Information and documentation required for a as required by
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PRODUCT CLASSIFICATION (IN-STATE ONLY) Information and documentation required for a PRODUCT CLASSIFICATION Payment in advance is required – check or money order made payable to the as required by FDA and Georgia Department of Agriculture, University of Georgia, or provide credit card authorization information below. for food products that will be produced by a licensed co-packer. Product will not be shipped without full payment. All recipe/formula ingredient information is kept strictly confidential. Once approved, a letter of product classification will be issued to the INSIDE Georgia Department of Agriculture’s Consumer Protection Division, who GEORGIA Service/Item Cost Total ONLY will then contact you. Please allow at least three weeks for processing. Product classification fee (covers all $75.00 products submitted at one time) Please type or write legibly (on separate sheet) the information below about the Product testing (pH, Brix, etc.) add $25.00 for process used to make each product: each product 1) Recipe/formula with all ingredients with accurate measurement/weight SUBTOTAL OF ORDER (i.e., grams, pounds, ounces, etc. - household measure is acceptable). 2) Product lot/batch code procedure (consult your co-packer) ** Georgia Sales Tax (your county’s is ____%) 3) Recall procedures TOTAL OF ORDER $ Name of product(s): _________________________________________________ Payment Method Co-Packer Company: ___ Check No. _____ or money order for $__________ payable to the University of Georgia Contact Person: __ Visa __ MasterCard __ Discover __ AmEx Mailing Address: City/State/Zip: Card number: Phone/Fax: Expiration date (MM/YY): Email: Signature: Send required information with sample of product(s) and payment to the address Print name of signer: below. Please be sure your name and the product name appear on all pages! Contact Name: Mail to: Process Approval Company Name: University of Georgia Extension Food Science Mailing Address: 240A Food Science Building Street Address: Athens, GA 30602-2610 City/State/Zip: Phone: 706/542-2574 Website: www.EFSonline.uga.edu Phone/Cell: Fax: **Check or money order requests that do not include sales tax will be held until the balance of the payment is received. Sales tax will be figured into Email: credit card payments and a receipt will be issued.