Integrated Assessment Services Document ID: IAS 003-PRO

V1.2 12/04/2020
Application for Product certification

DETAILS OF MANUFACTURER OR TRADER

Name:
(Trader)
Address

Postal Code:

Name:

Address
(Manufacturer)
Postal Code:

Mobile Landline Number of

Employees:
E-mail IR

Name of Responsible Person for Contacts

with IAS

Employee Details:
Please list the number of employees in each area/site (please use additional sheets if required) S- Skilled, U-unskilled
Permanent Employees Part-Time Emp. Contract workers Total
Shift 1 Shift 2 Shift3 Shift 2 Shift2 Shift3 Shift1 Shift2 Shift 3 Employ
ees
S U S U S U S U S U S U S U S U S U
Site 1

Site 2

Site 3

THE FOLLOWING TABLE IS TO BE UPDATED FOR THE PRODUCT APPLIED FOR:

S/N Product and its range Description of Product

PRODUCT PHOTOS

Annex – 1 CE Marking

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 Integrated Assessment Services Document ID: IAS 003-PRO

V1.2 12/04/2020
Application for Product certification

S/N Description of Product or Applicable Directives Harmonized Standards (EN)

Installation

TYPE OF CERTIFICATION / INSPECTION APPLIED FOR.

Case of the Regulatory Requirements for the Certification or Inspection

Annex – 2 - Kosher & halal

MANUFACTURING INFORMATION
S/N Product Range of product Category

1. Has the company ever applied for Kosher / Halal certification?.................................Yes* No

If yes, please state the Kosher Agency:

2. Is the company using its own plant and another company’s plant to co-produce the
products?................................................................................................................................. Yes* No
If yes, please state the company name and address detail that is used for the production and the number of
runs a month approx.:

3. Does the company use the packaging services of another company?......................... Yes* No
If yes, please state the company that is used for the packaging and the number of runs a month approx.:

4. Is the certification for:

EXPORT TO ISRAEL: EXPORT TO THE USA:
UK/EU USE: MIDDLE EAST: GENERAL:

MANUFACTURING PROCESS INFORMATION

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 Integrated Assessment Services Document ID: IAS 003-PRO

V1.2 12/04/2020
Application for Product certification

Please give us the process flow for the product applied for, from raw material receipt to deliver of
product.

Name of Product:

MANUFACTURING PROCESS INFORMATION-

Part 2- LIST OF RAW MATERIAL AND PACKING MATERIAL USED.
Please give us the list of raw materials used in the product.

Name of Product:

List of Raw Material Used Packing making used

Integrated Assessment Services Use Only

Date:
Reviewed by:
Can Application be further
processed?
If application is rejected
specify the reason?
Authorized Date:
person
Name and
Signature