受检单位-慈心有机验证.DOC

Declaration about natural flavours to be used in multi-ingredient organic food products 多種成分有機食品之香料成分聲明 Answers回答: Company Name公司名稱: Address地址: Person Providing this Information填單者: Position職稱: Name(s) of flavour(s)香料的商品名稱: 1 2 3 Are these flavours natural according to Part 205 NOP?依據美國國家有機方案，該香料係”天然的”? For these flavours, is “commercial availability” documentation maintained?該香料是否確認保有”有機原料市面無法獲得”的相關文件 Which carriers are used for each of them?使用哪些載體? Are these carriers synthetic or non-synthetic?這些載體為合成的或非合成的? Which solvents are used for extraction?萃取時使用何種溶劑? Are these solvents synthetic or non-synthetic? 這些溶劑為合成的或非合成的? Which preservatives are used?使用哪些防腐劑? Are these preservatives synthetic or non-synthetic? 這些防腐劑為合成的或非合成的? Do the flavours contain genetically modified organisms (GMOs)? 香料是否含基因改造生物? Have the flavours been produced with the help of GMOs? 香料是否曾藉由基因改造物生產? Has ionizing radation been used at any stage for any of the ingredients? 所有成分在任一階段處理是否曾使用離子化輻射線？ Has any of the agricultural raw materials been produced on land, where sewage sludge was applied?任何農業原料是否曾在使用過汙水汙泥的土地上生產？ * The above information should be provided and signed by a correspondent at the flavour producing company 下列資訊需由香料生產公司的負責人簽字後提供 * You can use one template for up to 3 flavours produced by your company. For more than 3, please use copy of this template! 1份表單可以填寫貴公司生產的最多3種香料。3種以上請影印該表單後使用！ If applicable, please attach a complete Material Safety Data Sheet (MSDS) for each flavour! 如適用，請附上每一香料完整的物質安全資料表（MSDS）。 Date and signature, company stamp日期、簽名、公司蓋章: __________________________ Thank you for your cooperation 謝謝您的合作！ 慈心有機驗證股份有限公司 Tse-Xin Organic Certification Corporation2/2 Document number文件編碼：TOC-NOP-A03 Version版次：1.0 Date of issuance發行日期： 2013/01/16