Refer to the Multi-Ingredient Product Profile Instructions When Completing This Form

Refer to the Multi-ingredient Product Profile Instructions when completing this form.

Applicant: / Applicant No.:
If packaging for another company, please list:
Brand on label:
Product:
Check the claim this product’s label will make. Attach samples of labels for all products for which this Organic Product Profile is used.
"100% organic" "organic" (95% organic ingredients) "made with organic (ingredients or food group(s))” (<95% and 70% organic ingredients)
organic ingredients identified only in information panel (<70% organic ingredients)
Ingredients: Provide complete information about all ingredients used in this product.
Organic Ingredient / Handler or distributor on label / Certification agency / 100% organic or organic ingredient / Proof of certification (transaction certificate, organic certificate, label) / Verified / % of finished product
Nonagricultural Ingredient / Supplier of nonagricultural ingredient / Allowed in the National List §205.605? / Verification that ingredient was produced in accordance with any restrictions specified in §205.605 / % of finished product
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Nonorganic Agricultural Ingredient / Supplier of nonorganic agricultural ingredient / Allowed in the National List §205.606?[1] / Verification that ingredient was not produced using any of the following:
excluded methods[2]sewage sludge ionizing radiation / % of finished product
Yes No
Yes No
Yes No
Yes No
Yes No
Does this product include organic and nonorganic forms of the same ingredient?[3] Yes No
Processing Aids (used in processing but not present in final product): Provide complete information about all processing aids used in the manufacturing of this product.
Processing aid / Supplier of processing aid / Is the processing aid certified organic? / If organic, list the organic certification agency / If organic, proof of certification (transaction certificate, organic certificate, label) / If not organic, is processing aid allowed in the National List?
Yes No / Yes No
Yes No / Yes No
Yes No / Yes No
Yes No / Yes No
Product percentage of organic ingredients: % / Total Ingredients: %

Signature Date

Multi-ingredient Product Profile / Organic / Print Date: 5/9/2019
Controlled Version: 3/2/2018 / Page 1 of 2 / © 2018 Minnesota Crop Improvement Association

[1] Does not apply to “made with” products or products containing less than 70% organic ingredients. Refer to the Multi-Ingredient Product Profile Instructions.

[2] Excluded methods included cell fusion, microencapsulation and macroencapsulation, and recombinant DNA technology, (gene deletion, gene doubling, introducing a foreign gene, and changing the positions of genes when achieved by recombinant DNA technology)

[3] For products labeled as “100% organic” and “organic,” handlers cannot use organic and nonorganic forms of the same ingredients. This is not required for products labeled as “made with . . .” or products containing less than 70% organic ingredients.