Haccp Form

MCS HACCP - Guideline for HACCP Certification
Appendix 2
Form MCS HACCP App(1/00)
MINISTRY OF HEALTH MALAYSIA
APPLICATION FORM FOR HAZARD ANALYSIS

AND CRITICAL CONTROL POINT (HACCP) CERTIFICATION
I. BACKGROUND INFORMATION
1. Name of Company : _____________________________________________________

(in capital letters)
2. Name of Food Premises, if different : _______________________________________

(in capital letters)
3. Registration of Company (ROC) No. : ________________________________

(please attach a copy of ROC Certificate/license)
4. Food Premises Registration No. from Local Authority : __________________________

(please attach a copy of premises registration Certificate/ licensee)
5. Food Premises Address:-

Phone No. : ________________
_________________________________________
_________________________________________ Fax No. : _____________
_________________________________________ E-mail : ___________________

_________________________________________
6. Correspondence Address, if different:-

Phone No. : ________________
_________________________________________
_________________________________________ Fax No. : _____________
_________________________________________ E-mail : ___________________

_________________________________________
7. Contact Person : ______________________ Position : ______________
8. Number of full time workers : ___________________________
9. Annual sale turn-over : ____________________________________

(please enclose a copy of latest Company Audited Account)
1
10. Category of Industry : Large industry Small and medium industry
11. Type of Application :
i. New
ii. Annual Renewal
iii. Application for Added Product
iv. Reapplication
12. Reason(s) for Application :
i. Voluntary
ii. Parent company/franchise requirement
iii. Export requirement (please state the country youre exporting to) :
__________________________________________________________
13. Award of Quality/Safety System Certification : Yes No

If Yes, please specify of certificate awarded and it purposes:
___________________________________________________________
___________________________________________________________
14. Application for HACCP Certification is for the following product(s) :

(Please refer Section IV for the number of products allowed)
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
II. SUBMISSION OF DOCUMENTATION
Enclose herewith are two (2) copies of each the HACCP Manual and supportive documents
for your certification purposes. (Manual and documents submitted will be returned to applicant
after the certification process)
2
III. DECLARATION BY APPLICANT

The Company/Food premises hereby undertakes
i. to declare that the information in the application and accompanying HACCP Manual and
supportive document is true;
ii. to declare that the HACCP programme has been implemented for more than 3 months
and the pre-requisite programmes are in-place;
iii. to comply with the requirement for the HACCP Certification procedure; and
iv. to pay all fees related to the certification process irrespective of the granting of
certification.
Signature : ______________________ Date : ________________
Name of authorized representative of

applicant and Company/Premises ______________________________
Stamp/Chop :
Please return duly completed form to: Director,

Food Safety And Quality Division,
Ministry of Health Malaysia,
3rd Floor, Block E, Parcel E,
Federal Government Administration Centre,
62590 PUTRAJAYA.
3
Form MCS HACCP App(1/00
IV. NUMBER OF PRODUCT/ PROCESS PER CERTIFICATION
Each application is for one certification and the products within each application
shall be from under the same food group as listed below:
1. Live animals & animal 7. Intensive horticulture 12. Canning, UHT,

feeds. operations. and aseptic
2. Slaughtering & boning 8. Extensive broadcare operations.
operations. agriculture 13. Preserved foods
3. Small goods operations. & sauces.
manufacturing. 9. Drink & beverage 14. Fermented
4. Seafood & seafood processing. products.
processing. 10. Fruit & vegetable 15. Food ingredient
5. Dairy food processing. processing. manufacturing.
6. Bakery operations & 11. Catering & food 16. Food retailing.
cereal food processing. service operations. 17. Other : (indicate).
The number of product(s) to be included under one application can be categorized

as follows:
One (1) product from one (1) process type
or;
One (1) product from a maximum of three (3) process types with minor
variations, e.g. IQF, block freezing and spiral freezing;
or;
A maximum of six (6) products from the same process type;
or;
A maximum of three (3) product per process from two (2) different process
types with minor variations e.g. raw frozen (prawn, squid, cuttlefish) and cooked
frozen process lines (cooked peeled prawn, peeled cooked prawn, cooked shell-
on prawn).
The criteria for deciding the number of products and process types that can be
considered for one certification will depend on the risk category of the product and
the complexity of the process type. The above groupings are only guides and the
final decision will be made by Ministry of Health Malaysia.

Haccp Form

Uploaded by

Copyright:

Available Formats

Haccp Form

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Haccp Form

Uploaded by

Copyright:

Available Formats

What is the purpose of this application form?

What is the purpose of this application form?

What are the criteria for deciding the number of products that can be included in one HACCP certification application?

What are the criteria for deciding the number of products that can be included in one HACCP certification application?

MCS HACCP - Guideline for HACCP Certification

MINISTRY OF HEALTH MALAYSIA

APPLICATION FORM FOR HAZARD ANALYSIS

1. Name of Company : _____________________________________________________

2. Name of Food Premises, if different : _______________________________________

3. Registration of Company (ROC) No. : ________________________________

4. Food Premises Registration No. from Local Authority : __________________________

5. Food Premises Address:-

_________________________________________ E-mail : ___________________

6. Correspondence Address, if different:-

_________________________________________ E-mail : ___________________

7. Contact Person : ______________________ Position : ______________

8. Number of full time workers : ___________________________

9. Annual sale turn-over : ____________________________________

Form MCS HACCP App(1/00)

10. Category of Industry : Large industry Small and medium industry

11. Type of Application :

ii. Annual Renewal

iii. Application for Added Product

12. Reason(s) for Application :

ii. Parent company/franchise requirement

13. Award of Quality/Safety System Certification : Yes No

14. Application for HACCP Certification is for the following product(s) :

II. SUBMISSION OF DOCUMENTATION

Form MCS HACCP App(1/00)

III. DECLARATION BY APPLICANT

Signature : ______________________ Date : ________________

Name of authorized representative of

Please return duly completed form to: Director,

Form MCS HACCP App(1/00

IV. NUMBER OF PRODUCT/ PROCESS PER CERTIFICATION

1. Live animals & animal 7. Intensive horticulture 12. Canning, UHT,

The number of product(s) to be included under one application can be categorized

One (1) product from one (1) process type

A maximum of six (6) products from the same process type;

You might also like

_______________________ E-mail : _

_______________________ E-mail : _

7. Contact Person : ________ Position :

Signature : ______ Date :