A statement to Foreign Governments explaining the regulatory setting for dietary supplements can be obtained upon request from Medsafe, the government agency with responsibility for administration of the
Dietary Supplements Regulations 1985.
For further information please contact dietarysupplements@moh.govt.nz
Product details
Name of the product: (exactly as you wish to see it appear on the certificate)
Is the product freely available in the New Zealand market place?
OR
Has it been specifically formulated and/or packaged to be marketed overseas?
Please state intended destination country if you wish this to appear on the certificate:
Manufacture details
Company name Company address
Product owner: (the name and address of the New Zealand company who is responsible for the product)
Manufactured by:
Capsulated by: (if applicable)
Labelled by:
Packaged by:
Please provide a copy of the label for the exported product
Ingredient details
Please list each ingredient in order of ingoing weight:
Weight: Ingredient: (continued from previous column)
Weight:
Applicant details
Company name and physical address:
Postal address:
Purchase order number:
Contact person:
Contact email: Phone:
I declare that the above is an accurate description of the product I intend to export.
Signed ______________________ Date:
Invoice number Export certificate number
Invoicing batch number Customer number