Annex
Production questionnaire for products exported to Australia
Effective 22 July 2016 to 18 October 2018Production questionnaire for products exported to Australia
Section A: General information | ||
Purpose of this form |
Information provided in this form will be assessed and used to determine the risk of the product and the import conditions that will be applied to the import permit. | |
Questionnaire requirements |
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What you must know |
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To complete this form |
Enter data in all relevant fields, expand text boxes if space is insufficient, save the document and ensure to include with BICON permit application. If you have any questions please contact Department of Agriculture and Water Resources Animal and Biological Import Assessment Branch |
Section B: Importer and Manufacturer
1. Importer details
Importer company name |
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Import permit application number (if known) |
Previous import permit number for this product (if applicable) |
2. Manufacturer details (establishment where final product is made)
Name of manufacturer |
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Street address |
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City |
Country |
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Phone |
Fax |
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Email |
If import documentation will be provided from an alternative location (e.g. head office) please provide details below.
3. Administrative Office details (Note: If different from Manufacturer details)
Administrative office |
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Street address |
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City |
Country |
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Phone |
Fax |
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Email |
Section C: Product
4. Product details
Product name |
Package type |
Package size |
End use |
E.g. Ricotta and tomato pasta sauce |
Glass Jar |
400g |
Human Consumption |
5. Product ingredients
Ingredients Please list all ingredients below, including added water. Please include percentages adding up to 100% |
% |
Sub–ingredients Please include percentages adding up to the same % as the ingredient they form. |
Species of origin (animal/plant) or Genus and species (fungi / microbial) |
Country of origin Required for animal derived material only. The country in which the animals resided at the time of collection. Please note: the EU is not a country. |
Processing Please include: - Pasteurisation parameters must be provided for all dairy/egg ingredients. - heat treatments applied to the core of the meat, egg or baked goods. - any additional heat treatments applied. |
e.g. Chopped tomatoes |
44% |
Not applicable |
90⁰C for 30 seconds | ||
e.g. Ricotta cheese |
25% |
Whey |
Bovine (cow) |
Italy, Austria, Germany |
Pasteurisation parameters: 72⁰C for 15 seconds |
Cream |
Bovine (cow) |
Italy |
Pasteurisation parameters: 72⁰C for 15 seconds | ||
Milk |
Bovine (cow) |
Not required for plant ingredients |
Pasteurisation parameters: 72⁰C for 15 seconds | ||
Salt |
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e.g. Onion |
5.5% |
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e.g. Sunflower seed oil |
5.5% |
Maltodextrin 2% |
Not required |
Not required for highly processed ingredients |
Not required |
e.g. Beef extract |
11% |
Bovine |
Australia |
100⁰C for 30 minutes | |
e.g. Flavouring: Tomato Flavour |
9% |
Natural flavouring Substances 35-45% Flavourings preparations <2% Maltodextrin 50-60% Silicon dioxide E551 5% Arabic gum E414 <2% Vegetable oils <2% |
Vegetable Yeast extracts (Saccharomyces spp.) Potato (Solanum tuberosum) Synthetic Acacia spp. Palm (Elaesis guineensis) |
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6. Manufacturing Overview (for all products)
Please insert here (electronically) either a manufacturing flow chart or a robust description of the manufacture of this product. Check if Commercial-in-confidence information Please provide an overview of how the above ingredients are combined to form the final product. Please include any additional treatments that the product is exposed to as part of the manufacturing process, for example:
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7. Dairy or meat traceability (for all products – if dairy or meat ingredient in the products)
Has the dairy or meat passed through any additional countries (other than the above specified country of origin and country of manufacture): no yes If yes, please provide details: e.g. The ‘Whey Powder’ was processed in Croatia using milk collected from animals which resided in the USA. |
8. Retort data (Basic parameters of the retort process should be recorded in this table – if product retorted/canned/sterilised)
Date of Retort |
Weight of product |
Machine type |
Pressure |
e.g. 26 December 2013 |
e.g. 400 gram glass jar |
e.g. Hydrostatic steriliser |
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9. Enzymes and Microorganisms (for all products – if enzyme or microorganism ingredients present)
Are any microorganisms used in the manufacture of the product: no yes If yes, please provide details: e.g. The Flavourings preparations are derived from Yeast extracts (Saccharomyces spp.) Are there any enzymes are used in the manufacture of the product? no yes If yes, please list enzyme/s used, % in final product and species of origin: e.g. Product contains 0.1% lactase derived from bovine (cow). |
Section D: Applicant declaration
To be completed by the Manufacturer listed in Section B of this application.
I declare that the information above is true and accurate to the best of my knowledge.
If manufacturing processes change, so that product is no longer compliant with all conditions on the import permit, I will provide details of the change to the Australian importer so that a new application for import permit (or an application for amendment to the current import permit) can be submitted to the Department of Agriculture and Water Resources
Signature |
Date (dd/mm/yyyy) |
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Full Name |
Email |
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Position |
Section E: Privacy notice
‘Personal information’ means any information or opinion about an identified, or reasonably identifiable, individual.
‘Sensitive personal information’ means any information or opinion about an individual’s racial or ethnic origin, political opinion or association, religious beliefs or affiliations, philosophical beliefs, sexual preferences or practices, trade or professional associations and memberships, union membership, criminal record, health or genetic information and biometric information or templates.
The collection of personal information by the Department of Agriculture and Water Resources (the department) in relation to this application is for the purposes of assessing your application and related purposes. If the relevant personal information requested in this application is not provided by you, the department will be unable to assess your application.
Personal information may be disclosed to other Australian agencies, persons or organisations where necessary for these purposes, provided the disclosure is consistent with relevant laws, in particular the Privacy Act 1988. Your personal information will be used and stored in accordance with the Privacy Principles.
By completing and submitting this form you consent to the collection of all personal information, including sensitive personal information, contained in this form. The department’s
Privacy Policy,
including information about access to and correction of your personal information, is available on the department’s website. To contact the department about your personal information or to make a complaint:
Phone +61 2 6272 3933
Email
privacy@agriculture.gov.au
Post Privacy Contact Officer
Department of Agriculture
GPO Box 858
Canberra ACT 2601