Application for Registration of Major Producer (Packaging) R1

Application to Laois County Council for Registration under theEuropean Union (Packaging) Regulations 2014

All sections of the application form must be completed

(Please Use Block Capitals)

Section 1: Major Producer Company or Body Corporate Details

Company Name______

(i.e. Major Producer Company)

Trading as______

(If different from above)

CRO Number (if applicable)______

Registered Address______

(i.e. Company Registered Office)______

______

Telephone Number______

Fax. No.______

E-mail address______

Section 2: Correspondence Details – Nominated Branch

Name & Address for Correspondence______

(If differentfrom above, otherwise state______

‘as in Section 1’)______

Telephone Number______

Fax. No.______

E-mail address______

Section 3: Details of Owner

Name of Owner______

Address of Owner______

______

______

Section 4: Details of premises subject to this Registration

Provide the details of premises operated by the Company to which this application relates (i.e. all premises owned/operated by the Company within the functional area of Laois County Council from which packaging waste is produced)

Trade Name & Description of Premises
(i.e. Shop, Pub, Hardware Store, Warehouse, Factory, Takeaway etc.) / Address/ Location of Premises

Section 5: Standard Information

NACE code (codes are listed on CSO website)______

Section 6: Packaging Quantities Information

Estimated weight of packaging that was/is intended for reuse and all other packaging received & supplied by the applicant in the twelve month period prior to the date of this application.

Specified Packaging Type / Reusable Packaging Received
(tonnes) / Reusable Packaging Supplied (tonnes) / All Other Packaging Received
(tonnes) / All Other Packaging Supplied
(tonnes)
Aluminium
Fibreboard
Glass
Paper
Plastic Sheeting
Steel
Wood
Total /

______x €15______

Fee Payable = (calculated on packaging supplied, min of €500, max of €15,000)

Estimated weight of packaging on products imported and supplied and/or products pack-filled

Specified Packaging Type / Reusable Packaging Received
(tonnes) / Reusable Packaging Supplied (tonnes)
Aluminium
Fibreboard
Glass
Paper
Plastic Sheeting
Steel
Wood
Total

Section 7: Packaging Supply Information

List producers from whom packaging and packaged products were received in the twelve month period prior to the date of this application.(This page may be photocopied if there is insufficient space)

Name / Address / Specified Packaging Type

List producers to whom packaging and packaged products were supplied in the twelve month period prior to the date of this application. (This page may be photocopied if there is insufficient space).

Name / Address / Specified Packaging Type

Section 8: Checklist

Please ensure that all items on the checklist are included with the completed application form.

Items to be included / Tick (as appropriate)
Completed Application Form
Copy of 3-year plan included with Application Form (Regulation 15)
Copy of notices prepared and displayed (Regulations 10(1), 10(2) and 15(1))
Appropriate Fee

Section 9: Declaration

I/We hereby make application for registration, pursuant to the provisions of the European Union (Packaging) Regulations 2014 as amended.

I/We certify that the information given in this application is truthful, accurate and complete (see note below).

(1.) / (2.) / (3.)
Signature
Print Name
Date
Position in organisation
On behalf of (Name of organisation)

Notes:

  • In the case of a partnership, all partners should sign the declaration
  • If the application is signed by an agent/consultant, the proposed registered party must also sign and date the declaration.

Send completed applications to:

Waste Enforcement,

Environment Section,

Laois County Council,

Portlaoise,

Co. Laois.

Page 1 of 5