Application form for acceptance of a Certification Body

Application for the acceptance of a Certification Body for carrying out certification in accordance with the
GMP+ FC scheme and/or for the expansion of scopes for already accepted Certification Bodies.

Name of (application) Certification Body
(legal registered name)

Name of applicant Certification Body *

name of the legal representative *

name of coordinator *

Location address *

Postal code *

Place *

Country *

Location address is the same as Postal address

Postal address *

Postal code *

Place *

Country *

Telephone no. *

E-mail address *

Website

This application relates to the issuing of certificates related to the GMP+ scope(s) specified on this form.

The undersigned hereby applies for acceptance as a Certification Body permitted to carry out GMP+ audits.

The undersigned is familiar with GMP+ C10 Acceptation Requirements and Procedure for Certification Bodies /
CR 1.0 Acceptation requirements of GMP+ International and the acceptance procedure and undertakes to
cooperate in the acceptance procedure.

signaturedata

Name representative *

Date *

dd/mm/yyyy

NB: The undersigned must be a legally-entitled representative of the Certification Body.

* = Input is required