APPLICATION FOR KOSHER CERTIFICATION(Please click the "PRINT" button for a printable version of this page or download the PDF here ).
COMPANY: ___________________________________________________________________
ADDRESS: ___________________________________________________________________
PHONE: ________________________________________ FAX:__________________________
COMPANY CONTACT:___________________________________________________________
TITLE: _____________________________________________PHONE: ___________________
EMAIL: _____________________________________DATE OF APPLICATION: ______________
PRODUCT (S) YOU ARE SEEKING CERTIFICATION FOR:
_____________________________________________________________________________
HAVE ANY OF YOUR PRODUCTS EVER BEEN KOSHER CERTIFIED? YES/NO
IF YES, BY WHOM? _____________________________________________________________
ARE ANY OF YOUR PRODUCTS CURRENTLY KOSHER CERTIFIED? YES/NO
HOW MANY PLANTS ARE INCLUDED IN THIS APPLICATION?
(Please attach a separate set of forms for each plant)
The Kashrut Authority covenants and agrees that it will not communicate or divulge to or use for the benefit of any other person, partnership, association or corporation any of the trade secrets, formulae or secret processes used or employed by the company in or about its business that may be communicated to The Kashrut Authority by virtue of this application. Submission of this application does not entail any commitment upon the part of the applicant or of the Kashrut Authority in any way until agreement for said purpose is duly entered into by both parties.
Everything contained in this application is true and correct to the best of my knowledge. The Au$250.00 application fee is enclosed. The company understands that when a visit is organised it will pay the $750 visit fee and any other travel and time related charges regardless of whether certification is finally approved. The $750 charge will be credited toward certification fee upon grant of certification.
Signature: ________________________________________________________________
Name & Position: __________________________________________________________
PLANT AND PRODUCTION PROFILE
IF THE FACILITY IS NOT LOCATED IN A MAJOR CITY, PLEASE INDICATE THE CLOSEST MAJOR CITY AND THE DISTANCE TO THE FACILITY:
_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________
DESCRIBE ALL THE MANUFACTURING PROCESS(ES) OF THE PRODUCTS. LIST ALL PRODUCTS AND PROCESSES ON THAT LINE:
_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________
(If you wish you may type this on a separate sheet and please use additional sheets if necessary).
PLEASE FILL OUT A SEPARATE PAGE FOR EACH PRODUCT. THIS FORMAT DOES NOT NEED TO BE FOLLOWED. YOU MAY USE YOUR OWN DATABASE FORMAT SUCH AS EXCEL ETC.
NAME OF PRODUCT ______________________________________
INGREDIENT MANUFACTURER KOSHER CERT CERT. EXPIRES (YES/NO)
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Industrial 
