Doc.Ref.No.

Request for Certification Service Page 1 of 3

4.4.2
22.08.17 Form

* The application fee must be paid upon submission of this request

1.0 Company Information
1.1 Company Name:
1.2 Legal Registration:
1.3 Top Management Rep: Position:
Tel No/Mobile no:
E-mail:
1.4 Contact Person: Position:
Tel No/Mobile no:
E-mail:
1.5 Company Address:
Building, Street, Sitio,
etc
Barangay
City/ Municipality
Province
2.0 Requested Certification Service
2.1 Standards Organic Fair Trade Others: specify
Product Category/Function
2.2 Final Crops specify if leafy vegetables, root crops, herbs &
Products to spices, etc
be certified Postharvest-Minimal specify if rice milling, green coffee beans, dried
*complete in Processed cacao, etc
product Agricultural Inputs- Seeds specify if seeds/seedlings of leafy vegetables, root
register and Planting Materials crops, herbs & spices, etc
specific Agricultural Inputs- Organic specify
crops Soil Amendments Function of MI: specify if phospate solubilizer,
decomposer, endophytic bacteria, etc
Agricultural Inputs- Organic specify if botanical or microbial
Biocontrol Agents
Allowed Inputs specify
Aquaculture and specify
Aquaculture Products
Live Animals and Animal specify
Products (including beekeeping)
Processed Plant Products specify
Processed Animal and specify
Fishery Products
Mushroom Production specify
Cosmetics specify if lotion, creams, bath and shower
preparations, hair care, etc,
Others specify
2.3 Target Philippines Thailand
Market Europe Taiwan
US China
Japan Other countries:
 Doc.Ref.No. Request for Certification Service Page 2 of 3
4.4.2
22.08.17 Form

Canada
2.4 Recognition  The company and/or your supplier has been registered or certified with another
of Prior certification body
Certification No Yes-fill in below
 Currently Certified by another CB but is considering to change
No Yes-fill in below
 Currently certified by another CB and requests for recognition under PNS
No Yes-fill in below
Current Certification Body of Company/Supplier:
Standards covered by the Certificate:
Products covered by the Certificate:
3.0 Extent of Operations
*complete in farm and Location of units Number of Units
facility register specific Province Municipality Barangay Sitio/ Purok/ size: in Number of
hectares farms/
locations and units
farmers
3.1 Farm
No Yes- Fill in info

3.2 Postharvest facilities

No Yes- Fill in info

3.3 Processing facilities

No Yes- Fill in info

3.4 Storage facilities

No Yes- Fill in info

4.0 Type of Management

Activities Directly owned/ Subcontracted Activities Grower Group with Internal
Managed Control System
4.1 Production No Yes No Yes No Yes
4.2 Consolidation No Yes No Yes No Yes
4.3 Processing No Yes No Yes No Yes
4.4 Others: specify No Yes No Yes No Yes
5.0 Submission
Name and Position:
Date:
 Doc.Ref.No. Request for Certification Service Page 3 of 3
4.4.2
22.08.17 Form

Actions by OCCP ICSI

4.1 Applicable Standards

4.2 Certification Body
4.3 Scope of Certification
4.4 Documents submitted
and other important
information taken from
the Company as
clarification to the
submitted application

4.5 Client Information Policy Brief Information related to the Scope of Certification being applied for
Package provided
Short Introduction on Certification Process
Date Policy Brief Information on Scope of Certification and Inspection
Policy Brief Information on Organic Labelling, Use of Marks of Conformity and
Certification Documents
Policy Brief Information on Sample Collection for Laboratory Analysis
List of Fees
Applicable standards and requirements
Product Register
Farm Register
Facility Register
4.6 Recommendation Application is accepted since the scope is covered by OCCP ICSI services
Application is rejected since the scope requested is not covered by OCCP ICSI
services
Application is rejected since it is not certifiable at the moment: reason

Completed by: Name and Position

Date
Approval by CEO
LEILANI RAMONA K. LIMPIN
Date
Other remarks for this
application
(including “reject application”)

The decision for accepting/rejecting this application is based only on the documents and
information provided by the Company at the time of application