New applicant (not currently certified) Reinstatement applicant (currently suspended by any certifier) ECOCERT ICO certified applicant Certified applicant, other certifying agency (please list if certified currently or surrendered in the past): Date of First Certification (Renewals or transfers only, certification must be held continuously from this date, no matter which certifier): Have you ever been certified by another organic certification agency? Yes No If yes, please identify the agency and dates below: Have you ever been denied, suspended, or had your certification revoked? Yes No Have you ever been to any operation whose certification has been denied, suspended, or revoked? “responsibly connected” in a partnership, member, manager, officer, director or holder of more than “Responsibly connected” means “affiliation as individual owner, partner a 10 percent ownership stake in a limited liability company, or officer, director or holder of more than 10 percent of the outstanding stock of a corporation or Yes No association.” (1) Crops Aquaponic/Bioponic/Hydroponic or container Production? Yes No Maple syrup production? Yes No Number of Acres Non Organic and Organic if applicable: Non Organic Proposed for Organic List of Crops: Operations which (1) handle or process only their own crops for their own use. For example: cleaning seeds, feed On Farm Processor? processing for their own livestock or (2) which have a simple process with their own crops but are selling the resulting product off farm. In that case, product must be kept in the same condition as it was during the harvest. For example: cleaning and packaging, cooling storing their own fruits, drying grain. Yes No Split Operation: Do you process both organic and non-organic products? Yes No (2) Livestock Number of Animals Proposed for Organic: Cattle: Dairy Cow: Goats: Hogs: Poultry: Other (please specify types of animals and numbers):
New applicant (not currently certified) Reinstatement applicant (currently suspended by any certifier) ECOCERT ICO certified applicant Certified applicant, other certifying agency (please list if certified currently or surrendered in the past): Date of First Certification (Renewals or transfers only, certification must be held continuously from this date, no matter which certifier): Have you ever been certified by another organic certification agency? Yes No If yes, please identify the agency and dates below: Have you ever been denied, suspended, or had your certification revoked? Yes No Have you ever been “responsibly connected” to any operation whose certification has been denied, suspended, or revoked? “Responsibly connected” means “affiliation as individual owner, partner in a partnership, member, manager, officer, director or holder of more than a 10 percent ownership stake in a limited liability company, or officer, director or holder of more than 10 percent of the outstanding stock of a corporation or association.” Yes No (1) Crops Aquaponic/Bioponic/Hydroponic or container Production? Yes No Maple syrup production? Yes No Number of Acres Non Organic and Organic if applicable: Non Organic Proposed for Organic List of Crops: On Farm Processor? Operations which (1) handle or process only their own crops for their own use. For example: cleaning seeds, feed processing for their own livestock or (2) which have a simple process with their own crops but are selling the resulting product off farm. In that case, product must be kept in the same condition as it was during the harvest. For example: cleaning and packaging, cooling storing their own fruits, drying grain. Yes No Split Operation: Do you process both organic and non-organic products? Yes No (2) Livestock Number of Animals Proposed for Organic: Cattle: Dairy Cow: Goats: Hogs: Poultry: Other (please specify types of animals and numbers):