1

Company Name:

2

Address:

3

Contact Person:

4

Product requiring certification:

i

Name of Product:

ii

Brand Name:

iii

Pack Size:

iv

Packaging Details:

5

Export Destinations:

6

Product Ingredients:

Name Supplier Original Source.
[Copy & paste up to 8000 words of text.]

7

Brief description of processing steps. Also state if any processing aids/additives used:

8

Will non-halal products be on the same equipment?

9

System and frequency of cleaning of equipment:

10

Method of storage and segregation of Halal and non-Halal ingredients before and during manufacture:

11

State if any security system is in place to prevent inadvertent usage or intermingling of Halal and non-Halal ingredients:

12

State what documentation and records are kept during manufacture:

13

Is this documentation sufficient to enable trace-back in case of queries?

14

Method of segregation and identification of Halal products after manufacture:

15

Proposed initial volume and frequency of production?

16

Additional comments:

I declare that the particulars given above, and any supporting document, to the best of my knowledge and belief, are true and correct and that I have not wilfully suppressed any material facts which are requested for in this application. I confirm that the information I have provided is correct and complete.

Signature:

Date:

Position:

Tel:

Mobile:

Email: