APPLICATION FORM FOR GRANT OF HALAL CERTIFICATION
AND USE OF HALAL MARK

The information filled hereunder shall be treated as confidential and shall not be divulged for the benefit of any other person or entity.

FORM ID: 2025101420195
1. Company Information
Name of Establishment / Company/ Organisation/ Business in full
Trading name (If different from the above)
Business Registration number
Nature of the entity (Partnership/Ltd)
2. Contact Information
Physical Location
Postal Address
Fax
Company Telephone
Company Official Email address
Name and Role of the contact person
Telephone Contact
Contact Email
3. Products/Services
Name and Description of Product(s)/service(s)
4. Ingredients Information
Please provide a complete list of ingredients per product, together with supplier / manufacturer details. Please state origin of ingredient i.e. animal, vegetable, synthetic etc.
5. Outsourced Processes
Are there any out-sourced processes that may affect conformity?
6. Food Safety Management System
To which level have you implemented the Food Safety Management System?
7. Details of Technical Personnel
No. Names Qualification and Training Responsibilities Action
1 delete
8. Declaration of Raw Materials
Name of Product Ingredients and raw materials/ processing aids Origin of ingredient (plant, animal or synthetic) indicate A,P or S Supplier or Manufacturer's Name and Contact Indicate whether certificates are available (attach if available) Action
delete
9. Additional Information and Documents
business Certificate of registration of business
assignment Trading license
account_box Organisational structure
archive Copies of labels and Packagings
device_hub Process flow diagrams
healing Medical examination certificates for food handlers
verified_user Halal certificates for raw materials
science External laboratory tests for Product analysis
description Material safety data sheet
build Calibration certificates of all equipment used
note_add Any other Relevant Information