List of Name(S), Address(Es) and Registration No(S) of Eggs Producer(S) from Whose Premises

APPLICATION FOR REGISTRATION OF EGG COLLECTOR

European Communities (Marketing Standards for Eggs) Regulations 2005 (S.I. No 140 of 2009) European Communities (Food and Feed Hygiene) Regulations 2005 (S.I. No 432 of 2009)

Applicant’s Name: ……………………………………………………………………………

Address: ……………………………………………………………………………………….

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PPS Number……………………………………………………………………………………

Business Name(s) - if different from above): …………………………………………………

Business Address: ………………………………………………………………………………

……………………………………………………………………………………………………

Company Registered Number…………………………………………………………………………………………… hereby apply for registration as an egg collector in accordance with the above-mentioned Regulations.

NB. Registration cannot be processed if either CRO or PPS number is not supplied.

Address of your proposed intermediate eggs storage depot (if any):

…………………………………………………………………………………………………

Give a brief description of the internal layout (which should include a plan detailing internal dimensions) and fittings of the proposed eggs storage depot:

List of name and address(es)) and registration (no) of egg producer(s) from whose premises “ungraded “ eggs will be collected, ( additional list of producer(s) may be submitted on attached sheet with this application):

(a) Name(s): ………………………………………………………………………………………………

(b) Address(es): …………………………………………………………………………………………… ………………………………………………………………………………………………………………

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(c) Registration No(s):…………………; ……………………….; ……………………………….;

List of name(s), address(es) and registration no(s) of eggs packing centre(s) that will be used by you for the delivery of eggs, ( additional list of packers may be submitted with this application):

(a) Name(s): ………………………………………………………………………………………………

(b) Address(es): ……………………………………………………………………………………………

………………………………………………………………………………………………………………

……………………………………………………………………………………………………………….

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(c) Registration No(s):…………………; ………………………..; ……………………………;

Usual storage location for eggs transport vehicle(s):

…………………………………………………………………………………………………………….

……………………………………………………………………………………………………………

I/We agree to comply with regulatory requirements and standards outlined in EU and National Regulations and future amendments thereof.

Signature of Applicant(s):………………………………………….

Date: …… /…… /

Telephone No …………………… Mobile Phone No ……………………………

Fax No …………………….. e-mail address: ……………………………..

Completed application forms to be returned to: Department of Agriculture, Food & the Marine, Poultry and Eggs Section, Meat Policy Division, Agriculture House, Kildare Street, Dublin 2.

[ Any queries in connection with this application and/or guidelines should be addressed to Department of Agriculture & Food, Poultry & Eggs Section, Meat Policy Division, Agriculture House, Kildare Street, Dublin 2, Telephone No. (01) 607 2263, Fax No. (01) 6072823

No liability shall attach to this Department regarding the existence or adequacy of Planning Permission or other regulatory requirements in connection with building(s) or land area relative to this application. Attached Sheet

List of name, address and registration no of egg producer from whose premises un-graded eggs will be collected:

Name: ………………………………………………………………………………………………

Address: ……………………………………………………………………………………………

………………………………………………………………………………………………………………

Registration No…………………

Name: ………………………………………………………………………………………………

Address: ……………………………………………………………………………………………

………………………………………………………………………………………………………………

Name: ………………………………………………………………………………………………

Address: ……………………………………………………………………………………………

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Name: ………………………………………………………………………………………………

Address: ……………………………………………………………………………………………

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