Kosher申请表KLBDKosher权威英文清真犹太认证网Word文档下载推荐.docx

Kosher申请表KLBDKosher权威英文清真犹太认证网Word文档下载推荐.docx

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DirectTelephoneNo:

     Email:

AlternativeContactName:

     JobTitle:

AccountsContactName:

MarketingContactName:

CompanyRegistrationNumber:

VATNumber（EuropeOnly）:

AnnualTurnoverUSD/STG/Euro:

HowdidyouhearoftheKLBDKosherCertification?

a）Recommendation-Name:

     Company:

-Supplier/Distributor/Importer/MarketingAgent（pleasecancelnotapplicable）

b）Exhibition-Name:

     c）WebSearch-SearchEngine:

d）DirectMail-from     

e）Other,pleasestate-     

FORINTERNALUSEONLY

AppNo:

     KLBDNo:

MANUFACTURINGPLANTINFORMATION-

Part1-LocationandContactInformation

Note:

IfthereismorethanonefactorylocatedinadifferentlocationpleasecompleteaseparateManufacturingPlantInformationpageforeachfactory.Ifthepackingfacilityisalsolocatedinadifferentlocation,pleasefillintheformandindicateaccordingly.

AddressofFactory

Nameoffactory:

FactoryManager:

     Email:

RawMaterialPurchasingManager:

Email:

Ifthefacilityisnotlocatedinamajorcity,pleaseindicatetheclosestmajorcityandthedistancetothefacility:

Nameofthenearestinternationalairporttothefactoryanddistancetothefactory:

Describeallthemanufacturingprocess（es）inthefactory:

Part2-GeneralProcessingInformation

1.DidthecompanyeverapplyforKoshercertification?

.....................................................Yes*No

Ifyes,pleasestatetheKosherAgency:

2.Wasthecompanyeversupervisedbefore,eitheronayearlybasisorforaspecificrunforanotherbuyer?

.............................................................................................................…........Yes*No

IfyespleasestatetheKosherServicethatwascertifying:

3.Hasthefactoryorproducingplanteverproducedarunofmeatorseafood（fish,shellfish,seaanimals）?

..........................................................................................……................................Yes*No

Ifyes,pleasestatethewhenapprox:

4.Is/Hasthefactoryorproducingplantproducingoreverproduced:

ProductsthatuseDairyderivedmaterials?

...............................................................................Yes*No

ProductsthatuseMeatderivedmaterials?

ProductsthatuseGrapederivedmaterials?

.............................................................................Yes*No

ProductsthatuseFishderivedmaterials?

................................................................................Yes*No

5.Is/Hasthefactoryorproducingplanthaveaconnectingplantinthesamesitethatmanufactures:

6.Isthecompanyusingitsownplantoranothercompany’splanttoproducetheproducts?

.................................................................................................................................Yes*No

Ifyes,pleasestatethecompanythatisusedfortheproductionandthenumberofrunsamonthapprox.:

7.Doesthecompanyusethepackagingservicesofanothercompany?

.........................Yes*No

Ifyes,pleasestatethecompanythatisusedforthepackagingandthenumberofrunsamonthapprox.:

8.Isthecertificationfor:

EXPORTTOISRAEL:

EXPORTTOTHEUSA:

UK/EUUSE:

GENERAL:

9.（Optionalquestion.OnlyfillifyouareawareofPassovercertification）

Isthecertificationfor:

INCLUDINGPASSOVER:

EXCLUDINGPASSOVER:

Part3-ProductInformation

PleaselistallproductstobecertifiedKosher:

（ifmorespaceisneededpleaselistproductsonaseparatesheetofpaper）.

A.Pleaseindicatethecodenumberofeachproductforwhichyouareseekingcertification.Thecodenumberiswhatyouwoulduseforsalesexternally.

B.Pleaselisteachbrandnamefortheproductthatyouareseekingcertification.Theremaybemorethanonebrandnamethattheproductissold.Inthiscasepleaselistitseparately.

C.Actualproductname:

Enterthenameproduct’sactualdistinction.

D.IndicateiftheproductisusedforRetailorIndustrial/Institutionaldistribution.

Seeexample

A.Codenumberofproduct

B.BrandNameofProduct

C.ActualProductName

D.RetailorIndustrialuse

e.g.12345A3

AAA

Cashews

Retail

Part4-ProductFormulation

Pleaselistallingredientsproductbyproduct.Makesuretheexactnameoftheingredientislisted.Pleasemorecopiesofthispageifnecessary.（Noneedtoindicatepercentages）

NAMEOFPRODUCT

includetheproductcodeandactualproductname

INGREDIENTUSEDINTHEMANUFACTURING

Fullnameandbrandoftheingredientnottheformula.Includeanyprocessingaidslikeantifoamingagents,releaseagents,solventsetc

Usethefollowingexampleasguideline

e.g.12345A3AAACashews

RawCashews

PeanutOil-KnifeBrand

GranulatedSugar

Part5-IngredientsInformation

NameofPlant:

1.Listallrawmaterialsinthefacility（includingreleaseagents,processingaids,antifoams,preservativesetc.）evenifnotintendedforkosheruse.

2.Identifywithanasterisk（*）anyingredientsintendedforuseexclusivelyinproductsthatyoudonotwishtocertify.

3.SubmitaLetterofKoshercertificationandclearlyidentifytheexactingredientbeingused.Ifyousubmitviafax,donothighlight.WherenoLetterofCertificationisavailable,supplydeclarationofitsmanufacturingprocess.BoththeingredientnameandsourcenamemustmatchtheLetterofCertification.

Definitions:

INGREDIENTNAME:

Givethenameexactlyasitappearsonthelabel.Includeallflavourandproductcodenumbers

SUPPLIER:

Includethefulladdressofthesupplierifthesuppliersnameappearsinthelabel.Ifnotleavethisspaceblank.Youneedtofillinthemanufacturer’scolumninanycaseaswell.

MANUFACTURER:

Givethemanufacturingsourceexactlyasitappearsonlabel.

BRANDNAME:

ListBrandNameexactlyasitappearsonthelabel.

PACKAGING:

IndicateifingredientisreceivedinBags,Cartonboxes,Trucktanker,Shiptanker,Drumsthatarenotnormallyrefilled.

CERTIFYINGAGENCY:

IndicatetheKoshercertifyingagencythatcertifiesthisingredient.

INGREDIENT

NAME

SUPPLIER

NameandFullAddress

MANUFACTURER

BRANDNAME

CERTIFYING

AGENCY

Usethefollowingexamplesasguidelines

Varioussuppliers

Sacks

PeanutOil

LamSoonEdibleOil

PasirGudang

Johor,Malaysia

Knife

Drums

KLBD

GranulatedSugarLOIGCXIGFine

CentralSugarsRefinery

SdnBhd

Batu3,40000ShahAlam

SelangorDarulEhsan

Malaysia

CSR

Bag

*Peanuts

MANUFACTURINGPROCESSINFORMATION-

Part1-ExplanationofManufacturingProcess

Pleasegiveusabriefexplanationofthemanufacturingprocess.Pleasedescribeeachproductionprocessindetail.

NameofProduct:

MANUFACTURING