HALAL INDIA PRIVATE LIMITED
CERTIFICATION DIVISION
APPLICATION FORM FOR HALAL PRODUCT CERTIFICATION
1. Details of the Applicant
Applicant Name (Organization
Name)
Regd. Address *
Address Line 2
Phone No *
Website*
Landline No:
Name of the Chief/ CEO/ Mobile No:
Director/ MD/ VP/ President of Email ID:
Applicant* Fax No:
Skype ID:
Website:
Type of Industry* Choose an item. CORPORATION
Annual Turnover*
2. Details of Manufacturer of Product(s) for Certification (Factory/Premises details)
Unit Name*
Unit Address*
Address Line 2
Brand Name
Primary Point of Contact Landline No:
Person* Mobile No:
Email ID:
Secondary Point of Contact Landline No:
Person* Mobile No:
Email ID:
NOTE: One application valid only for one Manufacturing unit/ factory only.
3. Product & Process Details:
*Specify Scope of Certification
(Please mention here the Process
information, e.g.: Slaughtering OR
Production & Packaging OR only
Processing, etc)
a. HACCP
b. ISO 22000
c. FSSC 22000
Is the Processing/Manufacturing
unit certified with: d. ISO 9001
e. BRC
f. GMP
g. Any Other Certification (Please specify) :
__________________________________________
*Halal Certification required for Yes No
export purposes only?
Issue/ Rev No.: 01/01 Prepared by: MR
Page 1 of 4
Doc. No.: HIPL-CD-PR7.2-01-FM-01 Issue/ Rev Date: Reviewed by: HO
01.08.2021/10.04.2023 Approved by: CEO
HALAL INDIA PRIVATE LIMITED
CERTIFICATION DIVISION
APPLICATION FORM FOR HALAL PRODUCT CERTIFICATION
*If export, Please Specify Export Asian Countries African Countries
Region. European Countries North American Countries
South American Countries Australia/ Oceanic Countries
Middle Eastern Countries
*Halal Management System GSO 2055-1:2015 GSO 2055-4:2021
Standards (for Certification of OIC/ SMIIC 1:2019 OIC/ SMIIC 4:2018
applicant) MS 1500:2019 MS 2200-1:2008
MS 2424:2012 HAS 23201
MS 2634:2019 OIC/ SMIIC 50-1:2022
Scheme (optional) Indian Conformity Assessment Scheme (i-CAS) for Halal
NOTE: Kindly Refer Annex-I For the Selection Of Halal Standard
4.Type of certification request:
Initial Certification Recertification/ Renewal
Please note that details of the trade-wise number of employees will assist HI in estimating the audit duration. Hence, please provide accurate details to
avoid any potential concerns during the audit. The details shall be reviewed during the audit and onsite audit man-days will be revised accordingly. If
any deviations are found. You may change the employee’s description as applicable to your industry.
Use additional sheets if required to provide the below-requested information.
Top Manager Office Production Operators Technician Sub-contractor
No of
Employees Management Staff Staff
Shift 2 Shift 3
General Shift Shift 1
No. of Shifts (Employee (Employees)
(Employees) (Employees)
s)
*No of HACCP Line/
Production Line / Processing
line:
Mention the details:
*ARE THE MANUFACTURING PROCESS (ES) SAME IN ALL SHIFTS? YES NO
IF NO, PROVIDE THE DETAILS OF OPERATION IN EACH SHIFTS:
*DOES THE ORGANIZATION UTILIZED CONSULTANT SERVICE FOR DEVELOPMENT OF HALAL MANAGEMENT
SYSTEMS:
YES NO
*IF YES, INDICATE THE NAME OF CONSULTANT OR CONSULTANCY ORGANIZATION:-
Halal Assurance System (HAS) Assessment: Does HAS Assessment cover any of the following and controls defined?
HAS Assessment has been made? YES NO
If yes, please submit:
Issue/ Rev No.: 01/01 Prepared by: MR
Page 2 of 4
Doc. No.: HIPL-CD-PR7.2-01-FM-01 Issue/ Rev Date: Reviewed by: HO
01.08.2021/10.04.2023 Approved by: CEO
HALAL INDIA PRIVATE LIMITED
CERTIFICATION DIVISION
APPLICATION FORM FOR HALAL PRODUCT CERTIFICATION
5.Manadatory Documents Required for Halal Application
GST Details Yes No
PAN Details Yes No
TAN Details Yes No
MSME Details Yes No
Valid Industry/Trade License Yes No
Factory License Yes No
Non-Disclosure Agreement Yes No
Product List and Specification (Form A) Yes No
RM Ingredient List with supplier details (Form B) Yes No
Process flow Yes No
Test Report from NABL accredited Laboratory Yes No
Declaration of Conformity by the Applicant on the Product(s) for Yes No
Registration using the Applicant’s Official Letterhead
Do you have any outsource process? YES NO
If yes, please Specify:-
Note: Other requirements may be required by HIPL if deemed necessary to ascertain compliance to the applicable
standards prior to product registration.
Declaration: I/we undertake that the information provided by us truly in the application for Halal Certification is based on real practices. All the
ingredients/Raw Materials are mentioned truly in the application & annexure (being used in the formulation). I/we hereby agree to pay the non-refundable
application fees charged by Halal India to process the application which will be valid for 90 days from the date of disbursement.
*Client authorized Representative Name/Signature Designation: Date:
& Stamp:
Note: If there are more than one unit to be Halal certified, kindly fill in a separate Application form
Confidentiality Statement:
Halal India Private Limited, undertakes that it will guarantee all information supplied by or obtained
from the application in respect to its processes, business secrets, prices, and operations will be kept in
the strictest confidence and it will not be disclosed for the benefit of any other company.
Note 1) Annexure-I (on the following page) is a List of your Products / Brands to be certified with the
details of ingredients (raw materials, additives, and processing aids) used in the product. The Annexure
MUST be duly filled completely, for us to process the quotation, based on the details in the Annexure.
An incomplete list of products or incomplete ingredients detail will not be accepted. We cannot quote
the Halal Certification fee without complete details.
Note 2) Application forms will only be accepted when fully completed and duly signed by the
Proprietor/Director or authorized representative with the company Stamp.
NOTE- KINDLY PROVIDE PRODUCTS DETAILS IN FORM A AND RM & SUPPLIER DETAILS IN FORM B
ATTACHED EXCEL SHEET.
Issue/ Rev No.: 01/01 Prepared by: MR
Page 3 of 4
Doc. No.: HIPL-CD-PR7.2-01-FM-01 Issue/ Rev Date: Reviewed by: HO
01.08.2021/10.04.2023 Approved by: CEO
HALAL INDIA PRIVATE LIMITED
CERTIFICATION DIVISION
APPLICATION FORM FOR HALAL PRODUCT CERTIFICATION
Annexure- I
DETAILS OF INTERNATIONAL HALAL STANDARD AND PRODUCTS
STANDARD REGION STANDARD
APPLICABLE PRODUCTS
NUMBER NAME
Farming of Animals for Meat/ Milk/ Eggs/ Honey
Farming of Fish and Seafood
Farming of Plants (other than grains and pulses)
Farming of Grains and Pulses
Production of animal products including fish and seafood, meat, eggs,
dairy and fish products
GSO- Gulf Standard Production of plant products including fruits and fresh juices,
1. GSO 2055-1:2015 Organisation for Middle vegetables, grains, nuts, and pulses
2. OIC/ SMIIC 1:2019 Eastern Countries. Halal Food – Production of mixed animal and plant products including pizza,
3. MS 1500:2019 General lasagne, sandwich, dumpling, ready-to-eat meals.
4. HAS 23201 Requirements Production of food products from any source that are stored and sold
5. MUIS-HS-S001 OIC- Organisation for
at ambient temperature, including canned foods, biscuits, snacks, oil,
Islamic Co-operative
drinking water, beverages, pasta, flour, sugar, food-grade salt
Countries – 57 OIC
countries. Preparation, storage and, where appropriate, delivery of Halal food for
consumption, at the place of preparation or at a satellite unit,
restaurants
MS- Malaysian Production of food packaging material
Standard- Malaysia
Production of food and feed additives, flavourings, enzymes and
processing aids Pesticides, fertilizers, cleaning agents
HAS- Indonesia
1. GSO 2055-4:2021 Halal Cosmetics and
2. OIC/ SMIIC 4:2018 MUIS – Singapore Personal Care- Cosmetics and personal care product
3. MS 2634:2019 General
4. MS 2200-1:2008 i-CAS - India Requirements.
Halal Production of vitamins, minerals, bio-cultures, drugs, pharmaceutical,
1. OIC/ SMIIC 50-1:2022 Pharmaceutical- biopharmaceutical etc.
2. MS 2424:2012 General
Requirements
Indian Conformity Applicable for Meat and Meat Product, Poultry and Poultry Products
(i-CAS) Halal Assessment Scheme & Bovine and Bovine Products.
for Halal
FOR OFFICE (HALAL INDIA PRIVATE LIMITED) USE ONLY:
APPLICATION DATE
CATEGORIES
NO: RECEIVED:
MARKETING DEPARTMENT REPRESENTATIVE
SIGNATURE
.
If you have any questions regarding the Application,
Please call +91 044 4356 7446 / 044 4265 5527 or mail us at enquiry@halalindia.co.in
Our website :: www.halalindia.co.in
Issue/ Rev No.: 01/01 Prepared by: MR
Page 4 of 4
Doc. No.: HIPL-CD-PR7.2-01-FM-01 Issue/ Rev Date: Reviewed by: HO
01.08.2021/10.04.2023 Approved by: CEO
