This form should be completed by food business operators in respect of new food business establishments and submitted to the Highland Council 28 days before commencing food operations.
Any person who in, or in connection with, the making of this application makes any statement which he/she knows to be false shall be guilty of an offence and liable on conviction to a fine or imprisonment.
Data Protection – the information you have supplied will be used for the purpose for which you have provided it and any relevant procedures following from this.  This data will be maintained in accordance with the Data Protection Act 1998 and will not be passed on or sold to any other organisation without your prior approval unless this is a legal requirement.

1. Name of food business (trading name)
 

2. Address Of Premises (or address at which moveable premises are kept)

Post Code

3. Telephone No:    Fax No:

4. e-mail Address

5.  Type of Premises Please tick ALL the boxes that apply

Farm / small holding                                          Staff restaurant / canteen / kitchen                 

Food manufacturing / processing                       Catering                                                        

Packer                                                             Hospital / residential home / school                  

Importer                                                            Hotel / pub / guest house                              

Wholesale / cash & carry                                  Private House used for a food business          

Distribution / warehousing                                Moveable Premises e.g. ice cream van            

Retailer                                                            Market Stall                                                   

Restaurant/Cafe/Snack bar             

Other (Please give details):

On the basis of the activities carried out, certain food business establishments are required to be approved rather than registered. If you are unsure whether any aspect of your food operations would require your establishment to be approved, please contact the Highland Council for guidance.

6. Food Related Activities (Please give full details of ALL food-related activities)

7. Number of vehicles/stalls/ships kept at, or used from, the establishment and used for the purposes of preparing, selling or transporting food.

0                5 or less                        6 - 10                        11 - 50                51 plus      (Please tick on box)
 

8. Private Water Supply     Does the establishment have a private water supply?      Yes          No
 

9. Food from other countries  Do you buy food direct from other countries?     Yes            No   
 

10. If this is a new business     Date you intend to open
 

11. If this is a seasonal business     Period of opening each year
 

12. Hours of Operation   
 

13. Number of people engaged in the food business (Count part-timer(s) - 25hrs a week or less as one-half)

0 - 10                       11 - 50                         51 plus            Please tick one box

Section A - To be completed if an individual   

Full Name (BLOCK CAPITALS)      Surname        Forename(s)   

Home Address

Telephone  Number  

e-mail Address

Age, Date and Place of Birth    Age            Date of Birth         Place of Birth 

14. Operator Details   Please complete section A or B

Section B - To be completed if a company or partnership

Full Name   

Address of Principal or Registered Office

Telephone No.   

e-mail Address

Name, Private Addresses and Dates of Birth of directors, partners or other persons responsible for its management e.g. Office bearer of a Committee

Full name, address and date of birth of employee or agent to carry day-to-day management of the activity

15. Name of Operator      Date   

Position in Food Business

AFTER THIS FORM HAS BEEN SUBMITTED, FOOD BUSINESS OPERATORS MUST NOTIFY ANY CHANGES TO THE ACTIVITIES STATED ABOVE TO THE HIGHLAND COUNCIL AND SHOULD DO SO WITHIN 28 DAYS OF THE CHANGE(S) HAPPENING.