Isle of Wight Council

	Declaration For Approval Without Prior On-Site Inspection (Article 17 of Regulation (EC) 183/2005)
	The Trading Standards Service Jubilee Stores, The Quay Newport, Isle of Wight PO30 2EH Tel: 01983 823370 / Fax: 01983 823387 / email: [email protected]
	This exemption relates to feed businesses that trade feed products but never hold the product on their premises. Completed Declarations are to go to The Isle of Wight Trading Standards Service, contact details as above.

Business Details

*	Name of Feed Business
	Business name(s) if different

Registered Office Address:

*	Building/house name/number
*	Street address
*	Town name
	County
*	Postcode

Trading Address of Establishment (if different):

	Building/house name/number
	Street address
	Town name
	County
	Postcode

Your Details

*	Forename
	Middle name/Initials
*	Surname

*

Contact telephone number

Products Being Traded

*	Approval Activity Code (please read the Approval and Registration Activities list before completing this question)
*	Description of Products Being Traded (please read the Approval and Registration Activities list  before completing this question)

Declaration

I hereby declare as a person authorised to make such Declarations on behalf of the feed business named above, that all the products the business trades on the market from the establishment are never held on premises under the control of this business and the establishment is, therefore, one to which Article 17 (1) of Regulation (EC) 183/2005 (The European Feed Hygiene Regulation) applies. I further declare that the products are sourced, stored and transported by feed businesses that are approved or registered in accordance with Regulation (EC) 183/2005. I have checked the information given on this Declaration form and to the best of my knowledge and belief it is correct. I understand that a false or misleading statement or that withholding relevant information may result in the refusal or revocation of Approval and/or may render me liable to prosecution.

Name................................................................ Signed............................................................... Job Title............................................................ Date..................................................................

For further information and/or guidance please contact: The Trading Standards Service Jubilee Stores, The Quay Newport, Isle of Wight PO30 2EH Tel: 01983 823370 / Fax: 01983 823387 / email: [email protected]

	Data Protection Act 1998
	This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request. The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's Access to Information Policy. Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest. Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law. Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. If you wish to receive this information for these purposes please tick this box To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. If you wish your non-sensitive personal information to be held by the Council please tick this box

Date printed: 08/03/2013