Application for Kosher Certification (U.S.)

KOF-K affirms/agrees that it will not communicate or divulge to any other party trade secrets, formulas, or secret processes used by the Company, conveyed to the KOF-K by virtue of this application.

Submission of this application does not authorize the applicant to use the KOF-K trademark. Authorization will only be given after a contract is executed and a kosher certificate is granted.

U.S. Application

The person authorizing this application:

First Name:

M.I.:

Last Name:

Company:

Address:

City:

State:

Zip:

Phone:

Fax:

Email Address:

Additional contact information:

Contact Name:

Phone:

Fax:

Brand Name(s) of product(s) to be certified:

Nature of Products:

Plant(s) at which products are made:

Other products made at these plants:

Do you store any other ingredients in your plant:	YesNo
Are there any owners of the company that are jewish? (This question is asked solely to determain if certain passover procedures must be followed.)	YesNo
Does your company have any plants other than those listed above?	YesNo
Does your company use any release agents or processing aids not listed above? (if yes, please add to ingredient list)	YesNo
Has your company ever been Kosher certified?	YesNo