Private Bag 9023 | Whangarei 0148 | New Zealand
T: 09 430 4200 | 0800 WDC INFO | 0800 932 463 | F: 09 438 7632
W: | E:
February 2016
Notification of intention to register:
- New (previously unregistered) food premises, or
- Change of occupier of an existing food premises
Pursuant to the Food Act 2014
Applicant’s full name: (if in the name of a company, then company’s name)
Applicant’s Postal address:
Name of contact responsible person:
Contact phone numbers:
Email address:
Proposed trading name of business:
Address of premises: (street & number)
Name of previous occupier: (if applicable)
Trading name of previous business: (if applicable)
Starting or takeover date of the business:
Please note that there is no fee payable for the processing of this notification form.
An Environmental Health Officer / Food Act Officer will contact you once this form has been received in order
to determine the appropriate registration category/fee and assisted in the completion of the relevant
registration application form.
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