Section 1. Type of Registration

Where is the location of the Facility or factory? *

• Within the US, District of Columbia or Puerto Rico
• Foreign (Outside the USA)

Are you a new owner of an already registered factory or facility? *

• Yes
• No

What is the title of the previous owner? *

• Mr.
• Mrs.
• Miss
• Ms
• Dr
• Other

What is the name of the previous owner? *

What is the previous owner's registration number? *

SECTION 2. NAME OF FACILITY/ ADDRESS

Name of the facility or factory *

Company suffix (Company, corporation, etc) *

Country *

Street name and number (1) *

Street name and number (2) *

Postal Code *

City *

State/Province/Territory *

Country phone code *

Telephone area code *

Facility phone number *

Extension (if applicable) *

Country fax code (optional) *

Telephone area code (optional) *

Facility fax number (optional) *

Facility Email *

Unique facility identifier or DUNS number * If you do not have a DUNS number, you can process it through the company by requesting the DUNS NUMBER REQUIREMENT format

SECTION 3. PREFERRED MAILING ADDRESS INFORMATION (OPTIONAL)

This section is OPTIONAL, but if your facility has a preferred mailing address, you can fill out this section

Facility or factory name *

Company suffix (Company, corporation, etc) *

Country *

Street name and number (1) *

Street name and number (2) *

Postal Code*

City *

State/Province/Territory *

Country phone code *

Telephone area code *

Facility phone number *

Extension (if applicable) *

Country fax code (optional) *

Telephone area code (optional) *

Facility fax number (optional) *

Facility Email *

SECTION 4. Parent company or corporate (OPTIONAL)

This section is OPTIONAL, if your company belongs to a corporation and the corporate data is different from the ones provided in section 2 or 3.

Name of the company *

Company suffix (Company, corporation, etc) *

Country *

Street name and number (1) *

Street name and number (2) *

Postal Code *

City *

State/Province/Territory *

Country phone code *

Telephone area code *

Facility phone number *

Extension (if applicable) *

Country fax code (optional) *

Telephone area code (optional) *

Facility fax number (optional) *

Facility Email *

SECTION 5. COMPANY EMERGENCY CONTACT

Title (Mr. Mrs, Miss) *

First name (Optional) *

Middle name (Optional) *

Last name (optional) *

Position (Director, Manager, Plant Manager, etc) (Optional) *

Country telephone code *

Code of the city of the emergency contact *

Emergency contact phone number *

Extension number (if applicable) *

Emergency contact email *

SECTION 6. TRADE NAMES

If your company uses an alternative business name to the name provided in section 2, you can indicate it here

Alternative business name *

SECTION 7. UNITED STATES AGENT (US Agent)

This section is required for successful registration of facilities outside of the United States. To be filled out by the US Agent

Is the agent an individual, corporate, company or association? *

Title (optional) *

Names *

Surnames *

Country/Area *

Street name and number (1) *

Street name and number (2) *

Postal Code *

City *

State/Province/Territory *

Telephone area code *

US Agent phone number *

Extension (if applicable) *

US Agent emergency phone number (this number must be available 24 hours a day, 365 days a year) *

US Agent Fax Number (Optional) *

US Agent Email *

SECTION 8. PERIODS OF OPERATION OF THE COMPANY

If your company operates seasonally, you have the option to indicate in which periods it operates (for example, 2 harvest periods, etc.).

Indicate the approximate months during which the facility or company works.

Operation periods for harvest 1 *

Operation periods for harvest 2 *

SECTION 9. COMPANY CATEGORY

Indicate the category of activities carried out by your company

• Food for human consumption
• Food for animal consumption

SECTION 9a. CATEGORIES FOR COMPANIES THAT PROCESS FOOD FOR HUMAN CONSUMPTION

Select the category or categories of your company

• Alcoholic beverages
• 2. Baby food (including infant formula)
• 3. Baking products, donut mixes or glazes
• 4. bases for beverages
• 5. Non-chocolate sweets, specialties and chewing gums
• 6. Cereal preparations, breakfast foods, instant foods/instant cereals
• 7. Cheese and cheese products
• 7th Soft cheeses, matured cheeses
• 7b. semi soft cheeses
• 7c. hard cheeses
• 7d. Other types of cheese or cheese products
• 8. Chocolate and cocoa products
• 9. Coffee and tea
• Food coloring
• 11. Conventional diet foods or meal replacements
• 12. Food supplements
• 12a. Proteins, amino acids, fats and lipids
• 12b. Vitamins and minerals
• 12c. Animal by-products and extracts
• 12d. Botanical and herbal products
• 13. Spices and dressings
• 14. Fish/ Sea products
• 14 to. Finfish, whole or fillet
• 14b. Shellfish - molluscs
• 14c.Other shellfish
• 14d. Fish products (ready to eat)
• 15. Food additives, GRAS ingredients or other ingredients used for processing
• 16. Sweeteners
• 17. Fruit or fruit products
• 17th fresh product cut
• 17b. raw agricultural commodities
• 17c. Other fruits or fruit products
• 18. Fruit or vegetable juices, pulps or concentrates
• 19. Jellies, rennet, pudding mixes, or pie fillings
• 20. Ice cream and related products
• 21. Imitation milk products
• 22. Products with macaroni or noodles
• 23. Meat, meat products and poultry
• 24. Milk, butter, or powdered milk products
• 25. Multiple dinners, gravies, sauces and specialties
• 26. Edible nuts and seeds (dried fruits)
• 26th Nuts and nut products
• 26b. Edible seeds and edible seed products
• 27. Prepared salads
• 28. Shell eggs and egg products
• 28th. Chicken egg and fire products
• 28b. Other eggs and their products
• 29. Snack items (flour, molasses, or plant-based)
• 30. Spices, flavors and salts
• 31. Soups
• 32. Light drinks and water
• 33. Vegetables and vegetable products
• 33rd fresh cut vegetables
• 33b. raw agricultural commodities
• 33c. other plant products
• 34. Vegetable oils (including olive oil)
• 35. Vegetable protein products (simulating meat)
• 36. Whole grain or ground grain products, whole grains (flours), or starches
• 37. If it does not fall into any of the previous categories, select this box (that does not appear in any of the previous ones)

If the food you make does not fall into any of the categories, you can describe it here: *

SECTION 9a. TYPE OF COMPANY ACTIVITIES (Food for human consumption)

According to the selected activities, select the type of activities performed by the company

• Storage of food at room temperature
• Storage of refrigerated products
• Storage of frozen products
• Acidified Food Processor
• Low Acid Food Processor
• Interstate Catering Service/Catering Point
• Contract Sterilizer
• Labeller/Relabeler
• Manufacturer/Processor
• Packer/Re-packer
• Storage
• Refurbishment center
• Farm type facility

Other activities: *

SECTION 9b. CATEGORIES FOR COMPANIES THAT PROCESS FEED FOR ANIMAL CONSUMPTION

Select the category or categories of your company

• 1. Grains or grain-based products (sorghum, corn, oats, rice, wheat, or other grains or grain products)
• 2. Seed oils or seed oil products (cotton, soybean or other seed oils)
• 3. Alfalfa products or lespedeza products
• 4. Amino acids or related products
• 5. Animal protein products
• 6. Botanicals or herbs
• 7. Brewery products
• 8. Chemical preservatives
• 9. Citrus products
• 10. Probiotics
• 11. Distillery products
• 12. Enzymes
• 13. Fats and oils
• 14. Fermentation products
• 15. Fodder
• 16. Food byproducts
• 17. Sea products
• 18. Dairy products
• 19. Minerals or mineral products
• 20. Miscellaneous or special purpose products
• 21. Molasses or molasses products
• 22. Non-protein nitrogenous products
• 23. Peanut products
• 24. Animal processing waste
• 25. Screened
• 26. Technical additives
• 28. Vitamin products or vitamins
• 28. Yeast products
• 29. Mixed feeds (poultry, cattle, horses)
• 30. Pet food
• 31. Pet treats or pet chews
• 32. Nutritional supplements for pets (vitamins, minerals
• 33. Check this box if none of the categories match your activity

If the category of food you process is not listed, describe it: *

SECTION 9b. TYPE OF COMPANY ACTIVITIES (Food for animal consumption)

According to the selected activities, select the type of activities performed by the company

• Animal feed manufacturer/processor
• Animal feed storage/distributor
• Acidified Food Processor
• Low Acid Food Processor
• Contract Sterilizer
• Packer/Re-packer
• Labeller/Relabeler
• Reconditioning company
• Farm type installation

Other type of activity: *

SECTION 10. OWNER, OPERATOR OR AGENT IN CHARGE INFORMATION

Name of the entity or person that owns, operates or agents in charge of the company *

Country *

Street name and number (1) *

Street name and number (2) *

Postal Code *

City *

State/Province/Territory *

Country phone code *

Telephone area code *

Phone number *

Extension (if applicable) *

Country fax code (optional) *

Telephone area code (optional) *

Fax number (optional) *

Email address *