Messrs. Overseas Merchandise Inspection Co., Ltd. Tel: 81(03) 3669 5184 Attention: Organic Certification Dept. Fax: 81(03) 3669 5198 E-mail: [email protected]

Application Form for Fee Estimation of EU Organic Certification (Handlers- Processing/Non-Processing) 1. Date of application:

2. Applicant Name of business entity: Name of representative: Title and name of contact person: Address of business entity: Contact information: Tel ( ) - , Fax: ( ) - , E-mail:

3. Party to be certified Name of business entity:

4. Common name of Products：

5. Organic operation ☐Handling except processing or ☐Handling including processing

6. Facility for handling (Attach location maps.) Facility name Location Exclusive or shared use*

*Exclusive use for organic products or shared use with non-organic products.

7. Information on whole or partly subcontract handling if any (Attach location maps. Use another sheet for multiple consignments.) 1 Name of subcontractor: 2 Location of Facility: 3 Handling works to be subcontracted: 4 Handling line: Exclusive use for organic products or shared use with non-organic products

8. Route and transportation means of inspectors to the facility sites:

9. Requirement of OMIC explanatory lecture on EU organic scheme □ Required □Not required