CHAIN-OF-CUSTODY CERTIFICATION

APPLICATION

1. CONTACT INFORMATION

Company Legal Name: / dba*:
Date: / Jurisdiction of Company:
Type of Legal Entity:
Primary Contact: / Title:
Contract Signer**: / Title:
Mailing Address:
City: / State/ Prov: / Country:
Email(s): / Post. Code:
Tel: / Fax: / Website:

* ”doing business as” – for contracting purposes please ensure that your company’s full legal name is listed above.

** Contract Signer must have legal authority to represent the company

2. BUSINESS BACKGROUND

Help us create a profile of your business to plan for your chain-of-custody assessment

a) BUSINESS TYPE

Please state the nature of your enterprise:

Primary manufacturing / Import / Export / Broker / Trader / Agent
Secondary manufacturing / Distribution / Wholesale / Retailer
Converter of Paper Products / Other / Printers and Paper Merchants please complete CoC Application_Printer_Merchant http://www.rainforest-alliance.org/forestry.cfm?id=applications

b) COMPANY FACILITIES

Briefly specify type and number of facilities (e.g., factory, sawmill, warehouse, shop) and addresses if different from your principal address above:

Total number of company facilities:
Number of facilities to be included in the CoC certificate:

Facility name/ type:

(e.g., sawmill, warehouse) Physical Address:

c) FSC CERTIFIED PRODUCTION

If you are a manufacturer, please choose the CoC scheme, if known:
We will process and sell certified material separately from all other material: / We would like to mix certified and non-certified material during processing:

3. SIZE CLASS OF CERTIFICATE HOLDER (This will be confirmed during the audit)

Note: size class is based on all wood / wood fiber based products for FSC Accreditation Administration Fee (AAF) purposes. The AAF is determined each year based on the current FSC AAF policy.
Check / AAF Size Class / Annual Turnover ($USD)
Class 1 / < $200,000
Class 2 / $200,001 – 1,000,000
Class 3 / $1,000,001 – 5,000,000
Class 4 / $5,000,001 – 25,000,000
Class 5 / $25,000,001 – 100,000,000
Class 6 / > $100,000,000

4. Planned Certificate Scope (Following Sections are Optional)

However, please note this information will be explained and requested by SmartWood prior to providing a cost proposal

a) FSC-CERTIFIED INPUTS (current or potential) N/A

Please specify FSC-certified material inputs (e.g., logs, sawn timber, paper, board products).

b) NON-CERTIFIED VIRGIN INPUTS N/A

Please specify non-certified material inputs (may be for FSC Mixed and/or FSC Controlled Wood products).
Note: non-certified, virgin inputs shall comply with FSC Controlled Wood requirements FSC-STD-40-005 or FSC-STD-30-010*.

c) NON-CERTIFIED RECLAIMED INPUTS N/A

Please specify reclaimed (post & pre-consumer/post-industrial) material inputs (may be for FSC Mixed or FSC Recycled products). Note: non-certified, reclaimed inputs shall comply with FSC requirements for reclaimed material inputs FSC-STD-40-007*.

d) FSC CERTIFIED PRODUCTS N/A

Please specify products you plan to sell as FSC-certified.

e) FSC CONTROLLED WOOD PRODUCTS N/A

Please specify non-certified products that you plan to sell as FSC Controlled Wood. Note: FSC CW sales shall only be to other FSC COC certified companies.

f) OUTSOURCING N/A

Please specify if you plan to outsource any part of FSC certified handling and/or production to subcontracted facilities (include a description of potential outsourced activities and number of subcontractors to be used).

g) MULTI-SITE CERTIFICATION Are you seeking multi-site COC certification Yes No

(If yes please complete supplemental COC Application Appendix A)

h) GROUP CERTIFICATION

Are you seeking group COC certification Yes No

(If yes please complete supplemental COC Application Appendix A)

* For more information regarding FSC Chain-of-Custody Certification and the standard requirements, please visit: http://www.rainforest-alliance.org/forestry.cfm?id=custody_certification

5. CHAIN-OF-CUSTODY PLANNING

Is there a specific date you would like your certification completed by? If yes, date:
Are there companies in your supply chain that may want to become certified? / Yes No
If yes, please list company names:

SEND TO:

Mr. Gianluca Gondolini, Africa Regional Manager –

Rainforest Alliance, SmartWood Program – European Regional Office, Madrid SPAIN.

Calle Arganda nº 36, Bajo izda,

28005 Madrid Spain

Telf: +34 902 109 515 Fax: +34 902 109 515

CoC Application 07Jul08 (CoC-05) Page 1