Please note that all fields are mandatory
 

Packer or Importer:
 
NAME AND CONTACT DETAILS
 
Name:
 
Address:
 
Phone No.
 
Email address:
 
Name of company shown on label:
 
Agent responsible for packing (as marked on the label) or code mark:
 
PRODUCT DETAILS
 
Name of goods shown on label:
 
Nominal quantity:
 
PRODUCTION DETAILS
 
Expected date(s) of packing:
Now
 
Number of packages to be e-marked:
 
Has this product previously been e-marked for export:
 
Quantity checks (Specify):
 
Submitted by:
 
Address:
 
Phone No.:
 
Email address:
 
 

 

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