USInk - Material Safety Data Sheet Request Form

US Ink provides a service for you to obtain electronic delivery of material safety data sheets (MSDS). As one of our customers you can enjoy this enhancement to implement health and safety issues in your operations with a dedicated site for storing all your MSDS.

In order for you to access/receive MSDS's electronically, we need to have an authorization letter from your company on file with our Regulatory Affairs department.

Please fill in the following information to create your letter of authorization.

Once you have completed/created the document, you will have the option to save a copy on your local hard drive.

* indicates required fields

	Company logo (jpg, gif):
	Company name*:
	Street address*:
	City*:
	State*:
	Zip Code*:
	Phone*:
	Fax:

11-21-2008
ATTN: MSDS Distribution
RE: Electronic MSDS Distribution

To Whom It May Concern:

This letter is to request that all MSDS's sent to
Your Company
from US Ink be delivered electronically as a PDF document attached to an email message sent to the individual named below:

	Name*:
	Title*:

Facility Account Number(s):

Account number(s) are required for authorization, if you do not know your account number(s) please contact your local US Ink branch or US Ink Sales Representative. Enter account numbers one at a time and click on the Add button.

MSDS Recipient's Email*:
Facility Account Number*:

You must click the Add button to continue the process.

Current List of Facility Accounts:

(empty)

It is our intention to use this method of delivery of the MSDS document from US Ink to enhance communication of regulatory details among all employees. This method of document delivery replaces the paper-based document we receive by mail.

We understand that the electronic MSDS document from US Ink is printable and can be used throughout our internal network to assist safety teams, EHS workers, employees and helpers at large. We also understand that the electronic versions of MSDS are only available for inks ordered since July 2008.

Additionally, we are requesting access to MSDS's through the internet website provided by US Ink. Please contact me directly if you have any questions or concerns.

Sincerely,

	Authorizing person's name*:
	Authorizing person's title*:
	Authorizing person's phone*:
	Authorizing person's email*:
By clicking submit below you will be issuing a letter of authorization for US Ink to set-up electronic delivery of MSDS materials for your organization. You are stating that the information you have provided above is accurate and that you have the authority to issue the authorization.