Document # HSD 10 - 013

Halal Certification Services Switzerland Revision date 10 / 04 / 10

Halalzertifizierungsdienste Schweiz Page 01 of 02
services Certification Halal Suisse
Date 10 / 04 / 10

Product Pre-Validation Questionnaire

Product Description Cis 3 Hexenyl Acetate, Natural Product (CAS #) 3681-71-8

Brand Name NSM Company Name N S Mint Products Pvt Ltd
Near 2 km stone, Moradabad Road, Sambhal –
Production Site Sambhal, India Address
244302, Uttar Pradesh, India
Scope of Company Manufacturer and Exporter Contact Person Mr Shashank Bhatnagar
Telephone +91 9997501641 Email sales@nsmint.com

Nr. Area of Interest Question Answer Further remarks

1 Product Info
1.1 Is the product Halal certified? (attach certificate) ☒ Yes / □ No Sent Earlier
1.2 Are GMO used in the product? If yes attach their source □ Yes / ☒ No
Are animal derived ingredients used in the product? (state
1.3 □ Yes / ☒ No
the source of these ingredients)
Derived from the
□ animal / ☒ plant /
1.4 State the source of the product? volatile oil of Mentha
□ synthetic / ☒ natural
Arvensis
Does the product include flavouring?
1.5 Please note that all flavours need to be accompanied by □ Yes / ☒ No No added flavouring
valid halal certificate
List all the raw materials, additives (e.g. emulsifiers,
stabilisers, colours etc), technical processing aids (e.g. Raw material –
1.6
carriers, enzymes [please include the information about the Mentha Arvensis Oil
used culture media], extraction, coating, encapsulation,
 Document # HSD 10 - 013
Halal Certification Services Switzerland Revision date 10 / 04 / 10
Halalzertifizierungsdienste Schweiz Page 01 of 02
services Certification Halal Suisse
Date 10 / 04 / 10

precipitation media etc.) used in the above mentioned

product. Please also state their source
2 Storage
2.1 Are porcine ingredients also stored in the premises? □ Yes / ☒ No
Are necessary steps in place to avoid cross contamination
2.2 □ Yes / □ No Not applicable
during storage? (state the steps)
3 Process
3.1 Does any production process involve porcine derivatives? □ Yes / ☒ No
Does any process involve ethanol? Please state the source
3.2 □ Yes / ☒ No
and the desired functionality
□ added
How is the occurrence of the ethanol in the product to be
3.3 □ naturally occurred in Not applicable
justified?
product
Please state the residual amount of ethanol in the product?
3.4 Laboratory analysis report should be attached stating at ……… % None
least 2 decimal places
Are additives being used during extraction/purification
3.5 procedure? (attach details of the additives and the extraction □ Yes / ☒ No
procedure)
Please provide a detailed process flow diagram (highlighting
3.6 where the raw materials, additives or processing aids are
used in the process)
Production
4
line(s)
The plant only
Are the production lines dedicated for plant-, animal-derived
4.1 ☒ Yes / □ No processes products of
products? (attach production site plan/ process flow)
plant origin.
 Document # HSD 10 - 013
Halal Certification Services Switzerland Revision date 10 / 04 / 10
Halalzertifizierungsdienste Schweiz Page 01 of 02
services Certification Halal Suisse
Date 10 / 04 / 10

Is/are the same production line(s), where the product is

4.2 □ Yes / ☒ No
made, also used for animal derived products?
Is/are the same production line(s), where the product is
4.3 made, also used for products containing porcine □ Yes / ☒ No
ingredients?
Is/are the same production line(s), where the product is
4.4 □ Yes / ☒ No
made, also used for products containing ethanol?
Is the manufacturing of the product done in an open
process? If yes is there a possibility that contamination
4.5 □ Yes / ☒ No
through foreign dust [caused by another open production
line in the same production area] can take place?
5 Cleaning
Does the cleaning procedure of the machines, used
5.1 production utensils and / or infrastructure (e.g. conveyor □ Yes / ☒ No
belt, etc.) involve usage of ethanol?
□ CIP (cleaning in
Distilled mint terpenes
Cleaning of the production equipment and surfaces prior to place) / □ dry cleaning /
and water are used for
5.2 production of the product includes the following steps [attach □ acid/caustic cleaning
cleaning of production
cleaning schedule] / ☒ just water / □ no
equipment.
cleaning
Do the cleaning procedure of the machines, used production
5.3 and / or infrastructure (e.g. conveyer belt, etc.) involve □ Yes / ☒ No
enzymatic-based detergents?
Is adequate amount of water used to rinse out ethanol
5.4 □ Yes / □ No
residual prior starting a new production?
 Document # HSD 10 - 013
Halal Certification Services Switzerland Revision date 10 / 04 / 10
Halalzertifizierungsdienste Schweiz Page 01 of 02
services Certification Halal Suisse
Date 10 / 04 / 10

I/We hereby declare that, following careful verification, the information given in this questionnaire is to the best of my/our knowledge and belief true,
correct, and complete. Any additional documents attached are true and complete copies of original documents.

Authorized Person: Himanshu Gadai

Position: QA Manager
Place and Date: N S Mint Products Pvt Ltd, Sambhal – 13th December 2021

Signature:

Company Stamp: