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Application for Food Export / Commodity Clearance

FDA application form for food export and commodity clearance

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: APPLICATION FOR FOOD EXPORT/COMMODITY CLEARANCE
Date: _____________________
THE DIRECTOR GENERAL
Food and Drug Administration
Civic Drive, Filinvest Corporate City, Alabang
City of Muntinlupa

ATTENTION:
Common Services Laboratory

DOCUMENT TRACKING
NUMBER

FE:
FCO:

REFERENCE NUMBER
Received
Rejected

Evaluated/Received By
Reason/s

Date:

Sir/Madam:
In accordance with the Philippine Exporters Manual O.M. #4 s. 1989, we wish to apply for:

EXPORT CLEARANCE

COMMODITY CLEARANCE

(quantity of goods and destination/consignee)

(Free Sale/Health Certificate/Safe for Human Consumption)

of the following product(s):

(please enter or attach on separate sheet the product description, size/weight, quantity)

For export to:
Consignee’s Name:
Complete Address:

Consignor’s Name:
Complete Address:

We hereby acknowledge that the failure to submit the requirements indicated above and submission of incorrect
and misleading information shall be grounds for denial of this application.

Company Applicant:
Representative Name:
Signature:
Contact Number:

Date Effective: 19 February2015 Revision 03
Issued by: Records Management Team

NOTE:
1.
2.

Please fill-out the form completely in A4 size paper and write all entries legibly.
This form shall be used only when requesting for export/commodity clearance only.

Form No.: QSP (SOP) 3.8-01

Annex 6
Page 1 of 2

APPLICATION FOR FOOD EXPORT/COMMODITY CLEARANCE
REQUIREMENTS:
 Photocopy of valid Certificate of Registration (CPR)
 Photocopy of valid License to Operate (LTO)
- as Manufacturer
- as Exporter
 Packing List or Sales Invoice

Date Effective: 19 February 2015 Revision 02
Issued by: Records Management Team

NOTE:
1.
2.

Please fill-out the form completely in A4 size paper and write all entries legibly.
This form shall be used only when requesting for export/commodity clearance only.

Form No.: QSP (SOP) 3.8-01

Annex 6
Page 2 of 2
 
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