APPLICATION FOR THE REGISTRATION OF A FOOD BUSINESS ESTABLISHMENT

APPLICATION FOR THE REGISTRATION OF A FOOD BUSINESS ESTABLISHMENT

	(Regulation (EC) No. 852/2004 on the hygiene of foodstuffs, Article 6(2))

	This form should be completed by food business operators in respect of new food business establishments and received by 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 Kennet District Council for guidance.

Address of establishment (or address at which moveable establishment is kept)

Trading Name

	Please state the trading name of the food business
	Telephone Number (e.g. 01380123456)
	Full Name of food business operator/operators (or Limited company where relevant)

	If you have an active e-mail address then we can send you a confirmation e-mail to confirm we have received the form. This will include a copy of the form you have completed for your records. (PLEASE NOTE IF YOU DO NOT GIVEN AN EMAIL ADDRESS HERE THEN YOU WILL NOT RECEIVE A CONFIRMATION EMAIL WITH A COPY OF THE FORM ATTACHED ONCE THE FORM IS SUBMITTED)
	E-mail Address
	Please retype your E-mail address

Head Office address

	Head Office address of food business operator (where different from address of establishment)

	Address Line 1
	Address Line 2
	Town
	County
	Postcode
	Telephone Number (e.g. 01380123456)

	Please only give an e-mail address if this is different to the one given above

	E-mail address
	Please retype your E-mail address

Type of Food Activity (Please tick ALL the boxes that apply)

			Staff restaurant /canteen /kitchen
			Retailer (including farm shop)
			Restarant/café/snack bar
			Market/ Market stall
			Takeaway
			Hotel/pub/guest house
			Private house used for a food business
			Wholesale/cash and carry
			Food Broker

			Hospital/residential home/school
			Distribution/warehousing
			Food manufacturing/processing
			Importer
			Catering
			Packer
			Moveable establishment e.g. ice cream van
			Primary producer - livestock
			Primary producer - arable
			Other

Water Supply

How is the Water supplied to the food business establishment?

New Business

Is this a new business?

	Name of food business operator
	Date completed online		4 / 12 / 2008 (day / month / year)

Submit form

	After this form has been submitted, food business operators must notify any significant change in activities to the activites stated above (including closure) to the food authority and should do so within 28 days of the change(s) happening.

	Please tick if you have read and understood the statement

	Currently the Councils policy prevents us from accepting online signatures. Therefore the form must still be printed in order for it to be signed. Once you think you have completed the form you should proceed by choosing one of the following three options.

	Press this button if you wish to print the form yourself to sign and return to the council offices. You will be emailed the form as an atachment and can then print it.

	Press this button if you do not have acces to a printer and you wish to come to the council offices to sign the form. You will be e-mailed a copy of the form and we will have a copy for you to sign.

	Press this button if you wish the council to send a copy of the completed form to you so you can sign and return it to the council offices