ANNUAL CERTIFICATION

Title 21 of the United States (U.S.) Code of Federal Regulations, part 1, subpart L, §1.505, and §1.506; requires all information and documentation related to a product's food safety program be kept up-to-date. To maintain your company's current good FSVP Importer coverage, we respectfully request that the following information be provided on an annual basis. 

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*

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– response required

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– response required, if relevant

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           – if your company is not the supplier, please provide the name of the supplier.

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1. Has any change been made to any product's food safety program in the last year? *

           – if yes, please describe the change and upload new food safety program

No

Yes

2. Has any change been made to any product's ingredients in the last year? *

           – if yes, please describe the change and upload new ingredient list / specifications

No

Yes

3. Has the supplier's conformance with FSVP (or appendant regulations) changed in the last year? *

           – if yes, please describe the change and upload new files / corrective actions

No

Yes

4. Has the supplier undergone a recall or been placed on FDA Import Alert in the last year? *

           – if yes, please describe the circumstance and upload substantiation

No

Yes

5. Has any product been stopped, held, or rejected by U.S. Customs, for any reason, in the last year? *

           – if yes, please describe the circumstance and upload substantiation

No

Yes

6. Is there any additional information that you would like to share?

No

Yes

7. How satisfied are you with the level of service provided by United Safety Agents

           – your response will not influence the certification process or its outcome

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           learn more

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                                                                                 THANK YOU FOR YOUR SUBMISSION                                                                                 

CERTIFICATION  By entering your name below, you certify that the information you provide on and in connection with this form is true, accurate, and complete to the best of your knowledge. Any false statements or deliberate omissions on this form or any other provided documents may be grounds for disqualification from successful Foreign Supplier Verification Program (FSVP) approval or, if discovered after FSVP approval takes place, could result in a product's FSVP approval status being revoked or terminated, and may result in a product or shipment being rejected from entry into the United States. 

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           – for confirmation message only

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Kindly notify USA if any change occurs after this form has been submitted.

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