Information Collection Form
REACH OR(T) – Only Representative Trustee – Coverage Non-EEA and EEA Customers

DIRECT Non-EEA / EEA Customer
(DIRECT customer is the one who places the order and pays the invoice to Dow)

Please note:
  • If you are a DIRECT customer of DOW, you may proceed and fill in the form.
  • If you purchase product(s) via DISTRIBUTOR, please contact your distributor informing them of your needs. The distributor must SUBMIT the request on your behalf, as DIRECT customer of DOW.

Contact Person of Non-EEA / EEA Customer

Please provide Name and Email Address if possible.

DIRECT Non-EEA / EEA Customer

Full address of Non-EEA / EEA Customer Company

Product Information

For multiple products, insert each product on a numbered, new line. Products must correspond with their details on the same number / line in each box. Click the correlating info button for examples.
(Indicate FULL product trade name; see and refer to the examples available clicking the info button below)
(Annual import volume into the EU – MT metric tons – per year) Note: Only fixed values are accepted. Not a range value (e.g. 3MT and not 3-4 t)
Please note that the MAXIMUM validity is 1 calendar year
So that we may best serve you, please complete all items marked with an asterisk (*). For an explanation on how we use this information, please see our Privacy Statement.