AHDAA_AFFHC-PP_2_ Version 4 3/12/2017 APPLICATION FORM AHDAA APLICATION FORM FOR HALAL CERTIFICATION (AHDAA_AFFHC-PP)
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1 AHDAA HALAL CERTIFICATION PROCESSED PRODUCTS APPLICATION FORM AHDAA APLICATION FORM FOR HALAL CERTIFICATION (AHDAA_AFFHC-PP) This Halal application form is the property of AHDAA, and must be completed properly, Australian Halal Development and Accreditation will check all information that you supply, and we will contact you as soon as we finalize your application. I. Role of applicant organization and product standards I.A Please select your category: (The applicant maybe different from the site to be certified) Office Manufacturing or Plant Packaging Warehousing Others (please specify): I.B Please kindly select products standards numbers (Certification standards) OIC/SMIIC UAE.S : 2015 UAE.S 993: 2015 MS 1500:2009 (Malaysia) H.A.S (Indonesia, Singapore) Others (please specify): New application Renewal of Halal certification Please kindly select Change of scope (Adding: new product/or service/or site(s)) Reduce the scope of Halal certification **************************************** Manufacturer Exporter Importer Distributor 1
2 II. Company/Business details A. Company/Business name Trading name (mandatory) B. Street/postal Address C. Contact phone number D. Business contact mobile number E. Fax number F. address G. Contact person and position H. Business registration certificate I. Business veterinary Certificate (Abattoir/Meat processing plants) J. Please kindly provide your health certificate (or Food Hygiene certificate where applicable) k. Business HCCAP certificate L. Company website The applicant owns The product Product recipes Brand Does not own the product brand (Just a manufacturer or acting on behalf of the applicant) 2
3 III. Products and Ingredients A. Products categories Food products n-food products Others (Please kindly specify) A. Food Products Animal protein products including poultry, beef, fish Bakery items like cheesecakes, chocolate and mousse cakes (in APMEA) Vegetable processing (in APMEA) Others (Please kindly specify with attached the data sheet) B. n-food Products Cosmetics Synthetic Others (Please kindly specify with attached the data sheet) B. Product s supplier name and full contact details C. Products data sheet attached? D. Products description (size, shape, color etc 3
4 please kindly attach product photos or leaflets information) E. packaging materials Cartons Plastic Glass Others (Please kindly specify) F. Please provide your packaging list (Materials used for packaging products) G. Packaging data sheet (Ingredients of packaging) H. List of ingredients I. Origin of ingredients Animal Plants Others (Please kindly specify) J. Are Halal certificates accompanying ingredients and or packaging materials available? (If please kindly provide the detail information and attached copies of relevant documents required) K. Please provide additional information for your products and ingredients where applicable 4
5 IV. Production and processing line A. During the product processing is there any use of artificial or sedative n-halal additives or ingredients (If please kindly provide the detail information) B. Are the Halal and non- Halal products processed on the same equipment? (If the answer is then go to section C below otherwise go to section D) C. Are the Halal and n- Halal products processed the same day? (If the answer is then go to section D) D. Is there any proper separation or segregation between the Halal/non Halal at the chillers/cold storage? E. Is there any daily documentation for the n Halal and Halal productions? F. How many shifts do you operate? 5
6 Do you have appointed personnel to monitor and record Halal and n-halal processes? G. Is there any a pork or pig product processed within or around 5km of your premises? H. Please kindly explain your Halal production line and n-halal products management system (Briefly) Please kindly provide us with the total number of employees in the factory or company Please kindly provide us with the number of shifts and hours Please kindly provide us number of employees per shift Day Night Remark: Employees in this context do include permanent, seasonal, temporary and sub-contracted staff Is your company certified by any Certification body? If, please give the details: PRODUCT CERTIFICATION SCHEME OIC/SMIIC: Group of standards including UAE, MS 1500, Turkey and others UAE.S : 2015 General Requirements for Halal Food GSO.S 993: 2015 Animal Slaughtering Requirements According to Islamic Rules MS 1500: 2009 (Malaysia): Halal Food - Production, Preparation, Handling and Storage H.A.S (Indonesia, Singapore): Halal Assurance System: Animal Slaughtering Requirements Others (please specify): 6
7 V. Traceability and Halal security A. Is there traceability or back track procedures for the Halal/non-Halal products in place B. What is the Halal assurance system or procedures that you put in place, to make sure that your Halal products is not contaminated by n-halal products? C. Please kindly provide us with your cleaning procedures for premises and Equipment D. Is your cleaning product free from non-halal materials or ingredients? IV. Further details and comments. 7
8 IIV. Declaration I declare that all documentation and information provided is correct to the best of my belief and knowledge. I further declare that I have not hidden any information or materials that are requested in this application. Applicant s Full name Applicant s position Applicant s signatures Date signed Company Logo and Stamp For office use only: Application received (date: DD/MM/YYYY)../ /.. Documentation initiated (date: DD/MM/YYYY)../ /.. Staff member in charge of the application: Audit or site inspection to be conducted by (Technical and religious expertise) names: Decision of initial audit: Pass Pending (minor issues to be addressed) Fail Important tes: AHDAA has a clear policy and procedures in place to safeguard confidential information. We ensure that all information obtained from the applicant shall remain confidential. Unless requested by a government body or relevant authorities. Having mentioned the above statement, AHDAA shall ensure that its services are accessible to all applicants whose business processes are aligned with our scope of operations. All applications shall be treated in a fair and just manner 11 8
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