APPLICATION FORM - GLOBALG.A.P. CERTIFICATION
LIVESTOCK, AQUACULTURE AND COMPOUND FEED
Company name: (Please use full name of
Company Address: (Street, post code, city,
company with e.g. Ltd., Inc, SAC, SA, SARL, BV)
province, country, P.O. Box)
Legal Representative:
Contact person: (in addition)
Name :
Role :
Name :
Role :
Tel number:
Fax number:
VAT number/ Company registration
number: in country of registration
E-mail address:
Global Location Number/GLN (if
available):
GLOBALG.A.P. IFA V4 (mark preferred modules with “X”)
Livestock production
Aquaculture Production
Cattle & Sheep
Poultry
Finfish
Pigs
Calf/ Young Beef
Molluscs
Dairy
Turkey
Crustaceans
GLOBALG.A.P. Compound Feed Manufacturing (CFM)
Compound Feed Manufacturers
GLOBALG.A.P. Risk Assessment on Social Practice (GRASP)GRASP
Please fill Annex III
Certification Options (mark preferred option with “X”)
Option 1 Single site
Option 1 Multi-sites with QMS (N/A for CFM)
Option 1 Multi-sites without QMS
Option 2 (N/A for CFM)
Additional Services (if needed)
Pre-scoping - This helps you to identify the extent of the compliance of current farming system as per
GLOBALGAP requirements prior to the first inspection/audit.
1. Products
1.1 Livestock/ Aquaculture1 to be certified
Name Animal/
Product (for Aqua
products scientific/Latin
name is also needed)
Annual
Production
(Live weight/ no.
of organisms2)
GGN of the Parallel3
GGN of the
seedling
Production feed
supplier
(Yes/ No)
supplier
(For Aqua)
Country of
destination
Aquaculture1- additionally please fill Annex II
No. of Organisms2 – Aquaculture: for broodstock and/or seedlings estimated number of organisms need to be
mentioned instead of live weight in tons.
Parallel Production3 – Parallel Production is the situation where a farmer produces the same product partly as
certified and partly as non-certified.
Attach extra sheets if needed.
GAPAPPL.F01(20.1).LB.AB EN
Control Union Certifications Head office: P.O.Box 161 8000, AD Zwolle, The Netherlands
Tel.: +31-(0)38-426-0100 Fax.: +31-(0)38-423-7040 www.controlunion.com/certification
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1.2 Compound Feed to be certified (compound feed manufacturing)
Product Name
Annual Production (tons)
Country of destination
2. Production Management Units (e.g. farm sites, fields, arable lands, herd) – Not applicable for CFM
Note: for producer groups applied for Option 2, please fill the annex 1 instead of this table
Note: if parallel production is applicable, all Production sites applied for certification and sites that are not
applied for certification need to be listed below.
Units applicable for certification
Name unit
Address and
country
Name of
contact person
Products
(Livestock/
Aqua/ feed)
Annual
production
(tons)
Added/
Changed/
Withdrawn
Units not applicable for certification
3. Produce Handling Units/ Processing units (e.g. storage, packinghouse, feed manufacturing
unit). Please fill this table in for CFM. List all your units below and mark which
Number of
Name unit
Address
Process (-es) Products
processing
and country (e.g. storage,
lines4
packing)
you want to be
Parallel
Ownership5
(Yes/ No)
certified.
Added/
Changed/
Withdrawn
Processing line4 is the physical/mechanical line.
Parallel Ownership5 – Parallel Ownership is the situation where producers buy non-certified Products of
the same products they grow under certified production (Not applicable for CFM)
4. Subcontractors Are any of your production/processing/handling activities done by subcontractors
(e.g. chemical treatment)? If yes, please mention below.
Subcontractor
Address and country
Activity/Process
Certified or not (if
yes mention the
GGN)
Attach extra sheets if needed.
GAPAPPL.F01(20.1).LB.AB EN
Control Union Certifications Head office: P.O.Box 161 8000, AD Zwolle, The Netherlands
Tel.: +31-(0)38-426-0100 Fax.: +31-(0)38-423-7040 www.controlunion.com/certification
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5. Food Safety System of the organization (Please select the suitable option
for your organization) – Applicable only for Aquaculture production included
with post harvest activities
5a The organization has been currently certified against any GFSI (Global Food Safety
Initiative) recognized food safety standard (GFSI recognized standards: BRC – 5th Edition,
FSSC 22000, IFS Food Version 5, SQF, PrimusGFS, GRMS, Global Aquaculture Alliance Seafood
Processing Standard).
If marked, please mention the standard and the validity (Preferably attach a copy of the certificate)
5b The organization has not been certified for any GFSI recognized standard, but certified
for any other food safety standard (eg: ISO 22000, Dutch HACCP).
If marked, please mention the standard and the validity (Preferably attach a copy of the certificate)
5c
The organization does not hold any certificate on food safety, but has a food system
implemented and the organization would like to get the food safety system certified as
per any of below mentioned food safety standards. (You will be received with an additional
application form, based on the selection of the food safety standard. Cost of food safety system
certification will be charged additionally to GLOBALG.A.P. IFA - Aquaculture)
If marked, please select the desired standard.
☐ BRC
☐ HACCP
☐ ISO 22000
5d The organization does not hold any certificate on food safety, but has a food system
documented and implemented and does not require any other standard than GLOBALGAP
IFA – Aquaculture certification. (In this case, organization’s food safety system will be verified
as per Codex Alimentarius HACCP requirements and the additional time required is charged from
the applicant)
6. Has the project ever been registered, inspected or certified?
If YES, please mention: GGN number and the reason for changing Certification Body.
Note: If previously certified by another certification body and not communicated the GGN will result in a
surcharge of the registration fee of EURO 100 to an Option 1 producer and EURO 500 to an option 2
producer group, as per 4.2.2 of Part I of General regulation of GLOBALGAP.
7. Please describe the location of the production/processing unit
Travel time between units. If applicable, estimated time needed for traveling from nearest international
airport etc.
8. Declaration on disclosure of information in GLOBALGAP database
I agree on the disclosure of information in one of the following ways in the GLOBALGAP database: mark the preferred
data release level with a “X”.
Level 1 : Disclose only minimum obligatory data to the public.
(The GGN, registration no., GLOBALG.A.P Certificate no., scheme, version, option, CB, products and
status, produce handling/processing declaration, number of producers (in Option 2), country of
production and destination, Production Management Units and Produce Handling Units)
Level 2: Disclose company name and address together with data mentioned above under Level 1 to the
public.
Attach extra sheets if needed.
GAPAPPL.F01(20.1).LB.AB EN
Control Union Certifications Head office: P.O.Box 161 8000, AD Zwolle, The Netherlands
Tel.: +31-(0)38-426-0100 Fax.: +31-(0)38-423-7040 www.controlunion.com/certification
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9. Attached documents:
ex. Current Globalgap certificate
10. Preferred audit period:
Undersigned declares to have completed this application form truthfully.
NAME COMPANY
NAME OF THE LEGAL REPRESENTATIVE
FUNCTION WITHIN COMPANY
DATE & SIGNATURE
Based on the above information, Control Union Certifications will
draw up a no-obligation offer for a contract.
Attach extra sheets if needed.
GAPAPPL.F01(20.1).LB.AB EN
Control Union Certifications Head office: P.O.Box 161 8000, AD Zwolle, The Netherlands
Tel.: +31-(0)38-426-0100 Fax.: +31-(0)38-423-7040 www.controlunion.com/certification
4/7
Name of the
Producer
GAPAPPL.F01(20.1).LB.AB EN
ID Code
Address and
country
Role (Auditor/ Inspector)
Name of the producer group
Product
Annual
Product
-ion
(tons)
GGN/GLN
Number
Mention the
address if different
from column 3
Has a Produce
Handling
Unit?(Yes/No)
Name of internal auditor(s)/ inspector(s)
Added/
Changed/
Withdrawn
Annex I
Attach extra sheets if needed.
Control Union Certifications Head office: P.O.Box 161 8000, AD Zwolle, The Netherlands
Tel.: +31-(0)38-426-0100 Fax.: +31-(0)38-423-7040 www.controlunion.com/certification
5/7
ANNEX II
Please fill the below detail for Aquaculture
In house production (as applicable)
Broodstock
Species (trade
estimated
name and
organisms in
Latin name)
no.
Seedlings
(ovas)
estimated
organisms
in no.
Seedlings
(juvenile)
estimated
organisms in No.
Farmed
fish
annual
quantity
(TN).
Quantity
feed used
to obtain
Feed
the annual supplie
production r GGN
per species
(TN).
Ovas
supplier
GGN
Seedlings
(juvenile) Juvenil
estimated
e
organisms supplie
in no. Per r GGN
year
Specie 1
Specie 2
Specie 3
Specie 4
In case you buy your broodstocks, seedlings (ovas) or seedling
(juvenile); please fill out the following table:
Broodstock
Seedlings (ovas)
Species (trade
Broodstock
estimated
estimated
name and
supplier
organisms in
organisms in no.
Latin name)
GGN
no. Per year
Per year
Specie 1
Specie 2
Specie 3
Specie 4
Attach extra sheets if needed.
GAPAPPL.F01(20.1).LB.AB EN
Control Union Certifications Head office: P.O.Box 161 8000, AD Zwolle, The Netherlands
Tel.: +31-(0)38-426-0100 Fax.: +31-(0)38-423-7040 www.controlunion.com/certification
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Annex III
Please fill the below details for GRASP-Assessment
Total number of
employees
Worker Analysis
High season
1
2
3
4
5
6
Low season
Local
Migrant
Permanent/ indefinite
contract
Temporary/ definite
contract
Causal workers/ 0 hr
contract
Agency workers
Students working
Homeworking
Total
Please mention the name of the Worker Union
Are any workers covered by Collective Bargaining
Agreement (CBA)?
YES
please explain:
NO
Do you use an employment agency for hiring labour? If
yes, please indicate the name and place of the agency(s).
Is there a piece rate payment system?
YES
please explain:
Is accommodation(s) to the workers provided?
NO
YES
please mention address(es) of
the place(s) below
NO
Note: For Option 2: please indicate the number of employees per each farmer together with this
application.
Attach extra sheets if needed.
GAPAPPL.F01(20.1).LB.AB EN
Control Union Certifications Head office: P.O.Box 161 8000, AD Zwolle, The Netherlands
Tel.: +31-(0)38-426-0100 Fax.: +31-(0)38-423-7040 www.controlunion.com/certification
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