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Embed code for: Application_for_Registration_of_Business_(Unit_6)_260916
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Application Form for the Registration of a
Food Business Establishment.
This form should be completed by food business operators in respect of new food business establishments
and submitted to the relevant food authority 28 days before commencing food operations. On the basis of the
activities carried out, certain food business establishments are required to be approved rather than registered.
If you are unsure whether any aspect of your food operations would require your establishment to be approved,
please contact your nearest Public Protection office for guidance.
1. Address of establishment ______________________________________________________
(or address at which moveable establishment is kept)
_____________________________________________ Post Code______________________
2. Name of food business _________________________ Telephone No.____________________
3. Full name of food business operator ________________________________________________________
4. Home Address of food business operator ____________________________________________________
_______________________________________________________Post Code _________________________
Telephone No. ___________________________ E-Mail ___________________________________________
5. Type of food business (Please tick all boxes that apply) 6. Type of Business
Farm Shop Staff restaurant/Canteen/Kitchen Sole Trader Food Manufacturing/Processing Catering Partnership Packer Hospital/Residential home/School Limited Company Importer Hotel/Pub/Guest House Other (Please give details): Wholesale/Cash & carry Bed & Breakfast Distribution/Warehousing Private House used for a Food Business Retailer Moveable Establishment e.g. ice cream van Restaurant/café/snack bar Market Stall Market Food Broker Seasonal Slaughter Takeaway (If limited Company, Please Other: complete 7. below) Please give us a brief description of your business
7. Limited Company Name ____________________________________ Company No. __________________
Registered Office Address __________________________________________________________________
___________________________________________________________ Post Code _____________________
8. Number of vehicles or stalls kept at, or used from, the food business establishment and used for the purposes of preparing, selling or transporting food:
5 or less 6-10 11-50 51 plus
9. Water supplied to the Food Business Establishment. Public (mains) Supply Private Supply
10. Full Name of Manager (if different from operator) ____________________________________________
11. If this is a new business ______________ 12. If this is a seasonal Business ____________________
(Date you intend to open.) ( Period during which you intend to be open each year.)
13. Number of people engaged in food business 0-10 11-50 51 plus (Please tick one box)
Count part-time worker(s) (25 hrs per week or less) as one half
Signature of Food Business Operator __________________
Please send completed forms to: Cornwall Council, Public Protection, Unit 6, Threemilestone Industrial Estate, Truro, TR4 9LD
Data Protection Statement
The information you provide on this form will be held by Cornwall Council; the information given may be retained on computer or in our records. It will be used by the Council for the specific purposes for which it was collected and any other relevant Council purposes including Government anti-fraud data matching - especially Benefits, Council Tax, NNDR, Housing/Rents, Salaries, Employment, Pensions and Members Allowances. It will be held for not less than 3 years in line with the Environmental and Safety Information Act 1998. It will not be exchanged or sold to any third party. Anonymised information may be used for statistical purposes. Any queries please contact Business Compliance on 0300 1234 212
For Office use only: Information checked by:……………………. Date:……………….. Entered by:……………. Date:……………. LocID:………….……
AFTER THIS FORM HAS BEEN SUBMITTED, FOOD BUSINESS OPERATORS MUST NOTIFY ANY CHANGES TO THE ACTIVITIES STATED ABOVE TO [THE FOOD AUTHORITY] AND SHOULD DO SO WITHIN 28 DAYS OF THE CHANGE(S) HAPPENING
d operations would require your establishment to be approved,
The information you provide on this form will be held by Cornwall Council; the information given may be retained on computer or in our records. It will be used by the Council for the specific purposes for which it was collected and any other relevant Council purposes including Government anti-fraud data matching - especially Benefits, Council Tax, NNDR, Housing/Rents, Salaries, Employment, Pensions and Members Allowances. It will be held for not less than 3 years in line with the Environmental and Safety Information Act 1998. It will not be exchanged or sold to any third p