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HalalCertificationApplicationForm国际清真洁食认证内部专用资料注意:请用中英文对照填写(第16问可用中文填写)DateofApplication(申请日期):Companyname(申请单位名称):Address(地址):City(城市):province(省份):Country(国家):PostCode(邮编):TelephoneNo(电话):Fax(传真):E-mail(电子邮箱):Website(网址):ContactName(本认证联络人):JobTitle(职位):Mobile(手机):Msn:QQ:AddressofFactory(生产工厂信息)Factoryname(生产工厂名称):FactoryAddress(地址):City(城市):province(省份):Country(国家):PostCode(邮编):TelephoneNo(电话):Fax(传真):E-mail(电子邮箱):Website(网址):Nameofthenearestmajorcitytothefactory(离工厂最近的大城市):Nameofthenearestinternationalairporttothefactory(离工厂最近的机场):Howmanykilometersisitfromairporttoyourfactory?(机场距离你们工厂多少公里):PLEASENOTE:Pleasenoteifthereismorethantwofactoriesthatareproducingtheproduct,pleaseincludethefulladdress,contactnumberandcontactpersonineachplant.Ifthereisaseparatepackagingplant,pleaseincludedetails.(请将您认为合适的空方框“□”涂成黑框“■”,复制粘贴即可)1.Hasthecompanyeverappliedforhalalcertificationpreviously?.......Yes□No□Ifyes,pleasestatethehalalAgencythatwaspreviouslyappliedto:公司以前申请过halal认证吗?如是,请写出此清真认证机构的名称。2.Marketingtype申请认证企业的产品类型是什么?请标出FoodService(bulk)食品餐饮□Retail零售□DirectMarketing直复营销□Industry实业□Others3.Hasthefactoryeverbeensupervisedbefore,eitheronayearlybasisorforaspecificbatchproductionforanotherbuyer?...............................….Yes□No□IfyespleasestatethehalalAgencythatwascertifying:生产工厂曾由清真认证机构监督过生产吗?如是,请写出此清真认证机构的名称。4.HasthefactoryobtainedKOSHER/HACCP(ISO22000)/GMP/OrganicFoodcertificate?□KOSHER□HACCP(IS22000)□GMP□OrganicFoodIfyes,pleaseprovideitsscannedcopytoe-mail:kosher-halal@vip.163.com生产工厂是否已经通过KOSHER认证、HACCP(ISO22000)、GMP以及有机食品认证?如果通过,请将证书英文扫描件(或电子版)发送到上述vip信箱:kosher-halal@vip.163.com5.Doyouproduceproductusingporkorporkderivativeinyourfactory?Yes□No□Ifyes,yourcompanyarenotqualifiedbyhalal.在工厂生产中用到猪或者猪的衍生品吗?如果是,你的公司将不能被halal认证。6.Doyouproduceproductusinganimalmeatoranimalderivativeslikebeef,chicken,deerormutton?Ifyes,siteinspectionmustbedoneandcostofinspectionisborneontheapplicant.Yes□No□工厂生产中用到动物肉或者动物衍生品,像牛肉、鸡肉、鹿肉或者羊肉吗?如果是,必须进行工厂的现场审查,工厂现场审查产生的费用由申请方承担。7.Doyouusegelatineorcapsuleinyourproducts?Yes□No□Ifyes,pleasesendusthehalalcertificatesforeachofthembykosher-halal@vip.163.com在产品生产中用到明胶或者胶囊吗?如果是,请通过上述邮箱提交其halal证书,否则不能进行认证。8.Ifyourproductsarefoodproducts,doesitcontainalcoholexceeding0.5%?Ifyes,wehavetorejectyourapplication.Yes□No□如果产品是食用制品,它含有酒精是否超过0.5%?如果是,我们拒绝halal认证申请。9.Doyouproduceproductusingglycerineoritsderrivatives?Yes□No□Ifyes,pleaseinsertthehalalcertificateforeachofthem.产品生产中用到甘油或其衍生品吗?如果是,请提供该产品的halal证书。10.Geographicareaswhereproductis/willbemarketed.认证的产品主要销往哪些国家或地区,请标出USA美国□Canada加拿大□Malaysia马来西亚□Indonesia印尼□Singapore新加坡□SaudiArabia沙特□UAE阿联酋□Egypt埃及□Pakistan巴基斯坦□Worldwide世界各地□Others其他_______11.Wheredoyouknowaboutus?您从那里了解我们,请标出Google搜索□百度搜索□雅虎搜索□朋友介绍□食品展会□其他□12.Pleaselistallproductstobecertifiedhalal.请列出所有要做伊斯兰认证的产品No.BrandNameofProductActualProductsName产品商标名称(若无则不填)申请认证产品名称12345678910111213141516171819202122232425262728293013.Pleaselistallrawmaterialsproductbyproduct.Makesuretheexactnameoftheingredientislisted.请列出生产申请认证产品所用的所有原材料(填写要准确无误)No.PRODUCTS’NAME申请认证产品名称RAWMATERIALSFullnameofallrawmaterialstobecertifiedeveryproducts.(nottheformula)每个认证产品的所用的全部原材料名称(不要填写分子式)12345678910111213141516171819202122232425262728293014.Pleaseprovidemoreinformationontherawmaterialslistedinpoint13.Includethefulladdressofthesupplierifyougetthematerialviaasupplier.Ifyougetthematerialdirectlyfromthemanufacturerdonotfillthatcolumn.PleaseaskthemanufacturersforaHALALcertificatecoveringthematerial.PleaseindicatewhichHALALAgencycertifiestherawmaterialandprovideacopyofthecurrentHALALcertificate.IfthereisnoHALALcertificatepleaseindicatewiththewordYES/NO.Pleasemakemorecopiesofthispageifmorerawmaterialsareneededtobelisted.请提供更多的在第11问中所列原材料的详细信息.No.RAWMATERIALSFullnameofrawmaterialsnottheformula.原料的名称RawMaterials’sComponent原材料的组成成分MANUFACTURERNameandFullAddress生产商名称和地址METHODPACKAGINGBags,Trucktanker,Drums包装方式HalalcertificationHalal认证机构的名称(如没有认证,可不填)12345678910111215.Pleasegiveusabriefexplanationofthemanufacturingprocess.请概要介绍认证产品的生产过程(可另附资料)NAMEOFPRODUCT(申请认证产品名称):1921031141251361471581616.Pleasegiveusabriefexplanationofthecleaningprocess.请概要介绍生产人员和生产设备的清洁(洗)过程.
本文标题:halal清真食品认证申请表
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