Country of dispatch

1. Consignor/Exporter

Name

       Address

1. Certificate number

1. Recognized Authority of the exporting Country and its contact details:

1. Consignee/Importer:

Name

Address

1. Country of origin:

1. Country of destination

1. Conditions for transport/storage to be maintained

1. Product Description

a.       Name of the product/s (Nearest food category as per FSSR)

b.      Producer/manufacturer (name & address)

c.       Lot no./Batch no.

d.      Net weight:

e.       No. of unit/packages

f.        Type of packaging

g.       Date of manufacture/packaging

h.      Date of expiry(If applicable)

1. Product composition

1. Intended purpose

1. Whether the product is meant for repacking or relabeling in destination country.

a.       If Yes, then details of premises for Inspection clearance.

YES/NO

1. Declarations

The undersigned Authorized Official certifies that the product(s) described above satisfies the following requirements:

a.       The food product(s) has not involved any animal testing for any purpose including safety evaluation, unless provided by any Regulatory Authority.

b.      The stages of production, processing, and distribution are designed with appropriate precautions in conformity with Good Manufacturing Practices to avoid the unintended presence of non-vegan substances.

c.       Vegan and non-vegan raw materials are stored separately. The production line of the above company is separate from Non-vegan products or ingredients.

d.      If Not separate thorough cleaning or comparable measures in conformity with Good Manufacturing Practices have been carried out before production of vegan products commences and also for all associated machinery, equipment, utensils, and surfaces.

e.       Backward traceability of ingredients and their source is established.

1. Authorized official:

Name:

Designation:

Date:

Signature:

Official stamp: