1. Date of Application* 2. Company/Business Name* 3. Company Registration No* 4. Registered Office Address* 4a). Telephone 4b). Email* 4c). Fax 4d). Website* 5. No of sites for Audit* 6. Complete address of the Production Site. City/Country* (List all sites, if multiple sites to be audited): 7. Total number of Outsourced Products & Sub-Contractor Sites for Audit*: 8. Complete Address of above incl. City/Country (List all sites, if multiple sites to be audited): 9. Warehouse details (if different than Production plant) 9a). Contact Person* 9b). Designation* 9c). Telephone 9d). Cell 9e). Fax 9f). Email* 9g). Address*
10. Describe a brief History of Supply Chain of Ingredients/Raw Materials: 11. Please briefly describe the Production Process Flow OR attach Process Flow Chart: 12. Product and Process Details: Nature of the business* (please tick): Processed Food ManufacturerSlaughterhouseManufacturer of Raw Material/ Ingredients/Additives(Food, Beverages, Pharma, Cosmetics)RetailerImporterExporterDistributorCosmetics & Personal Care Products ManufacturerManufacturer of Pharmaceutical ProductsManufacturer of Non-Food itemOthers
13. Schedule for Halal production* (please tick): Regular / Routine halal productionIrregular / weekly / monthly halal productionSeasonal / Occasional / Order based halal production
14. Is Pork (or any porcine derivative/material) handled, processed or stored on site? YesNo
15. Are Intoxicants used as an ingredient in any of the above products? YesNo Please provide details of segregation:
16. Are you willing to use IHCP Logo on Halal Certified Products, your website and Marketing materials? YesNo
17. Which halal standard do you want to be certified under?* GSO/UAE 2055-1 (Halal Food Standard)GSO/UAE 993 (Halal Slaughtering Standard)GSO/UAE 2055-4 (Halal Cosmetics & Personal Care Standard)MS 1500 (JAKIM Malaysian Halal Standard)PS 3733 (Pakistan Halal Food Standard)OIC-SMIIC Halal StandardMUIS (Singapore Halal Standard)PS 5319 (Pakistan Halal Cosmetics & Personal Care Standard)
18. Have you previously been certified under any of the above standards? YesNo (IF YES, Please specify):
19. Has the factory obtained any other Certification? HACCPISO 22000FSSC 22000ISO 9001BRCOther (IF Others, Please specify):
20. Please state the Body that gave Halal and other Certifications:
21. Halal Certification required for export purposes only? YesNo
22. If yes, please specify the markets (or regional territories): Saudi ArabiaUAEMalaysiaIndonesiaOthers (Please specify):
23. Preferred audit date: 24. The Scope to be Halal Certified:
25. Number of HACCP Studies:
26. Total No. of Employees: Technical Sharia Experts
27. Number of Shifts: 28. This Question Only for Slaughterhouses: A. Total number of Muslim Slaughterman: B. Number of Muslim Slaughtering Supervisor: C. Halal Slaughtering Done: By Hand By Mechanical D. Halal Slaughtering Done with Stunning? YesNo If yes, then Please Specify the type of stunning : 29. Does your company produce other products that are not offered to us for Halal Certification? (Please list below or provide list as an attachment.) A. Product Name Using the same production line with products offered for Halal Certification? YesNo B. Product Name Using the same production line with products offered for Halal Certification? YesNo C. Product Name Using the same production line with products offered for Halal Certification? YesNo D. Product Name Using the same production line with products offered for Halal Certification? YesNo E. Product Name Using the same production line with products offered for Halal Certification? YesNo
Statement from Applicant: I/we undertake that the information provided by us truly in the application for Halal Certification is based on real practices. All the ingredients/Raw Materials are mentioned truly in the application & annexure (being used in the formulation).
Applicant Name: Designation:
Confidentiality Statement: International Halal Certification, undertakes that it will guarantee all information supplied by or obtained from the application in respect to its processes, business secrets, prices and operations will be kept in the strictest confidence and it will not be disclosed for the benefit of any other company.