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Welcome to
West Somerset Council

Food Business Registration Form

Fields marked with * must be completed
Address of Establishment (or address at which moveable establishment is kept) *:
Postcode *:
Name of Food Business (trading name) *:
Telephone Number *:
Full Name of Food Business Operator *:
Address (incl. Postcode) of Food Business Operator:
Telephone Number:
Email Address:
Type of Food Business - please tick ALL boxes that apply *:	Farm Shop Food manufacturing/processing Packer Importer Wholesale/cash and carry Distribution/warehousing Retailer Restaurant/cafe/snack bar Market Seasonal slaughter Staff restaurant/canteen/kitchen Catering Hospital/residential home/school Hotel/pub/guest house Private house used for a food business Moveable establishment, eg ice cream van Market stall Food broker Takeaway Other, please specify below
Other:
Type of Business *:	Sole Trader Partnership Limited Company Other, please specify below
Other:
If Limited Company please complete the next 3 questions
Limited Company Name:
Company Number:
Registered Office Address (incl. Postcode):
Number of vehicles or stalls kept at, or used from, the food business establishment and used for the purposes of preparing, selling or transporting food *:	5 or less 6-10 11-50 51 plus
Water supplied to the food business establishment:	Public (Mains) Supply Private Supply
Full Name of Manager (if different from operator):
If this is a new business, date you intend to open:	Date and timeNow
If this is a seasonal business, period during which you intend to be open each year:
Number of people engaged in food business (count part-time worker(s), 25 hrs per week or less, as one-half) *:	0-10 11-50 51 plus
Your Name *:
Position in business *:
Date *:	Date and timeNow
Declaration
Confirmation of registration information. It is an offence to give false or incomplete information under the Food Safety Act 1990, and the Food Safety (General Food Hygiene) Regulations 1995.
I confirm that the information included within this form is true and accurate.
Tick box to agree *:
Security Code *:

Your form will be received by our Customer Services Team who will forward your request to the relevant department.