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/ Food Business Registration or Cancellation Form
Food Business Registration or Cancellation Form
Food Business Registration Form
Notification of Food Business Registration.
Food Business Registration
Proprietor name:
(Required)
Postal address:
(Required)
Street Address
Address Line 2
Suburb
State
Post Code
ABN
ACN
Phone
(Required)
Email
(Required)
Primary language spoken:
Number of equivalent fulltime staff
Premises Details
Food Business Name:
(Required)
Shopping Centre Name (if applicable):
Shopping Centre Shop Number (if applicable):
Street Address:
(Required)
Street Address
Address Line 2
Suburb
Post Code
Phone:
(Required)
Email
Name of person in charge and title (if different to proprietor):
(Required)
Details of food vehicle (make, model, registration plate, VIN):
Details of any associated premises:
Description of use of premises. Please tick all boxes that apply:
(Required)
Manufacturer / processor
Retailer
Food Service
Distributor / importer
Packer
Storage
Transport
Restaurant / Cafe
Snack bar / takeaway
Caterer
Hotel / motel / guesthouse
Pub / tavern
Canteen / kitchen
Hospital / nursing home
Childcare centre
Home delivery
Temporary food business
Mobile food operator
Market stall
Charitable or community organisation
Meals-on-wheels
Other
Use of Premises - Other
Additional details:
Please provide additional details about your type of business:
(Required)
Do you provide, produce or manufacture any of the following foods?
Choose all foods appropriate for your business:
(Required)
Prepared, ready-to-eat table meals
Frozen meals
Raw meat, poultry or seafood (i.e. oysters)
Processed meat, poultry or seafood
Fermented meat products
Meat pies, sausage rolls or hot dogs (ready-to-eat)
Sandwiches or rolls
Soft drinks / juices
Raw fruit and vegetables
Processed fruit and vegetables
Confectionary
Infant or baby foods
Bread, pastries or cakes
Egg or egg products
Dairy products
Prepared salads
Other
Other foods appropriate to your business
Nature of Food Business
Are you a small business?
(Required)
Yes
No
Is the food that you provide, produce or manufacture ready-to-eat when sold to the customer?
(Required)
Yes
No
Do you process the food that you produce or provide before sale or distribution?
(Required)
Yes
No
Do you directly supply or manufacture food for organisations that cater to vulnerable persons?
(Required)
Yes
No
To be answered by manufacturing/processing businesses only
Do you manufacture or produce products that are shelf stable?
Yes
No
To be answered by food service and retail businesses only
Do you sell ready-to-eat food at a different location from where it is prepared?
Yes
No
Different location phone:
Different location email:
Operating hours
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Food Recall Contact
Name
(Required)
First
Last
Phone
Email
Declaration
Name of Applicant:
(Required)
Position (in the case of a company, the signing officer must state the position in the company):
Date
(Required)
Day
Month
Year
Declaration
(Required)
I declare that I am the person named as applicant on the form above and that the information contained in this application is true and correct in every particular. I also declare that I am authorised to complete and submit this application on behalf of the proprietor listed on the form above.
Documents:
Drop files here or
Select files
Max. file size: 65 MB.