The completed form should be sent to:
For Office Use:
FORM
The Food Safety Commission Secretariat
Directorate for Environmental Health
Continental Business Centre,
Old Railway Track,
St Venera SVR 9018
Tel: 21337333
Date of Registration: …………........……
01
Registration Number: ………………........
ENGLISH
APPLICATION FORM FOR THE REGISTRATION OF FOOD PREMISES IN TERMS OF
THE FOOD SAFETY ACT (XIV/2002)
PART 1
1. Premises Name: ______________________________________ 2. Address of Premises / Place of Storage: ________________________
____________________________________________________ Town or Village: ______________________ Post Code: ______________
PART 2
3. Tel. No of Business: ____________________/_______________________/____________________ Fax: _________________________
E-mail address: ________________________
4. Type of Premises: (please tick ONE box only)*.
4.1
CATERING
4.3
RETAILERS
a
Hotel
a
Butcher shop - Selling Only
b
c
d
e
f
g
Apart hotel
Guesthouse
Hostel
Tourist Village
Restaurant
Snack Bar / Cafeteria /
Takeaway
Bar
Hospital / Clinic
Sea Craft serving meals/Snacks
Institutional Establishment
Staff Canteen / Tuck Shop
b
Butcher shop - Licensed by the
Superintendent of Public Health to
prepare meat products
c
Grocery (includes self service,
mini-market, etc.)
Supermarket
Other premises selling food items
Specify in ‘Remarks box’ below
Green Grocery shop
Confectionery (Selling Only)
‘Wines & Spirits’ by bottle only
‘Drinks and water’ by bottle only
Other
Tick here 
(specify in ‘Remarks box’)
j
k
Fish shop
Stationery / souvenir shop licensed
to sell pre-packed food
Pharmacies selling food items
Fixed Kiosk (permanent site)
h
i*
j*
k
l*
m
d*
e
f
g
h
i
4.2*
HAWKERS / KIOSKS
a
Kiosk selling open food
prepared on site
l
m
b*
Kiosk selling open food
prepared elsewhere
4.4
c
e
f
g
h*
i
j
k
Kiosk selling pre-packed snacks
Kiosk selling ice-cream only
Fish
Groceries
Delicatessen
Confectionery
Bread
Other
Tick here 
(specify in ‘Remarks box’)
PACKING / CANNING
Canning includes preserving in jars, cans, bottles
or in any other food-grade containers.
a
b
c
d
e*
f*
Canning: Fruit / Vegetables
Canning: sauces, mayonnaise, etc
Canning: Meat products with less
than 10% meat (e.g. Stews, etc).
Edible oils
Packing: Dry foods
Contact Material
4.5
a
b
c
d
e
f
g
h*
i*
j
k
l*
4.6
a*
b
c*
d*
e*
f*
g*
h*
*
MANUFACTURING /
PROCESSING
Beer
Carbonated Drinks
Non-carbonated drinks
Water
Squashes / Juices
Alcoholic drinks
Wine
Outside Caterer
Bake house
Confectionery manufacturer
Meat products with not more
than 10% meat (e.g. Pizza,
Pies,)
Other
Please tick
(Specify type in ‘Remarks’ box
below) Use separate form for
each type.
MISCELLANEOUS
Importer / First seller
Wholesaler
Food Transport: Give vehicle
Number in ‘Remarks Box’
Temperature-controlled vehicle
Number in ‘Remarks Box’
Cold Store
Stores
Reception Hall
Vending Machine
Please see note overleaf.
REMARKS:______________________________________________________________________________________________________________
5. Name & Surname of the person responsible for the food business: _________________________ Position held: _____________________
Home address: ____________________________________________________________________________________________________
Telephone / Mobile No.: ___________________________________________________________ I.D. Card No.: _____________________
6. Company name & address (if applicable): _____________________________________________________________________________
7. Declaration: I, the undersigned, hereby declare that the information given above is accurate, complete and not misleading.
Name of person filling form: __________________________________________ Position Held: ___________________________________
I.D. Card No.: ____________________________ Date: _____________________ Signature: _____________________________________
Data Protection Statement: All Data collected is processed in accordance with legal provisions and the Data Protection Act 2001. Personal Data is
not disclosed to third parties if not required by Law or by other EU Regulations/obligations.
Author: J. Vella
Version No: 2
Approved by: DEH
Issued By: DEH
Issue Date: 24.07.14
Form No: A F006
Page 1 of 2
NOTES TO ASSIST IN THE FILLING IN OF THE APPLICATION FORM FOR THE REGISTRATION
OF FOOD PREMISES IN TERMS OF THE FOOD SAFETY ACT, (ACT XIV /2002).
GENERAL NOTES: PLEASE NOTE THAT A COPY OF THIS FORM IN MALTESE IS READILY AVAILABLE.
NOTE 1: Registration of food businesses is required by the Food Safety Act, 2002 (Chapter 449) Part IV Article 11 and by L.N. 180 / 2001.
Also, food businesses so registered are not to be used other than for the purpose for which they are registered (LN 180 / 2001 Regulation 3(2).
Registration is free of charge, however Certificate of Registration, if requested, costs €11.65 as per L.N. 134 / 2004, as amended by L.N. 407/2007.
NOTE 2: Registration of food premises with the Commission does not exempt anyone from acquiring any licences or permits required under any
other Laws or Regulations. Registration is NOT a licence to operate a food business (LN 180 / 2001 Regulation 3 (3)).
It is an offence to give misleading, inaccurate or incomplete information on this form (LN 180 / 2001 Regulation 4 (2)).
NOTE 3: Establishments that have more than one food outlet within the said establishment are to register each outlet separately on a separate form.
(E.g. Hotel with more than one kitchen and restaurant; Supermarkets with partitioned-off butchery area, fish shop and / or bakery; hospital with more
than one kitchen; staff canteens; etc.).
SPECIFIC NOTES:
Part 2
4: Please note that you are to tick ONE box ONLY. If two or more boxes are ticked, the application form will be returned to you for amending before
your food business can be registered with the Commission.
4.1 (i), (j) and (l): If the food served is not prepared / cooked in the hospital, clinic or on board a sea vessel, please give the address of where the food
is prepared / cooked in the Remarks Box.
4.2: ALL hawkers are to give the address of place of storage of the leftovers in Part 1. 2 ‘Address of Premises / Place of Storage:’
ALL hawkers are to give the vehicle number in the Remarks Box.
4.2 (b): Please give the address of where the food is prepared / cooked in the Remarks Box.
4.2 (d): If any ice cream sold is not prepared in the kiosk, please give the address of where the ice cream is prepared or of the supplier in the Remarks
Box. This does not apply to ice cream that is prepared in ice-cream factories and is labelled according to local labelling regulations.
4.2 (h): If delicatessen is prepared / pre-packed for direct sale, please give the address of where the preparation / packing is carried out in the Remarks
Box. If the delicatessen is obtained from other sources, please give the address of the supplier.
4.3 (d): Supermarkets are to register the butchery area and / or the fish shop and / or the bakery on separate forms.
4.4 (e): Please specify what type of food is packed in Remarks box. E.g. nuts, dried legumes, seeds, sweets, etc.
4.4 (f): Contact Material: packaging material that comes into contact with the food. Please indicate in Remarks Box whether you are: the first seller in
Malta (see note 4.6 (a) below), importer from third countries, manufacturer or retailer of the contact material.
4.5 (h): Outside caterer means those that cater for ALL types of receptions and serve the food in all types of ‘reception halls’ including clubs, parish
halls, etc. and also in private residences.
4.5 (i): Bake house includes ONLY bake houses used for the manufacture of bread and bakery goods. Bakery goods means: qagħaq, fingers, ottini,
krustini, etc. Bake houses for the manufacture of confectionery (e.g. cakes, buns, cream cakes, pastries, etc are to be registered in 4.5 (j).
4.5 (l): Please use a separate form if you manufacture / process more than one type of food.
4.6 (a): Note: First seller in Malta means the ‘importer’ of products originating from other E.U. Member States. Please indicate what type of food is
imported: e.g. food of animal origin, food ingredients for the production of foodstuffs, pre-packaged foods without storage in environmentallycontrolled conditions, pre-packaged food in environmentally-controlled conditions, wines & spirits. (Please note that first sellers and importers of live
animals, live plants or fruit and vegetables are to register on Form 2).
4.6 (c): Food transport refers to those businesses that provide food transport services for others or those that their primary work is to provide transport
of food, e.g. burdnara. A separate form is required for each vehicle. Note: A wholesaler who provides transport vehicles for his own business need
not register the vehicles.
4.6 (d): The explanation given in 4.6 (c) above applies also to ‘temperature-controlled vehicles’.
4.6 (e), (f): Food cold stores and stores that do not form part of registered premises or premises that require registration are to be registered separately.
E.g. if a food manufacturing establishment has a cold store or stores not forming part of the manufacturing establishment, the cold store and / or stores
and the manufacturing establishment are to be registered separately.
4.6 (g): Reception Hall includes ALL types of halls where receptions / parties are held, including band club halls and parish halls.
4.6 (h): Vending machines that need to be registered are those that carry out a process before serving, e.g. toast making machines, coffee / tea making
machines, and those that have a temperature-controlled environment to preserve the food from deteriorating, e.g. sandwiches under cold storage
conditions, etc. Vending machines that sell bottled water, carbonated drinks, iced tea etc. need not be registered. Vending machines are to be
registered by the person responsible for the premises where they are installed. Please indicate what type of food / drink is sold from each
vending machine in the Remarks Box. Please give the name of the supplier of the vending machine in the Remarks Box. Vending machines for
private use in offices need not be registered.
Author: J. Vella
Version No: 2
Approved by: DEH
Issued By: DEH
Issue Date: 24.07.14
Form No: A F006
Page 2 of 2