Food Premises Notification Form - Retail Premises

Please select the most appropriate category *

Note: Change of ABN or business owner falls under ‘New Business’. Please select the appropriate New Business option.

New Business (First use of premises as a food business)New Business (Existing food premises)Update Information (Business with an existing licence)

Trading Details

Trading Name *

Trading Address *

Postcode *

Business Details

Note: Trust/Trustee names are only accepted as per the following either:

“John Smith ATF Family Trust” or “Smith Pty Ltd ATF Family Trust”
An individual for the Trust must be an appropriate person to act for the Trust

ABN *

Lookup

ACN

ABN Status

ABN Status Effective From

Registered Business Name *

Registered Office Address (alternative address to trading location required) *

(For correspondence and invoices)

Postcode *

Email Address *

Business Phone *

Mobile Phone *

Business Contact

Other *

Family Name *

Given Name *

Home Address *

Postcode *

Home Phone

Mobile Phone *

Email Address *

Type of Business

Other *

Food Safety Supervisor (FSS)

Family Name *

Given Name *

FSS Certificate Number *

Attach Food Safety Supervisor certificate *

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Staff

A food handler is defined as a person who directly engages in the handling of food for a food business. Staff involved solely in administrative or clerical tasks are not considered food handlers. Additionally, staff involved solely on register/check out duties are not considered to be food handlers for the purposes of determining the annual administrative charge.

The award for retail premises employees generally involves a 38-hour week.

The number of full-time equivalent (FTE) food handlers can be calculated as below:

No. of food handlers × time handling food per week (hours) / 38 hours.

It should be noted that staff members who engage in the handling of food must have skills and knowledge in food safety and hygiene matters commensurate with their work activities.
The Food Act 2003 defines the handling of food as “includes the making, manufacturing, producing, collecting, extracting, processing, storing, transporting, delivering, preparing, treating, preserving, packing, cooking, thawing, serving or displaying of food”.

Number of Full-Time Equivalent Food Handlers *

Declaration

Preferred Document Delivery Method *

EmailPost

I certify that the details I have provided are true and accurate. I undertake to keep Hornsby Shire Council informed of any changes. *

As the licensee, I declare that I will comply with the Food Act 2003 and Food Standards Code 3.2.2, 3.2.2A and 3.2.3. *

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