Please fill out completely – this application serves as a basis
for the calculation of your offer – it is NOT A CONTRACT

Company Information

Address of the Company certificate holder Address where Kiwa BCS will send the Certificate ☐	Address of the production site if not the same as certificate holder Address where Kiwa BCS will send the Certificate ☐
Company Name:	Company Name:
P.O.Box / Street:	P.O. Box / Street:
Zip Code / Town:	Zip Code / Town:
Province / State:	Province / State:
Country:	Country:
Geographical Reference e.g. 49°27'30.86"N 11°5'41.20"E	Geographical Reference e.g. 49°27'30.86"N 11°5'41.20"E
VAT Reg. No. Only EU-clients
Contact data of owner	Contact data of responsible person if not the owner
Name:	Name:
Phone:	Phone:
Mobile:	Mobile:
Fax:	Fax:
E-mail:	E-mail:
Address of the post-harvest / processing site if not the same as certificate holder	Address of a second production or post-harvest / processing site / export unit if relevant
P.O. Box / Street:	P.O. Box / Street:
Zip Code / Town:	Zip Code / Town:
Province / State:	Province / State:
Country:	Country:
Geographical Reference e.g. 49°27'30.86"N 11°5'41.20"E	Geographical Reference e.g. 49°27'30.86"N 11°5'41.20"E
Contact data of responsible person if not the owner	Contact data of responsible person if not the owner
Name:	Name:
Phone:	Phone:
Mobile:	Mobile:
Fax:	Fax:
E-mail:	E-mail:
Note 1: If applicant is not legal owner of all facilities/sites ( sub-contractors), please fill in Annex-“Structogram”. Note 2: In case of NOP certification, refer to §205.100 and §205.101 for information on what has to be certified and what is exempt from certification. IMPORTANT: Marketing, sale and/or export/import of the organic products can be conducted by the certificate holder exclusively!

Please indicate the used/spoken languages on all levels: managers (if relevant), responsible persons such as employees/ workers, or farmers, beekeepers, etc. (in case of a group)
Is the person in charge able to speak and understand English? (Not relevant for countries in Latin America)

Schemes (certification-programs) to be certified

EU) (EU-Market)	☐	NOP (US-Market)	☐	JAS (Japanese Market)	☐	Demeter	☐
OSKSA	☐	Fair TSA	☐	Bio Suisse1)	☐	Naturland2)	☐
Loi n ° 99-30 - Règlement Tunisien de l’Agriculture Biologique	☐
Other national or private standard(s):

1)	Kiwa BCS will carry out the Bio Suisse inspection – which is covered by our offer. The certification will be done by International	Certification Bio Suisse AG (ICB). In most cases, you will need an agreement with a Bio Suisse-certified Suisse business partner.

2)	For Naturland certification, please kindly also contact Naturland (naturland@naturland.de) asap. Kiwa BCS will carry out the Naturland	inspection – covered by our offer. The Naturland certification will be done by Naturland e.V./Germany.

Scopes of Activities to be certified

Agriculture Individual / Farmer	☐	Post-harvest Handling	☐	Livestock (does not apply to NOP)	☐	Beekeeping	☐
Aquaculture	☐	Wild Collection/Crops	☐	Group of operators / Producer Group 3)	☐	Processing	☐
Distributor	☐	Export	☐	Storage	☐	Feed (EU / JAS)	☐
Retail Food Establishment (NOP*)	☐	Private Labeler (NOP*)	☐	Trader/Marketer (NOP*)	☐	Import to the USA (NOP*)	☐
Co-Packer (NOP*)	☐	Re-Packing (JAS)	☐	Wine	☐

3)	Always must have an ICS = Internal Control System  a documented internal quality system that includes a contractual arrangement with each group member. Qualified internal inspectors are to be nominated to conduct annually inspections of every group member.

* exclusively NOP

In case your operation is carrying out activities not fully covered by one of the above indicated options, please shortly list them.

Do you produce non-organic and organic products?	Yes ☐	Are non-organic and organic products in the same facility – or in different facilities?	Yes ☐
No ☐	No ☐
If YES: On which level? (e.g. processing only)	Which products, crops or species are affected?

Agriculture	Not relevant ☐

Total number of sites:	Total size of production area (including non-organic area):	ha
Would you like to apply for retrospective approval recognition of the conversion period? 4)	Yes ☐	Total organic production area:	ha
No ☐
If YES: Please indicate whether the affected areas are cultivated – and whether they were regularly inspected as part of a program to reduce farming intensity:

4) If yes, an additional procedure must be followed in order to request the retrospective recognition; please ask your closest Kiwa BCS local office.

Group of Operators / Producer Group – Farmer, Beekeeper, etc	Not relevant ☐

Total number of group members:	Range of farm sizes (from … to …):	ha
Is the group legally organized, e.g. Cooperative,etc.?	Yes ☐	What is the average farm size?	ha
No ☐	How many members have more farmland than the average?
Is an Internal Control System (ICS) already implemented?	Yes ☐	Total number of sites / facilities, incl. post-harvest handling and storage units, etc.
No ☐

Wild Crops Collection including wild algae	Not relevant ☐

Total number of the collection areas:	The respective size(s) of the collection areas:	ha
Total number of take over points / collection points:	Total number of post-harvest handling and storage facilities:
In case of collection of seaweed/ wild algae: Is the growing area of high ecological quality?	Yes ☐	If YES: Which ecological standard is met?
No ☐

Beekeeping	Not relevant ☐

Total number of bee hives - including non-organic:	Total number of organic bee hives:
Total number of locations of the bee hives:	Total of distances between the locations:	km

Aquaculture for collection of wild algae see 3.3	Not relevant ☐

Which kind of species?	Total size of production area (including non-organic area):	ha
No. of ponds/pools:	Total organic production area:	ha
In case of seaweed / algae: Used inputs/fertilizers?	In case of animals: Status (organic, etc.) of the used feeds?
Which kind of animal reproduction are used?	If juveniles are purchased: Which status do they have (organic …)?
Do you have a Sustainable Management Plan 5)?	Yes ☐	If annual production is more than 20 t: Have you prepared an Environmental Impact Assessment 6)?	Yes ☐
No ☐	No ☐

5)	Sustainable Management Plan (SMP) The SMP lists the details of the environmental effects of the operation, the environmental	monitoring to be undertaken, and measures to be taken to minimize negative impacts on the surrounding aquatic and terrestrial	environments, including nutrient discharge per production cycle or per year.

6)	Environmental Impact Assessment (EnvImpAs) The assessment should ascertain the conditions of the production unit and its	immediate environment and likely effects of its operation.

Livestock*	Not relevant ☐

Which kind of animals?	Number of the different kinds of animals?
Total size of production area (including non-organic area):	ha	Total organic production area:	ha
Total size of stable area(s):	m2	Total size of free-range area(s):	m2

*Does not apply to NOP.

Processing	(it refers to food, feed and wine production)	Not relevant ☐

Which kind of products?	Number of locations (sub-units, storage facilities, etc.):
Which ingredients / processing aids are used?	Are non-organic products stored in the organic facilities?	Yes ☐
No ☐
In case of FairTSA only – Total number of employees?

History of certification

Will this be the first organic inspection?	Yes ☐	If certified before: Since when?	Month	Year
No ☐
Previously certified organic by
According to which (organic) standard(s)?
Outcome of certification, including – if applicable – copies of any notifications of non-compliance or denial of certification:
EU specific (EU) 2018/848: If applicable, has the certificate been withdrawn by the previous certification body? Please, indicate the date (dd/mm/yyyy) Bear in mind that Kiwa BCS shall not certify operators or groups of operators that have been withdrawn by their previous control authority or control body in the last 2 years.	Yes ☐ indicate date of withdrawal
No ☐
NOP specific: Has your operation previously been suspended or revoked? (note that in case of a NOP suspension, you must request reinstatement with Kiwa BCS according to (§205.662(f)).) including – if applicable – copies of any notifications of non-compliance, revocation or suspension.	Yes ☐ indicate if suspension and/or revocation
No ☐
NOP specific: Does a person responsibly connected to another suspended/revoked operation work for your company? In case yes, please indicate name of staff, company and whether a reinstatement request already has been granted by the NOP. ((§205.662(f))	Yes ☐ indicate more info as requested on the left
No ☐
If certified before: Please provide a description and evidence ( copies of letters from the certification body, etc.) of all corrective measures implemented.
Internal Double Certification: Your production unit or part of it is currently certified within another project different from the currently applied one in Kiwa BCS, or are you planning to do so?	Yes ☐	No ☐
Internal Double Certification: If applicable Who is the certificate holder? - What is the validity of the certificate? - Which standard (organic)? - If applicable, what part of another group or project?
External Double Certification: Are you currently certified by a certification body other than Kiwa BCS - or are you planning to do so?	Yes ☐	No ☐
External Double Certification: If applicable: Which certification body? Which (organic) standard? What is the validity of the certificate? If applicable: what part of another group or project?

Documentation, ( JAS) Quality Management & Qualification of Responsible Personnel

Do you have a detailed and up-to-date documentation system (e.g. field registers, processing records, etc.)?	Yes ☐	No ☐
Do you keep purchase (e.g. agricultural inputs, raw materials for processing, etc.) and sales/export receipts on file?	Yes ☐	No ☐
Do you have written Quality Management Standards or a Quality Management Handbook (QMH)?	Yes ☐	No ☐
Do you have written regulations concerning the handling of irregularities (e.g. contamination of organic products), recall actions and complaints?	Yes ☐	No ☐
Qualification and professional experience (in years) of the production manager (e.g. farmer or responsible person for processing, etc.):
Qualification and professional experience (in years) of the quality manager – if applicable:
Have the production manager and other responsible persons (e.g. for quality control) participated in an organic JAS training - conducted by a JAS accredited certification body - before?	Yes ☐	No ☐
If YES: Do the participants have a written evidence of this JAS training?	Yes ☐	No ☐

Products to be certified*

Product	Hectare (ha)	Expected amounts in tons (t)
1
2
3
4
5
6
7
8
9
10

*)	in case of more than 10 products please attach a complete product list.

If one of the following products have been listed in the table above, please select it.

Yeasts used as food or feed	☐	Natural gums and resins	☐	Cotton, not carded or combed	☐
Mate, sweetcorn, vine leaves, palm hearts, hop shoots, and other similar edible parts of plants and products produced therefrom	☐	beeswax	☐	wool, not carded or combed	☐
Sea salt and other salts for food and feed	☐	Essential oils	☐	Raw hides and untreated skins	☐
Silkworm cocoon suitable for reeling	☐	Cork stoppers of natural cork, not agglomerated, and without any binding substances	☐	Plant-based traditional herbal preparations	☐

Location(s) of the facility(ies)

Next (inter-)national airport / railway station:
Estimated distances and travel times between airport / railway station and main project (in km and hours):
Accessibility, distances and travel times between all included/involved facilities or sub-units:

Information about Novel foods (relevant under EU regulation)

Novel food is defined as food that has not been consumed to any significant degree in the EU before 15 May 1997 (when the first novel food legislation entered into force). This can be newly developed, innovative food or food produced using new technologies and production processes, as well as food traditionally eaten outside of the EU.

Use the following link to identify if some or part of the products you wish be certified is considered as novel food: https://ec.europa.eu/food/food-feed-portal/screen/novel-food-catalogue/search

☐ We do not have any organic products/ingredients that are considered as novel foods.

☐ We have novel foods and these are listed in the Regulation (EU) 2017/2470 (if not, organic certification is not possible).

I, the applicant for the above-mentioned facility(ies),

declare to be legally entitled to request for an organic certification of products according to the scope of certification as indicated in item 2. of this application.

confirm that all above-mentioned information fully and accurately represents the operation.

accept that if a product(s) listed in point 6 is novel food, it will be evaluated under the EU Reg 2018/848. However, it will clearly mention that although it complies with the organic regulation it cannot be placed as food on the EU market unless I present a pre-market authorisation in accordance with Regulation (EU) 2015/2283.

understand and accept that my above stated information will be treated confidentially by Kiwa BCS.

Place / Date	Signature of Owner / Responsible Person

The part below is for Kiwa BCS internal use only!

A) This part is to be filled in and signed by the Local Office (49703) or Sales & Marketing Team (49702)

Based on the information provided by the data of the application, the operations´ *complexity is estimated to be

☐	Regular	☐	Large	☐	Complex	☐	Special

*Accredited office (AO) keeps the rights to modify complexity during review of the project, in case where assigned category is incorrect or project structure has been changed compared to the application stage.

Based on the information provided by the application the estimated inspection time is estimated to be:

Hours for preparation of the inspection
Hours for onsite inspection
Hours for finalization of inspection/assessment report
Hours for follow up – if applicable
Hours total as detailed above

The above determined parameters serve as a first appreciation for further planning and will be aligned during the review and certification process, based on the results of the onsite inspection.

B) This part is to be filled in and signed ONLY by the responsible person (Certifier/Reviewer; designated Application Reviewer) approved by Accredited Office (AO)

Comment on part A (if necessary!):

This organic certification application has been approved? (choose accordingly)

☐	Yes
☐	No	Please specify:
☐	Yes-under conditions	Please specify:

This decision does not refer to retrospective recognition approval.

Place / Date

Name	Signature Reviewer/Certifier

Person: An individual, partnership, corporation, association, cooperative, or other entity.

Responsibly connected: Any person who is a partner, officer, director, holder, manager, or owner of 10 percent or more of the voting stock of an applicant or a recipient of certification or accreditation.