Form B

Form B

CertiPUR-US® Program Registration | Form B Terms of Use Agreement

This is an agreement to follow the CertiPUR-US® Terms of Use, which gives details on how the CertiPUR-US® name, logo and mark can and cannot be used — and what marketing claims can and cannot be made with the program. Please read the entire CertiPUR-US® Terms of Use Manual before agreeing to the terms by submitting Form B below. We encourage you to share the CertiPUR-US® Terms of Use Manual with your team members who will be selling, marketing, developing content or talking with customers about your products that contain certified foam.

If you cannot fill out the online form below, email forms@certipur.us.

  • To register, please fill out this form on behalf of the company you represent only if you are purchasing CertiPUR-US® certified foam or products containing certified foam. A company must be registered to be granted permission to use the CertiPUR-US® program’s trademarked name, logo or mark.
  • There is no cost to register, but in addition to this Form B, each one of your direct suppliers of CertiPUR-US® certified foam, or products containing certified foam, must submit a CertiPUR-US® Program Supplier Verification Form A verifying you as their customer. Form A is available at certipur.us/forma.
  • Please remember that you do not have permission to use the CertiPUR-US® name, logo or mark until your company or brand is registered and listed on our website. Once registered, if you do not adhere to the Terms of Use, you will no longer have permission to use the CertiPUR-US® name, logo or mark and your listing on our website will be removed.
  • Once per year, all registered companies must renew their registration and confirm or update their directory listings by submitting Registration Renewal Form C. For companies and brands already listed in the directory, this occurs November 1-December 31 so listings are current for the next year’s directory.
  • Translations: Some key program documents, including our Terms of Use, are available in other languages on our Translations page.

Certificate of Knowledge Requirement

Before you complete Form B, you will need to successfully complete the free online CertiPUR-US® Certificate of Knowledge course at certipur.us/certificatecourse. The course should take 20 minutes. When you complete the course, keep following prompts to download your certificate. Your certificate will include the 16-digit number required below:

Section 1. Basic Information

This form should only be completed by an authorized representative of the Parent Company/Main Company named below.

Parent/Main Company Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Please include country code if applicable.

Enter the website for PARENT/MAIN company. You can provide websites or webpages for other companies or brands in Section 3. This is a required field.

Company Contacts

Please list Primary Contact first. In addition to a Primary Contact, please list a Customer Service Contact, if different. We will call or email the Customer Service Contact if we receive a question from a consumer about one of your products they have purchased (concerns, care instructions, etc.) We also suggest providing a Marketing/PR Contact.

Company Contact

First

Last

Contact Information

Please include country code if applicable.

Section 2. About Your Supplier(s) of CertiPUR-US® Certified Foam

Confidential. For use by CertiPUR-US® administrators only.

List the foam supplier (foam producer, reseller, or distributor) from whom you DIRECTLY buy certified foam or products containing certified foam.

If you are buying directly from a participating foam producer, we recommend you check their certificate on our website to be sure the foams you are buying are certified and in good standing. Go to certipur.us/producers and click on the name of your supplier to find their certificate. If you are buying from a distributor or reseller, check to be sure they are registered with us here: certipur.us/directory. Email us at compliance@certipur.us if you have questions.

If you have more than 3 suppliers, please email compliance@certipur.us

Identify the CertiPUR-US® Certified Foam Families You Purchase or Your Products Contain

(check all that apply) *

† Foam Producers Currently Offering Certified Biobased Foam

Section 3. Directory Listing(s) – Free and Required

Registered companies must have at least one directory listing. Multiple listings are encouraged. All listings are free. List any company or brand a consumer or customer would search for.

If your company or brand is not listed in the directory, you cannot use the trademarked CertiPUR-US® name or logo or be associated with the program in any way.

For the public directory listing you create below, we will use the information from this section to revise your current listing – or to add new listing(s). For EACH company, brand or collection you want listed, complete the entire section below separately. You will see an option to “add another listing” after you complete your first listing. You will also see a customized option if you have more than 4 listings.

Only information from Section 3 will be included in the online directory.

There must be a separate entry in Section 3 for each brand or company that you want listed in the directory, including the parent/primary company.

Sample Directory Listing
XYZ Mattress Store
AXYZ Mattress Store
CCompany Type: Mattress/Bedding Retailer, Pillow Retailer
DProduct Category: Adult Mattresses, Crib Mattresses, Pillows
ELocation: Texas
FRelated Listings (optional): XYZ Pet Beds

A. Company/Brand Name

B. Website/Webpage

C. Company Type

Choose company type if that company or brand sells CertiPUR-US® certified foam or products containing certified foam.

Please specify

D. Product Categories

For the directory, your company will only be listed in the categories you check. Check at least one. Only check a category if that company or brand sells CertiPUR-US® certified foam or products containing certified foam.

Example: If you manufacture both mattresses and furniture but you only use CertiPUR-US® certified foam in your mattresses, then do not check the upholstered furniture category.

E. Location

Check where the product is available for purchase.
For the directory, your company will only be listed in the locations you check. Check at least one.
If you check this, please do not check the other USA option.

F. Related Listings/Cross-References (Optional)

In this particular listing, do you want us to cross-reference any other listed or related companies or brands you have submitted?

Comments/Notes (Optional)

Please provide any additional information here that you would like us to know about this listing:

I have more than 4 listings of companies/brands and will email directory@certipur.us for a customized approach.

Section 4. Agreement to Abide by the Rules Set Forth in the CertiPUR-US® Program Terms of Use Manual

† Find the Terms of Use Manual at certipur.us/TermsofUse.
†† Translations: Some key program documents, including our Terms of Use, are available in other languages at certipur.us/translations.
† Email approvals@certipur.us.
† Find the Terms of Use Manual at certipur.us/TermsofUse.
  • Chemical-free
  • Eco-friendly*
  • Green*
  • Hypoallergenic
  • Made without chemicals
  • Made without flame retardants
  • No carcinogens
  • No flame retardants/free of FRs
  • Non-toxic
  • Recycled*
  • Renewable*
  • Safe
  • Sustainable*
  • Biobased (Exception: Biobased foams)

*Avoid using these or other similar unqualified environmental benefit claims which may be prohibited by the Federal Trade Commission Green Guides, a publication designed to help marketers avoid making environmental claims that may mislead consumers.

Clear Signature
Please use your cursor to sign if you are on a desktop computer.

Enter an email address to receive a copy of your form submission.

By submitting this document, I give permission to CertiPUR-US® program administrators to email periodic program updates.

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