FORM -15
[See regulation 9 (11)]
(for imported food consignment containing bulk packages and not having representative sample)
Declaration and undertaking by Importer
(To be printed on Letterhead of the FBO/Importer/Company)
I/We,_______________________________as Proprietor/ Partner/ Managing Director/ Director/ Authorized Signatory of M/S__________________________________,do hereby declare and under take that:
- I/We are importer of_________________<Name of food>______from_________________<country of origin of consignment> _____________ vide_________<Bill of Entry number>________dated_________
- The given consignment is aseptically packed and/or hygroscopic in nature and does not contain any representative sample;
- Hence, the FSSAI will not be held responsible for any damage observed before or after sampling of the given consignment;
- I/We shall be responsible and liable for any contravention of FSSA Act, 2006 and Rules & Regulations made thereunder.
- I/We affirm that all information given above is true and to the best of my knowledge and belief.
Signatures of the Importer with Stamp/ Seal | |
Place:-
Date:- |
Name:-
Address:-
Contact No.:- |
FORM -14
[See regulation 9 (10)]
(For imported food consignment containing bulk packages and having representative sample)
Declaration and undertaking by Importer
(To be printed on FBO/Importer/Company’s Letterhead)
I/We,_______________________________as Proprietor/ Partner/ Managing Director/ Director/ Authorized Signatory of M/S__________________________________,do hereby declare and under take that:
- I/We are importer of_________________<Name of food>______from_________________<country of origin of consignment> _____________ vide_________<Bill of Entry number>________dated_________
- The given consignment is aseptically packed and/or hygroscopic in nature and is accompanied with representative sample;
- I/We hereby undertake that the representative samples provided with the consignment is/ are true representative of the imported food product;
- I/We shall be fully responsible and liable for any contravention of FSSA Act, 2006 and Rules Regulations made there under.
- I/We affirm that all information given above is true and to the best of my knowledge and belief.
Signatures of the Importer with Stamp/ Seal | |
Place:-
Date:- |
Name:-
Address:-
Contact No.:- |
FORM -13
[See regulation 9 (3)]
Declaration regarding issue of provisional NOC for imported food consignment with less than 07 days’ shelf life
(To be printed on the Letterhead of the importing FBO/Importer/Company)
To,
The Authorized Officer, FSSAI
__________ <Port of import>___
Dear Sir,
I/We, resident of [as Proprietor/ Partner/ Managing Director/ Director/ Authorized Signatory of M/S ————-. are importer of ____________<Name of Food Items> _____________ having very short shelf-life (less than 7 days) in the consignment imported vide___________<Bill of Entry> ________dated at _____________<Port location>___________ ,and request you to issue provisional NOC.
I/We hereby under take to comply with the following terms and conditions on behalf of the importing firm/company as under:
- I/We shall be fully responsible for complete product recall in case of non – conformity of the product after lab analysis and shall comply with all the norms for destruction/ re-export, as may be decided by the competent Authority;
- I/We do hereby certify that we have satisfactory food recall mechanis min place;
- In case of failure of product in lab analysis, 1/We shall not be eligible to avail of the above mentioned facility in future and all subsequent imports of the product from the same manufacturer of the same source country or certified by the same lab will be subject to stringent 100% analysis irrespective of certificate issued by the source country prior to clearance by FSSAI Authorized Officer.
- In case of non-conformance of the product after lab analysis, I/We shall be liable for contravention of the FSSA Act, 2006 and Rules & Regulations made there under.
Signatures of the Importer with Stamp/ Seal | |
Place:-
Date:- |
Name:-
Address:-
Contact No.:- |
FORM -11
[See regulation 7 (6)]
(For imported food consignment meant for Sports Events)
Declaration and undertaking by Importer
(To be printed on FBO/Importer/Company’s letterhead)
I/We, _________________- [Proprietor/ Partner/ Managing Director/ Director/ Authorized Signatory of M/S ___________________<With address>_____________ do hereby declare and undertake that:
- I/We have imported the consignment of _______________< Name of product> ________________measuring _____________________<Weight/Units>________________from ________________<Country of origin of consignment> _____________vide ______________ <Bill of entry number> ______________________dated at_______________ <Port location>___________
- I/We undertake that the aforementioned Food Product is intendeds solely for the Sports Events.
- I/We undertake that the food shall not be released for sale to any other person.
- I/We undertake that the unused food shall be re-exported to Exporting country after the event or
- It shall be destroyed.
- I/We undertake that I shall submit the documentary proof thereof within thirty days from the last day of the event.
- I/We undertake that the quantities of food imported are not more than the quantities necessary for direct utilization by the persons concerned for the duration of the stay or event, whichever is earlier.
Signatures of the Importer with Stamp/ Seal | |
Place:-
Date:- |
Name:-
Address:-
Contact No.:- |
FORM -10
[See regulation 7 (5)]
(For imported food consignment meant for Display Purpose in Trade Fair/Exhibition)
Declaration and undertaking by Importer
(To be printed on FBO/Importer/Company’s Letterhead)
I/We, ___________________________________ [Proprietor/ Partner/ Managing Director/ Director/ Authorized Signatory of M/S ___________________<with address> ____________________do hereby declare and under take that:
- I/We have imported the consignment of _______________< Name of product> ________________measuring _____________________<Weight/Units>________________from ________________<Country of origin of consignment> _____________vide ______________ <Bill of entry number> ______________________dated at_______________ <Port location>___________
- The aforementioned Food Product is intended solely for the purpose of Display only in the Trade
- Fair/Exhibition____________ <mention the specific event> ______________and not meant for any other commercial purpose.
- The aforementioned food, apart from Display, is also intended to be used for the purposes of Tasting and I/we undertake that no part of the said product shall be released in the market for consumption purposes in any other manner;
- I/We undertake that after the conclusion of the event, the opened packages of these articles will be destroyed and the packed food will be re-exported to the country of origin;
- I/We shall furnish the details of the total quantity of the consignment imported into India, the quantity consumed in the process of Tasting, the quantity destroyed and the quantity being re-exported to the competent authority in respect of the above said consignment after the conclusion of the Trade fair/Exhibition.
Signatures of the Importer with Stamp/ Seal | |
Place:-
Date:- |
Name:-
Address:-
Contact No.:- |
FORM- 9
[See regulation 7 (4)]
(For imported food consignment meant for Research and Development purposes)
Declaration and undertaking by Importer
(To be printed on FBO/Importer/Company’s Letterhead)
I/We, ___________________________________ [Proprietor/ Partner/ Managing Director/ Director/ Authorized Signatory of M/S ___________________<with address> ____________________do hereby declare and under take that:
- I/We are the importer____________ <Name of food> ______________from _____________<Country of origin of the consignment> ________________ vide _______________<Bill of Entry number>_____________dated ____________
- The above consignment is_______________ <Net weigh __Quantity> __________________and will be used solely for______________ <purpose of consignment> ____________
- The consignment will be exclusively used for Research and Development purposes for assuring the highest quality standards only and will not be utilized or released in the domestic market for human consumption even if it is for test marketing or market research purpose.
- I/We shall be fully responsible and liable for any contravention of Food Safety and Standard Act, 2006 (34 of 2006) and rules & regulations made there under.
I/We affirm that all information given above is true to the best of my/our knowledge and belief.
Signatures of the Importer with Stamp/ Seal | |
Place:-
Date:- |
Name:-
Address:-
Contact No.:- |