/ TQ Cert Services Pvt. Ltd
A WHOLLY OWNED SUBSIDIARY OF TATA PROJECTS LIMITED
APPLICATION FORM FOR FSMS (ISO 22000 : 2005) CERTIFICATION
Company name (legal entity name)
Office Address
Invoicing Address
Contact person(Management Representative and alternate person) / 1. / 2.
Position
Telephone
Mobile
E-mail address
Web-site address
Contact person (Senior Management)
Position
Telephone
Mobile
E-mail address
Did you engage any consultant related to the management system?
(information required to ensure no conflict of interest) /

Consultancy company name
Name of the consultant
Please describe the products, activities and/or services of your company:
  1. Details of the Product Group manufactured?

  1. Number of Varieties in the each Product Group?

  1. Number of Production Lines? List out?

  1. Please list processes / flowchart and operations relevant for the scope of the management system? (Attach file if necessary)

  1. Any Significant aspects of process and operations

  1. Number of HACCP Studies?

  1. Details Regarding HACCP Studies?

  1. Please list any High Care Departments? Any other Special Production Conditions?

  1. Is your Production Fully Automated (Yes / No)

Please describe below the required scope of certification
(Write Scope as to be appeared in the certificate)
Are you subcontracting/outsourcing any of the activities within the scope of certification? /

Overview of subcontracted activities
Does your company has any other Management CertificationsDo u ? /

Name of the Certificate
Certification body
Certificate expire date
Other certifications to be mentioned, if any
Please complete the site specific information of the Head Office (Incase to be covered under Scope)
Activities performed on this site
No. of Employees in general shifts
(incl manager/supervisors/operators)
No. of Employees working in shifts
(incl manager/supervisors/operators) / No of shifts
No. of Contract employees
No. of Part time employees / Working days per year
If shifts are applicable please indicate the details for each shift below:
Shift 1 / Start time shift / End time shift
Key shift activities
Shift 2 / Start time shift / End time shift
Key shift activities
Shift 3
(add more if needed) / Start time shift / End time shift
Key shift activities
Are other sites/locations to be covered in the certification? /

Note –

Please indicate the number of employees, involved directly or indirectly affecting food safety issues, in the activities which are covered in the scope of certificate.

Site 1 information(add more tables if needed)
Address
No. of Employees in general shifts
(incl manager/supervisors/operators)
GeneralShift Timings
No. of Employees working in shifts
(incl manager/supervisors/operators) / No of shifts
No. of Contract employees
No. of Part time employees
No. of Outsourced employees
No. of Seasonal workers / Working days per year
If shifts are applicable please indicate the details for each shift below:
Shift 1 / Start time shift / End time shift
Key shift activities
Describe level of control for the shifts (based e.g. on internal audits, Quality Control)
Shift 2 / Start time shift / End time shift
Key shift activities
Describe level of control for the shifts (based e.g. on internal audits, Quality Control)
Shift 3
(add more if needed) / Start time shift / End time shift
Key shift activities
Describe level of control for the shifts (based e.g. on internal audits, Quality Control)

Undersigned / Authorized Representativedeclares that the information / data provided in this form is correct to the best of my knowledge

Name:
Signature / Position:
Date:

Even Soft copy can be filled-up and returned.

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