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Application for Halal Products Certification

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:

Applicant Name:

Designation:

Confidentiality Statement:



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