Bulk Consignee Approval

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					Bulk Consignee Approval
                                                                                                                                                    F: 08 8228 2066

                                                                                                                                                    P: 08 8228 2000
    Exporter Details                                                                                                                                W:
          Exporter Id

      Exporter Name

    Consignee & Bottler Details

    Consignee Name                                                                                   Bottler Name

             Address                                                                                       Address

                         (must be full address of the receiver of the goods)                                          (if different to consignee)

3   Accreditation Details
          To which of the following accepted standards is the bottler accredited:

                                              BRC Global Standard                                                       ISO 22000
                                              IFS - International Featured Standards                                    ISO 9000 series
                                              FEDIS FOOD pour PME                                                       HACCP

                                              An Equivalent Standard* - Continue to Section 4

    Certifying Agent Name

    Scope of Accreditation

                              Expiry Date                                              Will Australia be identified on the label?             Yes

4   Equivalent Standard Details*

     Name of Certification

     Certification must be equivalent to the standards listed above. Please attach supporting documentation outlining the type of certification along
     with a list of the elements included in the auditing standard. A copy of the standard should be attached to this form. The name and address of
     the independent auditing body must also be supplied.

                                            Approval can only be granted if copies of the relevant certificate(s) are attached


             -- Label integrity records have been made and retained to substantiate any label claims that will be made on the product(s) as required by Part VIA of the Australian
                Wine and Brandy Corporation Act 1980,
             -- Compositional information for the product(s) submitted for approval is consistent with label integrity records maintained for that product(s),
             -- Samples submitted for continuing approval are representative of the product(s) being shipped,
             -- The product(s) comply with provisions governing production and sale within Australia,

                                       I hereby declare that the information I have provided is true and correct to the best of my knowledge.

      Date Signed                                          Signature                                                           Print Name
                                                                       (of Exporter)                                                       (of Exporter)
   Prior to exporting a consignment of bulk wine or other grape products the exporter is required to meet the provisions of
   the Australian Wine & Brandy Corporation regulation 6(1)(b)(i) or (ii) and 6(1)(c) by providing information regarding the
   consignee. Authorisation will only be granted for the export of bulk wine to approved consignees. To obtain the approval
   the consignee must be certified in accordance with one of the following quality management standards;

                •          BRC (British Retail Consortium) technical standard,
                •          ISO 22000 standard,
                •          HACCP + ISO 9000 standards,
                •          International Featured Standard (IFS),
                •          FEDIS FOOD pour PME, or
                •          A standard `equivalent' to the BRC.

   Approval will expire upon the expiry of the certification. The approval may be conditional on the receipt of required return
   samples, the condition of the return samples, and the labelling of the return samples.

       Exporter Details
               Exporter Id: The identification number issued to the exporter by the AWBC. It is not mandatory to complete this item
                   however it will assist the AWBC in completing the approval process.
               Exporter Name: The exporter is the entity submitting the product for continuing approval. The continuing approval
                   number will only be issued to this entity. An entity may submit a product for continuing approval that may then be
                   exported by another associated entity.

2      Consignee & Bottler Details
              Consignee Name & Address: The person/company in the overseas destination to whom the goods are consigned. The
                  consignee full name and address is required.
              Bottler Name & Address: The person/company responsible for bottling the goods. This is only required if the bottler is
                   different to the Consignee. The bottler full name and address is required.

3      Accreditation Details
              Accreditation Details: Select the quality management system(s) for which the bottler has gained accreditation. The
                  relevant certificates must be supplied to validate these claims. If the quality management standard to which the bottler
                  is accredited is not listed, select the box titled "An Equivalent Standard".
              Certifying Agent Name: Provide the name of the independent certifying agent. This can be found on the certificate.
              Scope of Accreditation: The certificate will list the scope under which the accreditation has been issued to the company,
                  for example, wine bottling / wine packaging. List the scope of accreditation in this field.
              Expiry Date: The expiry date for the certification. This can be found on the certificate.
              Will Australia be Identified on the Label?: Select Yes from the drop-down box if Australia will be identified on the label.
                    Select No if Australia will not be identified. This answer may affect the certification requirement for the bottler as well
                    as the auditing program for returned samples.

4      Equivalent Standard Details*
              * Note: This section only applies if the box titled "An Equivalent Standard" has been checked in Section 3.
              Name of Certification: List the name of the certification under which the bottler has been independently accredited. A
                  copy of the standard must be supplied which must be assessed by the Corporation as equivalent to the BRC Technical
                  Standard. The name and address of the independent auditing body must also be supplied.

              Declaration: The exporter or their authorised representative must complete the declaration. By signing the declaration,
                   the exporter declares that the matters declared on the application are true.