Notification Form for Importation of Foods, etc.

Minister of Health, Labour and Welfare, Esq.

Name and address of importer (Or name of importing corporation and its address)

Notification Receipt *1 Name

Number
Address
Classification of Notification Prior Notification / Planned Import
(Telephone Number)
Code of Importer

Name and Code of Registration Number of

Country of Production Importer Responsible
for Food Sanitation

Name, Address and

Code of Manufacturer

Name, Address and

Code of Manufacturing
Factory

Name, Address and

Code of Shipper

Name, Address and

Code of Packer

Name and Code of

Port of Loading Date of Loading _______(Month) _______(Day) _______(Year)
Name and Code of
Port of Discharge Date of Arrival _______(Month) _______(Day) _______(Year)

Name and Code of Date of Storage _______(Month) _______(Day) _______(Year)

Warehouse
Date of Notification _______(Month) _______(Day) _______(Year)

Marks and Numbers of Accident

Yes / No
Cargo Brief Explanation (if Yes)
Ship Name or Flight Name and Code of
Number of Aircraft Submitter

Classification of Food / Food Additive / Continuous Sanitary Certificate

1 Apparatus / YN
Cargo Container-Package/ Toy Import Number
If the cargo includes
Item Code processed food,
describe its ingredients
Description of Article and their codes.
If the cargo includes
Shipped Volume apparatuses,
(Number of Units) container/packages or
toys, describe the raw
Shipped Volume kg materials and their
(Weight ) codes.
If the cargo includes food
Usage and its Code with additives, describe *2
the names and codes of
Kind of Package and additives. *2
its Code If the cargo includes
manufacturing agents in
Registration Number 1 the additives, describe
the names and codes of
Registration Number 2 additives.
(Additives used as
flavoring agents are
Registration Number 3 excluded for either case.)
If the cargo includes
processed food,
describe the method of
manufacturing or
processing, and its
code.

Remarks Stamp for Receiving Notification

Notes:
*1: Do not write here.
*2: When the article in the cargo includes food additives that are generally supplied in food or drink and regulated by the relevant statutes, describe the
names of the substances used. When the article includes manufacturing agents in the additives, excluding flavoring agents or food additives that are
generally supplied in food or drink, write the names of the agents.
The seal of importer can be substituted by a signature of importer.
 Classification of Food / Food Additive / Continuous Sanitary Certificate
Apparatus / YN
Cargo Container-Package/ Toy Import Number
If the cargo includes
Item Code processed food,
describe its ingredients
Description of Article and their codes.
If the cargo includes
Shipped Volume apparatuses,
(Number of Units) container/packages or
toys, describe the raw
Shipped Volume kg materials and their
(Weight ) codes.
If the cargo includes food
Usage and its Code with additives, describe *2
the names and codes of
Kind of Package and additives. *2
its Code If the cargo includes
manufacturing agents in
Registration Number 1 the additives, describe
the names and codes of
Registration Number 2 additives.
(Additives used as
flavoring agents are
Registration Number 3 excluded for either case.)
If the cargo includes
processed food,
describe the method of
manufacturing or
processing, and its
code.

Remarks Stamp for Receiving Notification

Classification of Food / Food Additive / Continuous Sanitary Certificate

Apparatus / YN
Cargo Container-Package/ Toy Import Number
If the cargo includes
Item Code processed food,
describe its ingredients
Description of Article and their codes.
If the cargo includes
Shipped Volume apparatuses,
(Number of Units) container/packages or
toys, describe the raw
Shipped Volume kg materials and their
(Weight ) codes.
If the cargo includes food
Usage and its Code with additives, describe *2
the names and codes of
Kind of Package and additives. *2
its Code If the cargo includes
manufacturing agents in
Registration Number 1 the additives, describe
the names and codes of
Registration Number 2 additives.
(Additives used as
flavoring agents are
Registration Number 3 excluded for either case.)
If the cargo includes
processed food,
describe the method of
manufacturing or
processing, and its
code.

Remarks Stamp for Receiving Notification