Application form for RecyClass certification

This application form refers to the RecyClass Recycled Plastics Traceability Certification – Audit Scheme 1.0 in line with EN 15343, inspection and certification provided by Control Union Certifications

General information
Legal name of company and legal status

Please use full legal name of company with e.g. Ltd., Inc, SAC, SA, SARL, BV or NGO to be listed on the Scope Certificate as certificate holder
Trade name of company

Please complete if different from legal name
Address of company Address of company
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Phone
Website
VAT number of company
The address and contact details of the company paying for certification are different from the details specified above
Name of company
Company contact
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
VAT number of company
Please upload proof of business registration, e.g. registration at the chamber of commerce or equivalent

Attach Files
Company's legal representative

Please give information about the person with the authority to sign contract within the company
Name Name First Last
Position
Email
Contact details for CUC database

Please assign a person as main contact for communication related to certification (quality manager or other)
Name Name First Last
Position
Email
Phone
How did you hear about this program?
Operation and process
Type of operation

e.g., converting, filling, printing, trading, manufacturing/producing, plastic recycling, etc.
Short description of the process
Output

Please indicate below the products to be included in the scope of certification
Product(s) name
Product(s) code
Product type

e.g., bottles, plastic bags
Main polymer

e.g., LDPE
Product description

e.g. LDPE light gray garbage bags 30 L and 60 L for household use
Add second product
Product(s) name
Product(s) code
Product type

e.g., bottles, plastic bags
Main polymer

e.g., LDPE
Product description

e.g. LDPE light gray garbage bags 30 L and 60 L for household use
Add third product
Product(s) name
Product(s) code
Product type

e.g., bottles, plastic bags
Main polymer

e.g., LDPE
Product description

e.g. LDPE light gray garbage bags 30 L and 60 L for household use
Add fourth product
Product(s) name
Product(s) code
Product type

e.g., bottles, plastic bags
Main polymer

e.g., LDPE
Product description

e.g. LDPE light gray garbage bags 30 L and 60 L for household use
Add fifth product
Product(s) name
Product(s) code
Product type

e.g., bottles, plastic bags
Main polymer

e.g., LDPE
Product description

e.g. LDPE light gray garbage bags 30 L and 60 L for household use
Add sixth product
Product(s) name
Product(s) code
Product type

e.g., bottles, plastic bags
Main polymer

e.g., LDPE
Product description

e.g. LDPE light gray garbage bags 30 L and 60 L for household use
Add seventh product
Product(s) name
Product(s) code
Product type

e.g., bottles, plastic bags
Main polymer

e.g., LDPE
Product description

e.g. LDPE light gray garbage bags 30 L and 60 L for household use
Add eighth product
Product(s) name
Product(s) code
Product type

e.g., bottles, plastic bags
Main polymer

e.g., LDPE
Product description

e.g. LDPE light gray garbage bags 30 L and 60 L for household use
Add ninth product
Product(s) name
Product(s) code
Product type

e.g., bottles, plastic bags
Main polymer

e.g., LDPE
Product description

e.g. LDPE light gray garbage bags 30 L and 60 L for household use
Add tenth product
Product(s) name
Product(s) code
Product type

e.g., bottles, plastic bags
Main polymer

e.g., LDPE
Product description

e.g. LDPE light gray garbage bags 30 L and 60 L for household use
Add more products
Please indicate the product name, code, type, main polymer and description of each extra product to be included
Sites of activity

Please indicate below all locations with relevant activity for RecyClass certification (administration/processing/manufacturing/recycling/transport/storage/packing/distribution/etc.). Please also consider and name relevant subcontractors
Name of site location/company
Activity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Add second site
Name of site location/company
Activity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Add third site
Name of site location/company
Activity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Add fourth site
Name of site location/company
Activity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Add fifth site
Name of site location/company
Activity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Add sixth site
Name of site location/company
Activity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Add seventh site
Name of site location/company
Activity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Add eighth site
Name of site location/company
Activity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Add ninth site
Name of site location/company
Activity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Add tenth site
Name of site location/company
Activity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Signature of the applicant

By signing below, I declare that I am legally authorized to sign on behalf of the applying company indicated under the section 'General information', and that this Application is completed truthfully and to the best of my knowledge
Name of organization
Name of legal representative Name of legal representative First Last
Date Date / DD / MM YYYY
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Application form for RecyClass certification

Application form for RecyClass certification

General information

Company's legal representative

Contact details for CUC database

Operation and process

Output

Sites of activity

Signature of the applicant