APPLICATION FOR THE REGISTRATION OF A FOOD BUSINESS ESTABLISHMENT Regulation (EC) No 852/2004 Article 6(2) This form should be completed by food business operators in respect of new food business establishments and submitted to the relevant food authority 28 days before commencing food operations. On the basis of the activities carried out, certain food business establishments are required to be approved rather than registered. If you are unsure whether any aspect of your food operations would require your establishment to be approved, please contact Shared Regulatory Services for guidance. 1. Please confirm if you would prefer all correspondence in Welsh or English Welsh English (please tick) New food business Notification of significant change in food activities 2. Reason for application (Please select one option) Change in ownership trading name Change in food business operator 3. Name of Food Business Telephone No. (trading name) 4. Address of Establishment (or address at which moveable Postcode: establishment is kept) E-mail (please print) Limited Sole Partnership Other 5. Type of Business Company Trader Complete Section 4(a) Complete Section 4(b) Complete Section 4(b) Complete Section 4(b) 5a. Details of Food Business Company Number: Operator Company Name: (if limited company) Company Address: Postcode: 5b. Details of Food Business Name: Date of Address Postcode Operator (if Sole Trader, Partner or Other) 6. Full Name of Manager (if different from business operator) 7 Number of vehicles or stalls Transporting Food: kept at, or used from, the food business establishment and Preparing, Selling Food: used for the purposes of; 8. Number of people engaged in food business (Count part-time worker(s) (25 hrs per week or less) as one-half) 9. Date you intend to Open 10. If this is a seasonal business (Period during you intend to be open each year) Mon Tues Wed Thur 11. Proposed days of opening Please tick all relevant days) Fri Sat Sun Proposed times of opening PTO TO CONTINUE THE FORM 12. Water Supplied to the Food Business Public (Mains) Supply Private Supply Establishment 13 Type of food business (Please tick ALL the that apply) Catering Distribution / Warehousing Farm Shop Food Broker Food Manufacturing / Processing Hospital / Residential Home/ School Hotel / Pub / Guest House Importer Market
APPLICATION FOR THE REGISTRATION OF A FOOD BUSINESS ESTABLISHMENT Regulation (EC) No 852/2004 Article 6(2) This form should be completed by food business operators in respect of new food business establishments and submitted to the relevant food authority 28 days before commencing food operations. On the basis of the activities carried out, certain food business establishments are required to be approved rather than registered. If you are unsure whether any aspect of your food operations would require your establishment to be approved, please contact Shared Regulatory Services for guidance. 1. Please confirm if you would prefer all correspondence in Welsh or English (please tick) Welsh English 2. Reason for application (Please select one option) New food business Notification of significant change in food activities Change in ownership trading name Change in food business operator 3. Name of Food Business (trading name) Telephone No. 4. Address of Establishment (or address at which moveable establishment is kept) Postcode: E-mail (please print) 5. Type of Business Limited Company Sole Trader Partnership Other Complete Section 4(a) Complete Section 4(b) Complete Section 4(b) Complete Section 4(b) 5a. Details of Food Business Operator (if limited company) Company Number: Company Name: Company Address: Postcode: 5b. Details of Food Business Operator (if Sole Trader, Partner or Other) Name: Date of Address Postcode 6. Full Name of Manager (if different from business operator) 7 Number of vehicles or stalls kept at, or used from, the food business establishment and used for the purposes of; Transporting Food: Preparing, Selling Food: 8. Number of people engaged in food business (Count part-time worker(s) (25 hrs per week or less) as one-half) 9. Date you intend to Open 10. If this is a seasonal business (Period during you intend to be open each year) 11. Proposed days of opening Please tick all relevant days) Mon Tues Wed Thur Fri Sat Sun Proposed times of opening PTO TO CONTINUE THE FORM 12. Water Supplied to the Food Business Establishment Public (Mains) Supply Private Supply 13 Type of food business (Please tick ALL the that apply) Catering Distribution / Warehousing Farm Shop Food Broker Food Manufacturing / Processing Hospital / Residential Home/ School Hotel / Pub / Guest House Importer Market
SRS-FH-AAA-Application-Form-for-the-Registration-of-a-Food-Business.docx