Use this form if you are currently certified by Pennsylvania Certified Organic for marketing, trading, handling, brokering and/or distributing. If you are not certified, or if you are certified by another certifier, you must use the full Organic System Plan Marketer-Trader-Broker-Distributor/Handler. Attach updated Organic Product Profiles for all products requested for certification. Use additional sheets if necessary. Do not leave any sections blank—instead write ”none” or “not applicable”. Remember to sign this form on the last page.Section numbers refer to the National Organic Program regulations (7 CFR, Part 205).
SECTION 1: General Information § 205.406 (a)(2)
Company Name:
/ Today’s Date:Address:
City: / State: / Zip code:
Primary contact person:
Direct phone number including extension of primary contact:
List names, job titles, phone numbers of all persons authorized to discuss certification matters with PCO:
Legal Status: Sole Proprietor Partnership Business Corp. Non-profit Corp. Trust or association
Other (specify):
Please check any of the following countries to which you intend to export organic products in the next 18 months:
Canada European Union Taiwan Japan
If you intend to export any of your organic products to Japan, European Union, Taiwan or Canada, complete Section 4 of this form.
SECTION 2 (a): Organic System Plan Update
List all products requested for organic certification. Attach an Organic Product Profile for each product.
Product Name / Brand Name / Where processed/co-packed?
Complete the table below for those who process (co-pack) your organic products. Co-packers must be certified. (Attach copies of co-packers’ current certification documentation)
Co-Packer
/Address
/Phone No.
/Certified by
SECTION 2 (b): Organic System Plan Update
I have made or plan to make the following changes in these areas:
Marketing-Trading-Brokering-Distributing/Handling Practice
/ Summary of Changes / No changes
Personnel overseeing organic production
Product composition and ingredient sources / * If changes, complete a new Organic Product Profile form and summarize here.
Production System (such as changes in production flow) / * Ifchanges,enclose new product flow chart.
Audit Control System
Quality Assurance
Pest management / *All pest management products must be listed on enclosed Materials Used – Processor form. In the event that a substance for pest control is needed that is not on the National List, you must show that it is used in accordance with the National Organic Program regulations (§205.271). You must obtain approval from PCO in advance using an Agreement to use a Synthetic in a Facility form from PCO for this purpose.
Packaging and labeling / *Attach samples of advertising materials and actual labels to the Organic Product Profile(s).
Storage
Marketing-Trading-Brokering-Distributing/Handling Practice / Summary of Changes / No changes
Transportation of organic products
Describe other changes to your operation not listed above:
SECTION 3: Annual Summary of Organic Sales § 205.103
Certified organic products sold during last full calendar year (1/1 through 12/31):
If no products were sold, note the reason.Organic Products / Actual Production
Amount / Market Value / Amount of Product Sold / Amount of Product Left to Sell
Estimated annual total production income: % organic % non-organic
NOTE: THE ABOVE CHART MUST BE COMPLETED OR THIS FORM MAY BE RETURNED TO YOU, RESULTING IN A DELAY OF THE CERTIFICATION PROCESS
SECTION 4: International Export: Japan, European Union, Taiwan, Canada
Please provide the following information even if you do not currently intend to export any organic products to Canada, European Union, Taiwan, or Japan in order for PCO to review this information. This will expedite any export verification needs you or your customers may have in the future. However, this information is not required for your Organic System Plan to be considered complete.
A. CANADA N/A
1. Have all ingredients been verified as compliant to NOP/Canada Arrangement? Yes No
2. Are you using any labels for products exported to Canada other than labels already approved by PCO? Yes No
If yes, attach labels for PCO to review.
Note: The 100% Organic Label is not permitted in Canada. Labels must be bilingual (English and French).
Product Names Requested to Ship to Canada / Brand Name / Co-pack or Own Company Product? / Projected Volume to Export to Canada
B. EUROPEAN UNION N/A
3.Are you using any labels for products exported to the European Union other than labels already approved by PCO? Yes No If yes, attach labels for PCO to review.
Note: The 100% Organic Label is not permitted in the European Union.
Product Names Requested to Ship to European Union / Brand Name / Co-pack or Own Company Product? / Projected Volume to Export to European Union
C. TAIWAN N/A
4.Are any products intended for export produced using any materials prohibited by the National List? Yes No
If yes, list.
5.Do you have verification from ingredient suppliers that no materials prohibited by the National List were used in the production of the supplied ingredients? Yes No
6.If livestock products are used in the product exported to Taiwan, do you have verification from the ingredient supplier that systemic painkillers or analgesics, including Lidocaine or Procaine were not used in the animals’ management?
Yes No N/A no animal products used in products exported to Taiwan.
Product Names Requested to Ship to Taiwan / Brand Name / Co-pack or Own Company Product? / Projected Volume to Export to Taiwan
D. JAPAN N/A
7.Do you have verification from ingredient suppliers that the following inputs were not used in the ingredients production?
- Alkali-extracted humic acid? Yes No
- Lignin sulfonate (used as a flotation agent)? Yes No
- Alkali-extracted humic acid? Yes No
- Lignin sulfonate (used as a flotation agent)? Yes No
Product Names Requested to Ship to Japan / Brand Name / Co-pack or Own Company Product? / Projected Volume to Export to Japan
SECTION 5: Conflict of Interest §205.501
9.Have you used any organic production consultants for your operation in the last 12 months? Yes No
(This does not refer to your inspector, certification specialist, or other PCO representative involved with your certification review.)
If yes, list the name and contact information for organic production consultant(s) your operation has used in the last 12 months (7 CFR 205.501 (a) (11) (ii):
Section 6: Affirmation
Information provided on this application is held in strict confidence and will be used only for certification purposes. I affirm that all statements made in this application are true and correct. I have made every effort to ensure that no prohibited products have been used, applied or otherwise allowed to compromise the integrity of the organic products produced or sold by me.
I understand and agree as follows:
- My operation may be subject to unannounced inspection and/or sampling for residues at any time as deemed appropriate to ensure compliance with the National Organic Program.
- Acceptance of this questionnaire in no way implies granting of certification by the certifying agent.
- Failure to comply with the applicable regulations, policies or procedures, or giving false information may result in denial, suspension, revocation or termination of certification.
- Payment of all certification fees is a condition of certification.
- Cooperate with the certification process by completing all documentation requested.
- Make every effort to ensure that no prohibited products have been used, applied or otherwise allowed to compromise the integrity of the organic crops or products produced or sold by me.
- Provide access to all areas and parts of my operation, including records, products and personnel.
- Comply with the National Organic Program Rule (7 CFR Part 205) and Pennsylvania Certified Organic certification policies and procedures.
- Make appropriate certification claims, which accurately reflect the type of certification granted.
- Ensure that my certificate or certification report is not used in a misleading manner and does not harm PCO.
- Only use certification claims, or the PCO name and logo, to indicate that products are in compliance with PCO standards, and use them correctly on advertising, marketing and packaging materials.
- Discontinue use of certification claims, and PCO name and logo, upon surrender, suspension, revocation or termination of certification, and return any certification documents or materials required by PCO.
- Notify PCO of any significant changes to my operation’s organic system plan.
- Notify PCO concerning any application, including drift, of a prohibited substance to any field, production unit, site, facility, livestock, or product that is part of an operation.
- Comply with all conditions of certification listed on Certification Reports or other certification documents.
I give permission for PCO to release information from my file to other recognized certification organizations for purposes of document review. I understand that PCO will obtain a confidentiality statement from the requesting certifier before releasing any information. PCO has my permission to obtain information, documents, or materials related to certification or de-certification from other certifiers.
Your signature(s): / Date:
If applicable:
Signature of Contracted Grower: / Date:
Required attachments: These records must be included with your application or it may be returned to you, resulting in a delay of the certification process.
Client Information Update (including Gross Organic Sales Figure)
Co-Packers’ Current Organic Certification Documentation
Product flow chart (if changes)
Organic Product Profile Updates (if changes)
Materials Used in Organic System – Processor (if applicable)
Label(s)used on your organic products - retail and non-retail (if changes)
Page 1 of 5 CERT B12 Marketer-Trader-Handler Update V2, R2, 1/4/13