dung t6c

icts, such (sera, bOt, dsu gOi)

ducts (lotions, powders, shampoos). ng cap chat dinh cluerng cho t6c (sera. kern, diu), products. (lotions, creams, oils).

ion kieu teic (sera, keo xjt Mc, sap) products (lotions, lacquers. brilliamines) riu (kern, xa phong, saa )

cams, foams. lotions, etc.) m va thy trang clUng cho mit vi mit -up and removing make-up from the face and the eyes mei

or application to the lips sot rang vi mieng the teeth and the mouth ham sac vi to diem cho mong Lay, ',tong chin. re and make-up ye sinh co quan sinh dye ngoai al intimate hygiene ng 3 da ma khang can tam ring. g without sun

da ucts n da

is

❑ San pham khric (d= nghj ghi re') Others (please spe ify) .

3. Mac Bich Su dung Intended use) - Kern xi ter &up t mem muot

4. Dana trinh bay (Pr duct presentation(s))

63 Dung don le (Sing product) ❑ Mat Mont cite Ma (A range of colours) ❑ Bang cat mAu tron mat clang san phim (Palette(s) in a range of one product type) ❑ Cie sin pliant phe hop trong mot Ix) san phim (Combination products in a single kit) ❑ Cie ding khac (de i ghj ghi re). Others (please specify)

THONG TIN VE NHA SAN XUAT/ BONG GOI

(De nghj dinh kern nh sach rieng nen nhu co nhieu hon mat cong ty than, gia san xuat/ dung

goi de tao ra mot sin pham hoAn chinh)

da

PARTICI. LARS OF MANI FACTURER (SFASSE‘IBLERIS)

(Please attach i T a separate sheet if there are more than one manufacturer/assembler)

5. Ten nha site xuat (Name of manufacturer):

C 6 N N H H Q 6 C T t

U N I L E V E R V I T N A M

Dia chi nha san xuat (Nude san xuat) (Address of manufacturer (state country)):

L6 A2 . 3 KIIU CONG NGHIP TAY

BAC CU CHI - Xit TAN AN HOI

HUYEN CI1 CH I - THANH PH A HO

cHt MINH

Country V I ET NAM

ITel: Fax: 8 4 - 8 - 5 4 I 3 5 6 8 6 8 4 - ti - 5 4 1 3 5 6 3 6

6. Ten cong ty clang ei (de nghj dinh cau vao muc thich hap. Co the dAnh dau nhieu hen 1 a

(Name of assembler ('lease tick accordingly. May tick more than one box)):

El Deng &di chinh ❑ Deng gee this cap

C

U

6

N

N

I E1V

T N

V

H

I

H Q U

N

6

A

C

M

T E

L E T

G T

Primary assembler

Secondary assembler

C 0 N

Y T N H H Q U 6 C T E

U N I L E E

V I T N A M

Dia chi cue cat* ty dong g6i (Address of assembler (state country)):

L' 0 A2 3 KHU CONG NGH I ell TAY

BAC CO CHI - XA TAN AN HO I

HUYeN CO CHI - THANH PH 6 /10

C H 1 M NH

Country VIST NAM

8 4 - 8 - 5 4 I 3 5 6 3 6

THONG TIN VETO CHUC, CA NHAN CH 1U TRACE NHIeM

DU'A SAN PHAM Mt PHAM RA TF11 TRUtNG

PARTICULARS OF LOCAL COMPANY RESPONSIBLE FOR PLACING THE COSMETIC PRODUCT IN THE MARKET

7. Ten tong ty (Name of company):

Dja chi Gong ty (Addams of company):

L 0 A2 . 3 KHU CoNG NGH ISP TAY

BAc CO CBI - xA TAN AN HOT

HU1/SN C U CHI - THANH PH 6 ri6 I

CHI MINH

Tel: 8 4 8 54 1 3 5 6 8 6

Fax:

.3

- t OW

a _ .,1 41. . P

i'r ft; ?AI A • .4 1 ti

T — -

A a • ;WI*. :hit •

-=- -r-•••••-.- ja a -,•••

• . ::--- t- . • • i • -

I t7 itto Its

-

'LI I

14-1

II I)

t t•

• lir

• II

-tPqmoir

-a_

1.1iI,I1 .44 1.7 )p.. A :pt •

sz Iv

: wzr4:74f,-! r.-•Tyn- 1 "2

# IA ty rt ft :t if .. I " !.I Frit ti I r .a: ..ti - t a TherAH. .--,--- . . ---., • • ••

, ',1-4y0-• ,, , vii , t• * r 01, 10 il : •ili) z.-11: • ; L c , 1

I- .."•• a 4:

i l tal

1

0im

I; Ai. . rilicriT't 4l- iiifit Tri, , - '.1 1 112711:

_ WI- tit : it ti 11

4

• -It 1

':ht.O.if:?, 144.1 /-•1: !./.,ttfr I ti

s aff 4 !ttt n I 1 int. ! oil ,"e• ,-...t..tti

'1•111 Ea' is' ittn4- rn-Trt • 40,in. I II rarer

• /4!,/ Eli r1 1. i,". .11.1ii"),

;it lit I • :frit it ;:-: sr-

4.): 1ST' t'S • -

L. . I I ! _• -1...rr . .1 — •!1 I 7 _

Tel: 8 4 8 5 4 1 3 5 6 86

Fax: 8 4 8 5 4 1 3 5 6 3 6

S6 giay phep kinh do nh/ S6 giay phep boat d6ng

Business Registration Number/License to Operate Number

0 3 0 0 7 6 2 I 5 0

THONG TIN VE NGU'ol HAI DIEN THEO PHAP LUAT COA CONG TY PARTICULARS OF PERSON REPRESENTING THE LOCAL COMPANY

8. Hp va ten (Name of person):

NGUYEN THI B ICH VAN

Tel :

8 4

8

5 4 I 3 5 6 8 6

Email : N g y e n t h b h V a n I- n e r oh

Chire vV a cong ty (Designation in the company):

T O N

C I A M

C

THONG TIN Vt CONG TY NHAP KHAU

PARTICULARS OF IMPORTER

9. Ten ding ty nhap khau/ Name of Importer:

Dia chi cong ty nhip khau/ Address of importer:

Tel:

Fax:

DANH SACH THANH PHAN

PRODUCT INGREDIENT LIST

sau day (Please check the following boxes)

n sira dbi tir phi' lye Il din phi' lye VII cita danh moo cAc thanh phan m9

•trgc b6 tren ban sira dei gAn day nhit cua lliep dinh m9 phAm

nhAn ring san phAm dtroc de cap den trong ban cong b6 nay khong chua

n bj cam nao va cOng win thii yen danh myc han chi va clic dieu kien qui

10. De nghj kiem tra

0 T6i dA kiem tra • phim ASEAN nhu

ASEAN. Toi xin xa bAt co. rnOt thenh ph

dinh trong cac phi' I

1 have examined the test revisions of the Annexes II to VII of the ASEAN Cosmetic Ingredient

Listing as published n the latest amendment of the ASEAN Cosmetic Directive and confirmed

that the product in this notification does not contain any prohibited substances and is in

compliance with the testrictions and conditions stipulated in the Annexes.

0 Toi darn nhan traclh nhiein tra 16i va hop tAc wan dien voi co quan co !ham quyen ve bat ky

boat ding kiem soAt khi ban hang khi co yeu tau boi co quan co tham quyen.

I undertake to respo d to and cooperate fully with the regulatory authority with regard to any

subsequent post-mar eting activity initiated by the authority.

Danh seat thenh p n day du (product full ingredient list)

(Yeu eau ghi day du anh sich thanh phan va ti le phan tram cut' nhang chat co glen han ve nOng

dO, him luqng sir do g trong in9 pham - To submit ingredient list with percentages of restricted

ingredients)

No Ten dAy du thanh phAn chuan da throe ding

Full Ingredient name references)

(ten danh phAp qu6c to hoc sir citing ten khoa hoc nh4in)

(use INCI or approved nomenclature in standard

Ti .le % ciia nhOng chit co gieri han vi

neing d6, ham Itamg

I Water

2 Cetearyl Alcohol

3 Dimethiconc

4 Glycerin

5 13elicntrimonium Ch

I

oridc 0.9583

6 Perfume I

7 Dipropylene Glycol

8 Stearamidopropyl Dirnethylamine

9 Amodimethicone

10 Lactic acid 0,108009

11 Sodium chloride

12 Disodium EDTA

13 Cetrimonium Chloride 0,04286

14 Phenoxyethanol 0,04286

15 PEG-7 Propylheptyl Ether

16 Cyclotetrasiloxane

17 Magnesium Nitrate

18 Methylchloroisothiazolinone 0,000675

19 Magnesium chloride

20 Methylisothiazolinoae 0,000225

21 Echinacea Purpurea Extract

22 Camellia Sinensis Leaf Extract

23 Acetic acid

24 Sodium benzoate 0,00001

25 Potassium sorbate 0,000004

CAM ICET (DECLARATION)

ty, teri xin cam ket san phim duqc de cap trong don tong b6 nay dat duce g Huang 4k My pham ASEAN vi etc phy lye cita n6.

half of my company that the product in the notification meets all the SEAN Cosmetic Directive, its Annexes and Appendices.

nhiem twin thu cat dieu khoan sau day (1 undertake to abide by the

cung ca clic (tieing tin k9 thuat vi tinh an man kin ca quan co them quyen h6 so ve cac sin pliant da duqc phrin ph6i de brio trio trong truemg hop sin

uct's technical and safety information is made readily available to the oncerned ("the Authority") and to keep records of the distribution of the

11 purposes;

y cho co quart co than quyen ve cue tic dyng phy nghiem trong gay chat h mang dui san phial bang dien thoai, fa; thu dien tic hok van ban truer th6ng tin.

of fatal or life threatening serious adverse event as soon as possible by • ismission, email or in writing. and in any case, no later than 7 calendar

dge:

o cao tic dyng php cita san pham (thco nuiu quy dinh) trong yang 8 ngtty Ong brio cho as quan co tham quyen ve !Mang lac dyng phu nghiem trong 2ii not tren vet cung cap bat dr thong tin nito then yeu can cur as quan c6

Cosmetic Event Report Form within 8 calendar days from the date of my hority in pan 2ii. above. and to provide any other information as may be rity;

co quart ce them quyen ve cac [Alin king phy nghiem twits nhung khong e doa den tinh mpg cirri san pham vi trong bit dr truing hop it, vise brio cao) ye the dyng phy phai duqc lien Ninth truck 15 ngay ke tir ngity

phy nay.

y of all other serious adverse events that are not fatal or life threatening as in any case, no later than 15 calendar days after first knowledge, using the nt Report Form;

ca Thant quyen khi oft bat dr sy thay d61 it trong bin tong b6 nay.

f any change in the particulars submitted in this notification;

ng nhang Mani tin durqc dua ra trong ban clang be nay,li dUng sir that. thong tin lien quan den noi dung tong bo se doe cung cap va cac tai lieu

hap ho .e sao y ban chinh.

iculars given in this notification are true, all data, and information of the notification have been supplied and that the documents enclosed arc

s.

I. Thay mat cho er5 tat ca cat yeu eau tro

I hereby declare on requirements of the

2. Toi xin chju trac following conditions

i. Dian bao ce sin de yet? cau N/A c6 day do pham phai thu heti.

Ensure that the pro regulatory authority products for product

ii. Pluit thong brio ngtren hoac de doa t

ngity Ice fir ngity b

Notify the Authority telephone, facsimile days after first knowl

iii. Phai hoin thank lam viec ke tir ngay t nhu da nau !song my them quyin.

Complete the Adver notification to the A requested by the Aut

iv. Thong brio ngay c gay chat nguOi hoac Kim cao (sir dyng ma Met ye tac dyng dung

Report to the Authori soon as possible, and Adverse Cosmetic E

v.Congbovoicoq

Notify the Authority

3.,T6i xin cam doan Tat ca care tai lieu, ca dinh kern la ban hop

I declare that the relevance in relation authentic or true copi

4. Tdi hien ring tni sol eh trach nhicm de dam ban tat ea dc to pham era chfing titi deti dap (mg et yeu phap lu,4t. va wan thu tat ca tieu chuan va chi lieu san pham dii duct cong ha veri co quan ce tham en.

I understand that I dull be responsible for ensuring that each consignment of my product continues to meet all he legal requirements, and conforms to all the standards and specifications of the product that I lute declared to the Authority.

5. Tai hieu rang tron truing hop cO tranh chap phap lust. tot khans duo*: quyen su dung ban (tong hi) chat lutmg Tan pham dii durrc co quan co tham quyen chap nhan neu san Siam cua chung tdi khang dat dluyv cac yeu du ye lieu chuan. chi tieu ma cluing ten dii cuing hd.

I understand that I c‘nrxit place reliance on the acceptance of my product notification by the authority in any lega proceedings concerning my product. in the event that my product has failed to conform to any of the standards or specifications that I had previously declared to the Authority.

5007,213 O CONG

TNH01.16C TE

co /4

es•UNILEVE

VliT NANA/ firlTuytt Ant twang Pilling Nglion Ctiu & Phit Trion San Phtum — Nginh Hang Chant Sac Ca Nhin

Ten va c cua nett iii dai dien then phap luat cua cong ty

if person representing the local company I

Name a nd Signature

Uaucua et:mg ty

f (lei I iN/c try

ICtimpany StamPI Ngay Patel

01 Nhu da Juch: LIO111 nghla r4 rang ming tai lieu liming Lean dine:ie. cans t5 ‘e hitt tat hie Jog pity SAM sat pham m5 pltirn A. defined in Me t itlitk: Manual for the InJustrz on ALI% etsc h cm IC:11min%! ufCO.rnctic. Phtlutts

(:1 Frith ha, thong phy hie I trong tai lieu luring Jan chit vac cong ty is hao can Jyng ply cvu Ian plitim nt5 pham Set out in .%pplahli% 1 to ( ittiLle Manual for the !naval-5 on .NJLersc I .cut Reporting of Cosmetics Ikidticis

It •T TI

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II I III 1.* 11

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PHAN DANN CHO CO QUAN OUAN LY

(FOR OFFICIAL USE)

Ngay nhon (Date acknowledged): 2,3 -C2- 2319

S6 tong bti (Product Notification No.):

000592 /19/CBMP-HCM Phieu cong be, co gial tri 05 niim ke lir ngay nhantv

Phirm Thi Thanh Huyen

A A 0 M K E X 0 E P C V V 0 N S N

H D T N N N

D 0 V E

1.2. Ten san pham (Fri/duct Name)

1.3. Danh sach cat darw hoar mini (List of Variants or Shade). Ten (Names)

- Khong co.

2. Dang san pham (Product t) pe(s))

PHIEU CONG BO SAN PHAM Mf PHAM TEMPLATE FOR NOTIFICATION OF COSMETIC PRODUCT

Danh dau vao o thi h kip (Tick where applicable)

THONG TIN SAN PHAM PARTICULARS OF PRODUCT

I. 'Fen nhan hang %a ten San pham (Name of brand & product ):

1.1. Nhan hang (Brand)

(Ci

gel ho*c din clang tren da (tay, mat, than, ....) otions, gels and oils for skin (hands, face, feet, etc.) hAm lam bong da nguen got hoa hoc) exception of chemical peeling products) ng, nhao, bOt) pastes, powders) n clang sau khi tam, bet vg sinh, ter-bath powder, hygienic powders, etc Ong khir mni ant soaps, etc n dung vg sinh,.... rs and eau de Cologne rn hoac gel (muei, xa pheng, dAu, gel,....) rations (salts, foams, oils. gels, etc.)

O Kern, nhil twang, s Creams, emulsions,

O Mat na (chi trir san Face masks (with th

O Cac chat pith mau ( I Tinted bases (liquid.

O Phan trang diem, ph Make-up powders,

O XA pining tam, xa p Toilet soaps, deodo

O Nu& boa, nuarc tho Perfumes, toilet wet

O San phim dung de t Bath or showy pre

O San phial lay long Depilatories

O San phAm klth mai Na thong Si. .Deodorants. and antperspirapus

RI San phAm cham secoc Hair care products.

- Nhuem va to /fair tints an

- Len tec, duOi Products for

- Cite sin pham SettinQprodu

- San pham la Cleansing pro

- San pham cu Conditioning

- Cac san pham Hairdressing

O San phim clUng cao Shaving product (Cr

O San pham trang diet Products for makin

O San pham dimg cho Products intended f

O San pham de cham Products for care .o

O San pham dung di c Productts for nail ea

O San pham dimg de v Products for extern.

O San pham chong na Sunbathing product

O San pham lam sam Products for tannin

O San phfim lam trang Skin whitening prod: cis

O San pham chting da Anti-wrinkle produc

9,

C

toc bleaches 6c, giq nap toc vying straightening and fixing. dinh clang toe

such (Om, bet, dau gei) acts (lotions, powders, shampoos), cap chAt dinh &rang cho the (sib, kern, dAu),

roducts (lotions. creams, oils). too kieu the (sea, keo xjt tee, sap) roducts (lotions. lacquers, brilliantine.$)

u (kern, xis phOng, sire ) ams, looms, lotions, etc.) va thy trang &mg cho not va mat

up and removing make-up from the face and the eyes i

application to the lips c rang va mieng he teeth and the mouth

m sot va td diem cho rneng tay, mong chin. and make-up sinh co quan sinh dye ngoai intimate hygiene

ma khong can tam nang. without sun. a

❑ San pham khac (de ghi ghi r6) Others (please speci

3. Miric dich sir dung (1 tended use) - Kern xi toe &tip toe em mug/

4. Dang trinh bay (Pro uct presentation(s))

Dang don le (Single ❑ M6t nhom clic mau ❑ Bang cac mau trong ❑ Cac san pham phOi ❑ Cac dang khic (de n

roduct) range of colours)

lot clang san pham (Palette(s) in a range of one product type) trong mot bo san pham (Combination products in a single kit)

hj ghi r6). Others (please specify)

HONG TIN YE NHA SAN XUAT/ BONG GO!

(Da nghj dinh kern dash sach rieng neu nhu co nhieu hon mot ding ty tham gia san xuat/ dung

gei do tao ra mot san phalli !loan chinh)

PARTICULARS OF ALMIFACTLIRER (SPASSEAI SUM(S)

(Please attach in a separate sheet if there are more than one manufactureriassembler)

5. Tan nha san xuat (Name of manufacturer):

C 0 N G N H H Q U 6 C T E

U N L E V E R V I T N A M

Dja chi nha san xuA (Ivnntrc san xuat) (Address of manufacturer (state country)):

L 6 A2 -3 KHU CONG NGH I CP TAY

BAC CI) CHI - XA TAN AN H6I

HUYCN CU CHI - THANH PH6 H6

CHI MI 'llH

Country VICT NAM

Tel: Fax: 8 4 - 8 - 5 4 1 3 5 6 8 6 1

8 4 -1 8 5 4 1 3 5 6 3 6

6. Ten cong ty dong g i (de nghj danh that' vac, muc thick hop. CO the &nil dau nhieu hon I 6

(Name of assembler (Please tick accordingly. May tick more than one box)):

Dong go' chinh ❑ Deng goi thir cap

tan ki melmisittguiib' ,i3•••

11/204 le

4TII ‘4 47 mrA' 4 'Oil

I.

•Ls !a— :In 4. 4 r: I An'll;11-.

A: •

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r : pipit f

LI NH loll - LIM . :Thal "../

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• • - 101:4 ea 11, L'1•:‘ 11173-4 .11

I Tr y 1 41 81 P i•ti • — • 1 4 t 4

I •

Tel: 8 4 8 5 I 3 5 6 8 61 I Fax: 8 4 8 5 4 I 3 5 6 3 6

C

U

6

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C

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T Y

V E

T

R

N

V I

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t

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L 6 A2 - 3 KHU CONG NCH I CP TAY

BAC et CHI_xA TAN AN Ho!

IIUYCN CU CH I - THANH PH6 /16

CHI

Country

MINH

V I CT N A M

THONG TIN VE TO CHUG, CA NHAN CHIU TRACH NHICM

DUA SAN PHAM MY PHAM RA THI TRIT6NG

PARTICULARS OF LOCAL COMPANY RESPONSIBLE FOR PLACING THE COSMETIC PRODUCT IN THE MARKET

7. Tan tong ty (Nam of company):

Dja chi ding ty (Address of comps

L 6 A 2 - 3 KHU CONG NCH! CP TAY

BAC CU CHI - XA TAN AN 1101

HUYCN CU CH I - THANH PEI 6 Rd

CHI MINH

Primary assembler

Secondary assembler

C 6 N

T N H H Q 6 C T E

U N I L E Vr R

V I T N A M

Dja chi dm ding ty dong goi (Address of assembler (slate country)):

), 1

V.9171: _Lfr

:1/741 I "$it-74 _

• rte. ji I if

`•:: }fit, • ' inIrlitss.c•;•; ftal/tins*

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This s c:`1 P14-1 # 2M, 't IV( e`tri

ill, :hit 41 in sIt'sfal 'Mist (Or •451 •!i1 .1/ tai t I 'it 'I

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8 4 - 8 - 5 4 1 3 5 6 3 6

S6 giAy phep kinh doa S6 giAy phdp hoat ding

Business Registration umber/License to Operate Number

0 3 0 0 7 6 2 1 5 0

THONG TIN VE DAI DIEN THEO PHAP LUAT CUA CONG TY PARTICULA OF PERSON REPRESENTING THE LOCAL COMPANY

8. I-19 va ten (Name f person):

NGUYEN 'HI BICH VAN

Tel :

8 4

8

5 4 1 3 5 6 8 6 I

Email : N g y e n t h

b

h V a n n e r oh

Chirc vv v tong y (Designation in the company):

T 6 N

I A M D 6 C

THONG TIN vf; CONG TY NHAP KHAU

PARTICULARS OF IMPORTER

9. Ten ding ty nhAp IchAu/ Name of Importer:

Dia chi tong ty nhAp khau/ Address of importer:

Tel: Fax:

Tel: III Fax:

9.;: ii:;' -iffrt, -1:1- 11 • •_,t f

• ••

•Motql - it, is - It.r[tits: t

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etti. ) 1:14. I :-.9 t t.1:117 Afititt 4.) t< i't)Z 11 %"` r rx• -twin r sle •,:kriStu $ 51 - • id!•1.1q -it1 kw

aCt —it,•.4,4.61;7•11 1

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10. De nghi kiem tra 6

DANH SACH THANH PHAN

PRODUCT INGREDIENT LIST

sau day (Please check the following boxes)

El Toi da kiem tra barn sire d6i tin phy lye II den phy lyc VII cite danh myc cac thanh phan my

phim ASEAN nhu dtroc cling 66 tren ban sira d6i gar) day nhAt cua Iliep dish my pham

ASEAN. T6i xin xac nhan rang san phAm &roc dA cap den trong ban cling b6 nay khOng china bat cu mot thanh phal bi cam nao va ding wan thu voi danh !nye hen the va cac dieu kien qui dinh trong cac phy lyc

I have examined the I. est revisions of the Annexes II to VII of the ASEAN Cosmetic Ingredient Listing as published i the latest amendment of the ASEAN Cosmetic Directive and confirmed that the product in t is notification does not contain any prohibited substances and is in compliance with the r trictions and conditions stipulated in the Annexes.

El Toi dam nhan tree nhiem tra lei va hop tae loan dien viii ca quan c6 thAm quy6n ).4 bat ks, khi ban hang khi c6 you du bin ca quan co thArn quyen.

I undertake to respon, to and cooperate fully with the regulatory authority with regard to any

subsequent post-mark ing activity initiated by the authority.

Danh sach thinh ph diy del (product full ingredient list)

(You du ghi day dud:111) sach thanh phAn va ti Ic phan tram caa nh&ng chat cd giai hen ve nAng dO, ham *mg sir chin trong my pham — To submit ingredient list with percentages of restricted

ingredients)

No Ten dAy du thanh ten khoa hoc cl

Full Ingredient

standard references)

phan (ten danh phap qu6c to hoc sir dkmg

uAn &I dupe cOng nhan)

name (use INCI or approved nomenclature in

Ti le % caa nhang chat

cO gi&i hen ve n8ng do. ham lacrng

1 Water

2 Cctcaryl Alcohol

i i, D methicone

4 Glycerin

5 Behentrimoniatn Chloride Ill 1214' 12 0.9583

}6 6 Perfume Perfume

7 Dipropylene Gbcol

8 Stearatnidopropyl Dimethylamine

host deng kiAin soar • C

.4

9 Amodimethicoae

10 Lactic acid IQ ,/,44 0,108013

11 Sodium chloride

12 Disodium EDTA

13 Cetrimonium Chloride i /La .0 ii) - 4

0,02143

14 Phenoxyethanol /.

0,02143

15 PEG-7 Propylheptyl Ether

16 Magnesium Nitrate

17 Cyclotetrasiloxhne

18 Methylchloroisothiazolinone :// it 3 D i 6-1, 4 CZ, 0,000675

19 Magnesium chbride

20 Propylene glycol

21 Methylisothiazolinone li Alb 0 /1"5-2

0,000225

22 Lavandula Angustifolia (Lavender) Flower Extract

23 Rosmarinus Officinalis (Rosemary) Leaf Extract

24 Acetic acid

25 Sodium benzoate vl 1 4,4 Z,rg 0.00001

26 Glucose

27 Potassium sorbete VI MI Ct. ble‘ 2 0,000004

4

V-

1: Thay mat cho cling tat ca cac yeti cau Iron

I hereby declare on requirements of the A

2. TOi xin chju trach following conditions):

i. Darn bao c6 sin de yeu eau va co day dit pham phai thu h6i.

Ensure that the prod regulatory authority c products for product r

ii. Phai thOng bzio nga nguoi hoac de dog tin 7 ngay ke tit ngay Net

Notify the Authority telephone, facsimile t days after first knowk

ct's technical and safety information is made readily available to the ncerned ("the Authority") and to keep records of the distribution of the all purposes;

cho ca quan c6 them quyen ye cac tac dung phv nghiem trong gay chat mang cim san pham bang dien thoai, fax, thu dien tit hoac van ban twat hang tin.

f fatal or life threatening serious adverse event as soon as possible by nsmission, email or in writing, and in any case, no later than 7 calendar ge;

cao tac dung phy dm san philm (theo mau quy djnh) trong yang 8 ngay ng bao cho ea quan co them quyen ye n11E-mg tac thing )rho nghiem trong

2ii not trCn vA cung cap bat cir thong tin nao theo yeu cau cua ca quan c6

Cosmetic Event Report Form within 8 calendar days from the date of my ority in para 2ii. above, and_to provide any other information as may be rity;

ca quan co them quyen ye cac pilau frng pho nghiem trong nhung khong e doe den tinh mang dm san pham va trong bat cir muting hop nao, viec bao cao) ye tAc dung phv phai dupe tion hanh truck 15 ngay ke tir ngay

nay.

of all other serious adverse events that are not fatal or life threatening as n any case, no later than 15 calendar days after first knowledge, using the nt Report Form;

co them quyen khi cb bat cir sir thay dei nao trong ban ding b6 nay.

any change in the particulars submitted in this notification:

ng nhang timing tin duos dua ra trong ban ding b6 nay, M dung sir that. thong tin lion quan den n6i dung cong b3 see doe cung cap vA cac tai lieu Ai) hoac sao y ban chinh.

CAM KET (DECLARATION)

y, t6i xin cam ket san pham duce de cap trong don cong b6 nay dal duct HuOmg dAn my pham ASEAN va cac phi Ipe curt no.

half of my company that the product in the notification meets all the EAN Cosmetic Directive, its Annexes and Appendices.

nhiem twin thu cac dieu khoan sau day (I undertake to abide by the

ng cap de thOng tin k9 thuat va tinh an town khi ca quan co them quyen • sa ve cac san pham da dirge phan phoi de bao cao trong truemg hop san

iii. Phai hoan thAnh lam viec ke tit ngay nhu da neu trong mvc than) quyen.

Complete the Adver notification to the Au requested by the Auth

iv. Thong bao ngay c gay chat nguiti holle bao car) (sir dung mil bier ve Mc dung dung

Report to the Authorit soon as possible, and Adverse Cosmetic Ev

v. Cong bo v6i ca q

Notify the Authority

3. Toi xin cam doan "At ca cac tai lieu, ca dinh ken, la ban hop

I declare that the iculars given in this notification are true, all data, and information of relevance in relation tp the notification have been supplied and that the documents enclosed arc authentic or true copi

4. Teti hieu rAng tin se :6 trach nhiem de dam bao tat ca cac to san pham cisa chime tin deu dap ting cac yeu cAu phap uat. va twin thti tat ca tieu chuan Ira chi tieu san pham da duce Ong b5 veri co quan co tham quyen.

I understand that I shall be responsible for ensuring that each consignment of my product continues to meet all the legal requirements. and conforms to all the standards and specifications of the product that I ha t declared to the Authority.

5. .1.01 ItiOu rang trong twang hop ce tranh chap phap lust. ten khong doge qufin sU dung ban cOng bit chat Itrong phain da duce co quan co tham quyen chap 'than net san pham cua thong ten khong dat dtmc cac yet' cau ye tieu chuan. chi tieu ma chang tOi da cong 66.

I understand that I cat not place reliance on the acceptance of my product 'unification by the authority in any legal proceedings concerning my product. in the event that my product has failed to conform to at y of the standards or specifications that I had previously declared to the Authority.

't. "i .50:176215-7,'

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VIET 1 Tuyet Anh N. trng Phimg Ngh en Cull & Phil Trien Sin Pliant — Nglinh Ding ('ham Sec Ca Nhan

45.u.2019

Dau dm &mg ty

ICompany stampl Ngay Date

Nhat da JEW.: Jinh ngrutu rrAVa sw Dung Jai tau u kutnig chock cling t, ‘11hio can Lk Amy phi' tut Nan Siam 1115 Phalli ticlilicd in 11w (iuitk %tgnwI rot Irk Intho.tr% Athcrsyl:.‘t.-nt Reporting of Cinnidit... Ptodutis

1=1 trial ha, trim): phy lye I tr rip Lai 14.;u huinlg din chi 4thk: tang i) ce him Gin lac Jan phy cut tan (tint InS phim Set out in .%ppottlitt I to the ( hid.: Manual lot tlw Iffilitstr? an Ad. CiSC Itt:poniny of Commits:. Products

Ten va chin kj tuna ngtr Ti dai dien then phap luat (Ala tong ty

IName and Signature ot person representing the local company I

MM.

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PHAN DANH CHO CO OUAN OUAN LY

(FOR OFFICIAL USE)

Ngay Man (Date acknowledged): 1 i Ma So Ong ho (Product Notification No.):

000613 /19/CBMP-HCM PhiEu cong 134 co gia tfi 05 nam kE ttr ngay nhan.p/

GIANIDEiC

'.AN lat DICII YU Y Tt

Thi Thanh Huyin

PHIEU CONG BO SAN PHAM MY PHAM -EMPLATE FOR NOTIFICATION OF COSMETIC PRODUCT

Danh dau vao hich hgp (Tick where applicable)

THONG TIN SAN PHAM PARTICULARS OF PRODUCT

- ra !than lthng v; ten San phalli (Name or brand & product):

1.1. Nhan hang (Brand)

0 V E

1.2. Ten san pham ( Product Name)

D A U G 0

I) 0 V

V A 0 N P S N

0 N

T

N

N

1.3. Danh such vac t ;mg hoc matt (List of Variants or Shade). .1.tIn (Names)

- KhOng co.

2. Dung san pliant (Product type(s))

O Kem, nha tucmg Creams, emulsi

❑ Mit na (chi tit Face masks (wit

❑ Cic chit phi) Tinted bases (liq

❑ PhAn trang diem Make-up powde

❑ X& pheng tam, Toilet soaps, de

❑ Nutic hoa, ntrac Perfumes, toilet

❑ San phim dung Bath or shower

❑ Sin phim tay lo Depilatories

❑ Sin phim khir Deodorants and

O San phim clam Hair careprodu

- Nhu0m v Hair tints

- UOn t6c, Products

- cac sin p Settingp

• - San pham Cleansing

- San pham Condition

- Cac sin p Hairdress

❑ San pham dung Shaving product

❑ Sin phfun trang Products for ma

❑ Sin pliant dUng Products intends

❑ San pham de ch Products for car

❑ San pham dung Products for nai

❑ Sin pham dung Productts for ext

❑ San pham chO g Sunbathing p

❑ Sin phim lam Products for tan

❑ San phim lim tr Skin whitening p

❑ Sin pham ch8ng Anti-wrinkle pro

is tay toe • nd bleaches 6i toc, girl nip toe

or waving, straightening and fixing, Am dinh clang the ducts, Am sash (sad, 138t, cau g8i) roducts (lotions, powders, shampoos), ung cap chit dinh duang cho toe (sera, kern, din), g products (lotions, creams, oils),

am tao kiitt toc (sera, keo xit toe, sap) g products-(lotions, lacquers, brilliantines) o rau (kem, xa pitting,

(creams. foams. lotions, etc.) tem va tay trang dung cho mat va mat 'ng-up and removing make-up from the face and the eyes ho mei for application to the lips

sec rang va mieng of the teeth and the mouth chant sec va to diem cho mang tay, ming chin.

care and make-up E vg sinh ca quan sinh due ngoai

al intimate hygiene ding cis

da ma kheng can tam wing. ing without sun.

g da oducts nhin da

sera, gel hoac din dung ten da (tay, mat, chin, ....) s, lotions, gels and oils for skin (hands, face, feet, etc.) n pham lim bong da ngu6n gee hod hoc) the exception of chemical peeling products) (king, nhao, bet)

ids, pastes, powders) phin ching sau khi tam, bot 34 sink .... , after-bath powder, hygienic powders, etc. phang khir mUi,..... orant soaps, etc ham dung 34 sinh,....

ters and eau de Cologne e tam hoac (mu6i, )(A phong, ditu, gel, ) reparations (salts, foams, oils. gels, etc.)

g

i va ch6ng mai. mi-perspirams

tee tw

❑ San phitm khac ate nghj ghi ri3) Others (please specify):

3. Niue Bich sir dung (Intended use) - Dung clE goi ilau ging lain midi toe

4. Dang trinh bay (Product presentation(s))

Dang don le (Sirgle product) ❑ Mot nhom cac tnau (A range of colours) ❑ Bang cac mau tiling mot clang sen pham (Palette(s) in a range of one product type) ❑ Ciic san pham phoi hap trong trot bo san pham (Combination products in a single kit) ❑ Cac dang khac (tie nghj ghi it). Others (please specify)

THONG TIN VE NHA SAN XUAT/ BONG G61

nghj dinh kern danh sach rieng neu nhu co nhieu hon mot tong ty tham gia san xuk' (long

gat de trio ra mot san pham hoar chinh)

PARTICI, LARS OF WANT FACTIAER myAssEm sLER(s)

(Please attach in a separate sheet if there are more than one manufacturer/assembler)

5. Ten nha sal xuAt (Name of manufacturer :

C 6 N G T

T N H H Q

C T E

U N L EV E Ft V I T N A M

Dia chi nha san xuat•(Nuoc san xuAt) (Address of manufacturer (state country)):

L

A

3 K H U C N

N H

T A Y

B A C C U C H

X A T A N A N H Q I

H U

N C

C H

T H A N H P H

H

CH i f M I N H

Country

V

T N A M

8 4 - 8 - 5 4 1 3 5 6 3 6

6. Ten tong ty doing goi (de nghj danh dau vao muc thick hqp. CO the danh dau nhieu han 1 6 (Name of assembler (Please tick accordingly. May tick more than one box)):

El Bong goi chinh ❑ Dong gOi thin cap

Tel: 8 4 8 5 4 1 3 5$ 6 81 6

Fax:

Primary assembler

Secondary assembler

C N

T

T N H H Q U 6 C T

U N I L E V E R V I T N A M

Dja chi mkt song ty clang goi (Address of assembler (state country)):

L 6 A 2- 3 KHU CONG NGHIP TAY

BAC CO CHI - XA TAN AN HOI

HUYeNt CO CHI - THANH PHO HO

CHI IVIINH

Country VleT N A M

Tel: 13. 4 8 5 4 I 3 5 8 6

Fax: 8 4 8 5 4 I 3 5 6 3 6

THONG. TIN VETO CHU'C, CA KHAN CH1U TRACH NHICM

DUA SAN PHAM Mt PRAM RA THf TRUONG

PARTICULARS OF LOCAL COMPANY RESPONSIBLE FOR PLACING THE COSMETIC PRODUCT IN THE MARKET

7. Ten tong ty (Name of company):

C 6 N

T

T N H H Q U 6 C T

U N I L E V E R V I T N A M

Dja chi ding ty (Address of company):

L 6 A2 - 3 KHU C6NG NGH I CP TAY

BAC CO CHI - XA TAN AN H01

HUY$7,1? CU CHI -THINH PH6 HO

CHI NiINH

Jr-1'4;1'14 r IT-7-;7;11%61711 ill

I I I J.,t ett. 1 7 EfittlittYlitall

' • • '

#T71fr 7., it. I -4'1211 111.1:4 2111!

1

T i 1.1 int? 2 Ete 7 ..—P—t•

I I I

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'11 a It_ r )1 0 1

ni

e 4 Allitti

-.....—...„--„ t ta:s •A : r :at); I

F

Ifcilitivr 74,1 ell fp./ • V -It I CI: 1:i • ai 1 11,•t:S$4-1-

in • ditt 0 1,5..0 rift e-jie 1 PI

t: -t 1.1,141 q.ttrli:.711114triT- I .? mt. r:1 Id) Alt r.4-1-1117 MI LI sm>. 114 1. I': r rtIt11PF tz • .11 *.et s' 1 •

Am-

It

• # " /. # I -ji'r•1it .1

1

; :1 I r t• Tr 4

2:72-, -.4 .4: ti LiA:l

► 1 1 . i i --..

/ I It 1 1 'LI !I iSLI i A I 1:71( I t I 4 :11 rikt"). s

_ I ___,—.— -,0

I iv ti' 'I 1 ! di . / I ? - 0:, • 7i17—; r4-'1 . ). 13/E117 1 L .

---.— — .. . - ==.4 ;tint 0;11 'I 0 e :i :.¶4 1 1 _ I A

-I ; I .II >1. 1 1,1714 • • 1 • II I j 1

II 1 L

II IM

- ti'l liltI _ _

Tel: Fax: 8 4 - 8 - 5 4 I 3 5 6 8'6 8 4 8 5 4 1 3 5 6 3 6

S8 giiy phep kinh oanh/ s8 giAy phep hoot Ong

Business Rcgistrat n Number/License to Operate Number

0 3 0 0 7 6 2 I 5 0

THONG IN Vt NGUE11 DAI DICK THEO PHAP LUAT CUA LONG TY PARTICU ARS OF PERSON REPRESENTING THE LOCAL COMPANY

8. I IQ Va ten (Na of person):

NGUYEN TIM BiCH VAN

Tel : 8 4

8

5 4

3 5 6 8 6

Email : N g y e n

t h

b

h V a n V e r

Chirc IN b c8ng ty (Designation in the company):

T 6 N Ga4

G A M D 6 C

THONG TIN Vt CONG TY NHAP KHAU

PARTICULARS OF IMPORTER

9. Ten cong ty nhjp khiu/ Name of Importer:

Dia cSti cong ty nhop kh.itt/ Address of imponer:

Tel:

Fax:

t • .1 • 13

r

1

:fit' ' • ' I t • e , 1) :.)* t i Zit .• oitr !/: f; 1.1171' si / • 73;9 IA •i; • r 1 7 .0:L7_1f I1 Iii:'(

E .;

♦ 1 T t

It if Is ii .1 s: i r Si,orte i;

I

: If I

IF1' I 4' 'I • r # . 1

71#

r

t

DANH SACH THANH PHAN

PRODUCT INGREDIENT LIST

o sau day (Please check the following boxes)

n sira del to phu We. II den pint Iuc VII cita danh muc cac thanh phan m9 dupe ding be trail ban sCm d6i gAn day nhAt cua Iliep djnh m9 phain

c nhan rang san phAm dupe de cap den trong ban tong b6 nay khong china an bi cam nao va ding tuan thin veri danh mut; han the va cac dieu kien qui µc.

latest revisions of the Annexes II to VII of the ASEAN Cosmetic Ingredient in the latest amendment of the ASEAN Cosmetic Directive and confirmed this notification does not contain any prohibited substances and is in

restrictions and conditions stipulated in the Annexes.

ich abler') tra I&i va hgp the roan dien yeti co quan j, .cO them quyen ve bat k sau khi ban hang khi co yeu cau beri co quan c6 them quyin.

nd to and cooperate fully with the regulatory authority with regard to any rketing activity initiated by the authority.

bin day du (product full ingredient list)

daub sach thanh pilau va ti le phAn tram cUa nhi-mg chat co gieri hart ve n6ng wig trong m9 pham — To submit ingredient list with percentages of restricted

10. De nghj kiem tt

Teli diS kiem tra phAm ASEAN nht ASEAN. TOi xin x

bat cir met thinh p djnh trong cac

have examined th Listing as publishe that the product i compliance with th

Tai dam nhan t horn CIOng kietrrsa

undertake to rest subsequent post-m

Danh sick think

(Yeu cau ghi day do, ham lucmg sir

ingredients)

• •

fl

No Tin day de

ten khoa hoc

Full Ingreti

in standard

thanh phAn (ten danh phial:, qu6c to hoc sir dung chain da duce Ong nhan)

ient name (use INCI or approved nomenclature

references)

Ti le % ciia ntang chAt có giOi han ve nOng do,

ham luqng

1 Water

2 Sodium Laureth Sulfate

3 Sodium c Joride

4 Cocamidoxopyl Betaine

5 Glycerin

i 6 Dimethiconol 1

7 Perfume

8 Sodium *mate 0,500027

9 TEA-Dode4ylbenzenesulfonate 0,48

10 Citric acid

11 Guar Hydraxypropyltrimonium Chloride

12 Laureth-23

13 Cyclotetrasiloxant

14 Disodium garn

15 Cyclopentasiloxarte

16 Phenoxyethanol 0,016

17 Propylene glycol

18 (odopropyt yl Butylcarbamate 0,000192

19 Lavandula Angustifolia (Lavender) Flower Extract

20 Rosmarinu 6 Officinalis (Rosemary) Leaf Extract

21 I.actic acid' 0,000013

22 Glucose

23 . , Potassium sorbate , - 0.000004

C_-- irS"

I hereby declare o behalf of my company that the product in the notification meets all the requirements of t ASEAN Cosmetic Directive, its Annexes and Appendices.

2. Tel xin chju t h nhiem wan this the dieu khosin sau day (I undertake to abide by the following conditio s)-

i. Dam Ma co sin e cung cap cac thong tin k5' thuat ta tinh an wan khi co quan co than quyen yen eau va co day it he) so ve cac san pham da duoc phan phoi de Mo cao trong truing hop san pham phai thu Mi.

I. Thay mat cho c di ea cat: yeti eau

CAM KILT (DECLARATION)

g ty. tOi xin cam ket sin pham dune de cop trong don ding b6 nay dot duyc ng Huang ciln my pham ASEAN vh cac phu Inc ciia no.

Ensure that the regulatory authori products for produ

ii. Phil thong km nguiri hooc de dop 7 ngay ke tir ngay

uct's technical and safety information is made readily available to the concerned ("the Authority") and to keep records of the distribution of the

t recall purposes:

gay cho co quan co than (men ve cac tic dung php nghiem ;Ring gay chet tinh mang cua san pham bang dien thoai. fax. thu dien to hoac van ban tnnic iet thong tin.

Notify the Autho ty of fatal or life threatening serious adverse event as soon as possible by telephone. facsimi e transmission. email or in writing. and in any case. no later than 7 calendar days after first k iedge:

iii. Phai honn tha ban cao tile thing phy cua san phtim (theo mau quy dinh) trong yang 8 ngay lam viec ke tir ng thong bao cho co quan co tham quyen ye nhOng tac dung phu nghiem !rung nhu da neu trong tic 2ii not iron ve cung cap bat cu thong tin nao theo you eau ciia co quan co

• ;ham quyen.

Complete the Ad% erse Cosmetic Event Report Form within 8 calendar days from the date or my notification to the Authority in para 2ii. above. and to provide any other information as ma) be requested by the uthority:

iv. Thong bao ng gay chet ngtrai ix bat) cao (sir dung biet ye tiic dung d

Report to the Aut soon as possible. Adverse Cosmet'

• cho co quan c6 !ham quyen ve cac phan ting phu nghiem trong nhung khOng c de dots den tinh wrong cua san pham va tmng Mt dr truing hop Mo. rick Liu bao cat)) ve talc dung phu pluii chroc nen hanh train 15 ngay ke tir ngay ng php nay.

ority of all other serious adverse events that are not fatal or life threatening as nd in any case. no later than 15 calendar days after first knowledge. using the Event Report Form:

quan co than quyen khi co brit cir sir thay d6i rulo trong ban cong M nay.

y of any change in the particulars submitted in this notification:

an rang Mang thong tin duce dua ra trong ball cong 1)6 nay la dung sir that. cac thong tin lien quan den noi dung cong b6 se doe cung cap cac tai lieu

phap boat sao y ban chinh.

particulars given in this notification are true. all data. and information of to to the notification have been supplied and that the documents enclosed are

opies.

vi. (*Ong M yen c

Notify the Autho

3. Tai xis( cam d Tat ca cac tai lie dinh kern la ban

I declare that t relevance in rela authentic or true

, ,

4. Toi hieu rAng tai se co troth nhiem de dam blio tat ca cac 16 san pltim cua chOng toi deu dap ang cac you cau phtip luat. va than thu tat ca lieu chuzin va chi tieu san phzim da doge cOng b6 veri en quan co than, quyen.

I understand that shall be responsible for ensuring that each consignment of my product continues to meet a I the legal requirements. and conforms to all the standards and specifications of the product that I have declared to the Authority.

5. Toi hieu rang trong trubng hqp co tranh chap phzip luat. tol. khans. doge quiyen sir dung ban cong he chat Itrcmg san pham door co quan.co tham quyin chap nhan neu san pham cua chang toi khans 4 &roc cac yeu cau ve chuan. chi tieu ma chang toi da cOng

I understand that I cannot place reliance on the acceptance of my product notification by the authority in any leval proceedings concerning my product. in the event that my product has failed to conform to any of the standards or specifications that I had previously declared to the Authority.

too762 Is&

C);,- CONG TY ost

i Clink TE

UNILEV ET NAM .. , ,, I li 4 ' yet Anh

• g Phong Nghiin Cult & Phit Trial Sin Phim — Nginh [ling Chim Sec Ci Nhin

Ten va ch& ky ctia nguai dai dien theo pluip luat cua cong ty

!Name and Signause of person representing the local company

Diu cua cling ty

451atiotelt)

Ngay Patel ;Company stamp'

Nbu Jt LIthn: ihnh n1c tia rd Katy ming tin Ik u huMnt thut cac eons ‘c Km cats is Jung rho san pham mS phain As &lined in the (hide Altunial for the InAhnirt on Adwrm: ham Repuning of Counctic5 Prodhat

CI has trong v.: I lump tai Ii.0 huony Jan oho tae eons:* st, Kitt can Me thing phy cua san plum m5 phiun Set twit in Appentli% I 10 the ( hide Manual lit the Industr) on Adterse hem Reporting ottostnetics Protliwts

SO KE ROACH VA THANH PH6 HO

PRONG DANG K

Aunt MINH

NH DOANH

CONG HOA XA HQI CHU NGHIA VIST NAM Di}c I$p — Ty. do — Hanh phut

CLAY CONG T

HUNG NH4N DANG Kt DOANH NGHIEP TRACH NHItM Heil HAN MOT THANH VIEN

Mi so doanh nghitp: 0309171089

ang ky lan (Lau: ngay 08 arcing 07 nam 2009

thay dot lan thti: 5. ngtiy 05 dicing 09 nam 2018

I. Ten ding ty

Ton cong ty viet bang VANG Tan ding ty via bang Ten cong ty viet tit: 2.,Dia chi try se. chin Tang 5, Toa nhti Song Chi Minh, Viet Nam Di0 thoai: 22168177 Email: info@echogro 3. VOn dieu If Bang chit Nam 0) eta 4. Thong tin ye chit s Ho va ton: LE XU Sinh ngay: 29/11/1

Loai &lye t& chin% th Sat giay chimg thyc Ngay cap: /3/04/2 Noi daily ky h6 khau Thank pha Ha Chi Mi

Cho a hian tai: 324 T Minh, Viet Nam 5. Ngutd dyi dial) th phip cOa cang ty

icing V*: CONG TY TNHH MOT THANH VIEN TIENG

tang ntr6c ngoili: ECHO COMPANY LIMITED HO CO., LTD

o, 62A Phom Ngac Thoth, Phttong 06, Quail 3, Thank pha Ha

Fax:39300651 p.vn Wcbsite: 5.000.000.000 dOng

N BINH Gieri tinh: Nam 77 Dan it) c: Kinh Qu6c tich: Viet Nam

cab nhan: Chang mink nhan don nhan: 023178112 06 Noi cap: CA.TPHCM trimg tr-6: 324 Tridnig Chink, Phitang 13, Quail Tan Binh.

ih, Viet Nam

g Chink, Phttang 13. Quern Tim Binh, Thank pha Ho Chi

* Ho va ten: ROAN TFil TRUNG DUNG Giai tinh: Nir

Chim danh: Gam d Sinh ngAy: 03/11/1 51 Dan toc: Kinn QuOc tjch: Viet Nam

Loai giAy to chimg th c ca nhan: Ch'ing mirth nhcin dan Se giAy chimg thvc c nhan: 020067288 Ngay cap: 21/04/2 04 Nai cap: CA TP. IICM Nai clang k9 hp khan huang tra: 324 Tritemg Chinh, Pinning 13, Quan Tan Binh, Than!, pha Ha Chi Minh, Viet Nam ChiS a hien tai: 324 Truang Chink, Pinning 13, QuOn Tan Binh, Thah pha IM Chi Mink Viet Nam