CPSC eFiling Intake Form — Catalyst Customs Brokers

2

Does this product require a CPSC safety certificate?

⚠️

Not sure? As the Importer of Record, you are responsible for determining your product's certification obligations. Use CPSC's Regulatory Robot at business.cpsc.gov/robot before proceeding.

📋 DISCLAIMER

3A

Which Disclaimer applies?

3B

Disclaimer A — Reason for Disclaimer

⚠️

A Disclaimer is a formal statement to a federal agency. The IOR must confirm the basis in writing before Catalyst will file.

Step 1 — Check all scenarios that apply

No CPSC rule, ban, or standard requires a certificate for this producte.g. hats, scarves, gloves; sport helmets other than bicycle helmets; 15(j) products other than drawstrings

Collectible or decorative item intended for adults — not a children's producte.g. collectible toys, figurines, or novelty items marketed exclusively to adults age 18+

Component parts for manufacturing or assembly — not sold to consumers as a finished producte.g. parts for incorporation into a finished product not yet in U.S. commerce

Outside CPSC jurisdiction — regulated by another federal agency (e.g. FDA)e.g. medical products classified as medical devices under FDA jurisdiction

Outside CPSC jurisdiction — non-consumer industrial or commercial equipmente.g. equipment for commercial or industrial use only, not sold to consumers

Upholstered furniture — 16 CFR part 1640 is the only applicable CPSC rule⚠️ If lead-in-paint or children's product testing also applies, a GCC or CPC is required instead

Personal use item exported for repair and being reimported by the same ownerSame product, same owner — returning after repair or refurbishment abroad

Consumer-to-consumer gift — from one private individual abroad to another in the U.S.Not a commercial sale; personal gift between private individuals

Goods destined for export — not entering U.S. commerceTransiting through the U.S. or imported solely for re-export

Military use only — not available to or intended for civilian consumersGoods purchased and used exclusively by the U.S. military

No scenarios selected yet.

Step 2 — Describe the product and confirm the disclaimer basis

Specific details and reason no certificate is required *Be specific to this product, even if boxes are checked above

This field is required.

IOR Authorized Signatory — Print Name & Title *

Authorization is required.

3C

Disclaimer A — Intended Use Code

Required — CPSC will reject without it. Select the code that best matches this product's intended use.

081.XXX

For Human Medical Use as Medical Device

e.g. FDA-regulated medical devices; hospital/clinical equipment

090.XXX

For Military Use as a Non-Food Product

e.g. goods used exclusively by the U.S. military

100.XXX

For Personal Use as a Non-Food Product

e.g. personal item reimported after repair; consumer-to-consumer gifts

130.XXX

For Consumer Use as a Non-Food Product

e.g. hats, scarves, gloves; adult collectibles; sport helmets (non-bicycle); upholstered furniture (1640 only)

155.XXX

For Commercial Assembly as a Non-Food Product

e.g. component parts for manufacturing; not sold to consumers as a finished product

940.XXX

For Compassionate / Emergency Use

e.g. goods for emergency relief or humanitarian response

970.XXX

For Export

e.g. goods entering the U.S. solely for export; in-transit shipments

Please select an Intended Use Code.

👶 FULL FILING — CHILDREN'S PRODUCT CERTIFICATE (CPC)

⚠️

CPC filings only accept CPSC-Accepted (accredited) laboratories. Verify your lab's 4-digit CPSC Lab ID at cpsc.gov/cgi-bin/LabSearch/Default.aspx.

3

Product Identification

Product Name / Model *

Product name is required.

Brand / Trade Name (optional)

Manufacture Month & Year *

Manufacture date is required.

Intended Use Code *

Intended Use Code is required.

Product ID Type

Product ID Number *

Product ID number is required.

3B

Manufacturer

Manufacturer Name *

Manufacturer name is required.

MID # (optional)

Manufacturer Address *

Address is required.

Phone *

Phone is required.

Email *

Email is required.

3C

CPSC-Accepted Testing Laboratory

CPSC Lab ID (4-digit) *

Lab ID is required.

Date of Testing *

Test date is required.

Citation Codes *Every rule, ban, or standard tested to — one per line or comma-separated

Citation codes are required.

3D

Certifying Entity & Records Contact

ℹ️

Leave blank if the IOR is both certifying and maintaining test records. CPSC defaults to the IOR for both roles.

Certifying Entity (only if different from IOR)

Name

Email

Records Contact (only if different from IOR)

Name / Title

Email

Compliance Attestation

⚠️

By signing, the certifying party affirms the product complies with all cited rules and all information is true and accurate. Knowingly false statements carry federal criminal liability.

Authorized Signatory — Print Name, Title, and Date *

Attestation is required.

✅ FULL FILING — GENERAL CERTIFICATE OF CONFORMITY (GCC)

3

Product Identification

Product Name / Model *

Product name is required.

Brand / Trade Name (optional)

Manufacture Month & Year *

Manufacture date is required.

Intended Use Code (recommended)

Product ID Type

Product ID Number *

Product ID number is required.

3B

Manufacturer

Manufacturer Name *

Manufacturer name is required.

MID # (optional)

Manufacturer Address *

Address is required.

Phone *

Phone is required.

Email *

Email is required.

3C

Testing Laboratory

ℹ️

GCC filings accept any qualified lab. CPSC-Accepted labs need a 4-digit Lab ID only — no address required. All other labs require full details.

Please select a lab type.

Citation Codes *Every rule, ban, or standard — one per line or comma-separated

Citation codes are required.

3D

Certifying Entity & Records Contact

ℹ️

Leave blank if the IOR is both certifying and maintaining records. CPSC defaults to the IOR for both roles.

Certifying Entity (only if different from IOR)

Name

Email

Records Contact (only if different from IOR)

Name / Title

Email

Compliance Attestation

⚠️

By signing, the certifying party affirms the product complies with all cited rules and all information is true and accurate. Knowingly false statements carry federal criminal liability.

Authorized Signatory — Print Name, Title, and Date *

Attestation is required.

4

Product Line Items, SKUs & Filing IDs

ℹ️

Add a row for each product variation in this shipment under this HTS line. CPSC requires a separate certificate for each materially different product — differences in design, factory, or component materials each require their own entry.

#	Product Name / Description	SKU / Model #	Color / Style	Lot #	REF: Product ID	REF: Version ID
1

Additional Notes for Catalyst (optional)

5

Review & Submit to Catalyst

⚠️

Hold Notice: CPSC may place any entry on review after filing, including disclaimers. If selected, you must hold all merchandise intact, unopened, and undistributed until CPSC issues a May Proceed notice. Releasing goods under CPSC review is a violation regardless of product compliance.

Print or save as PDF and email to your Catalyst Customs Brokers representative along with your commercial invoice, packing list, and certificate documentation.

Entry & Product Information

Does this product require a CPSC safety certificate?

Which Disclaimer applies?

Disclaimer A — Reason for Disclaimer

Disclaimer A — Intended Use Code

Disclaimer B — Confirm Eligibility

CPSC Product Registry Certificate Identifiers

Product Identification

Manufacturer

CPSC-Accepted Testing Laboratory

Certifying Entity & Records Contact

Product Identification

Manufacturer

Testing Laboratory

Certifying Entity & Records Contact

Product Line Items, SKUs & Filing IDs

Review & Submit to Catalyst