AIB Worldwide: Latin America
China          Japan
Europe, Middle East, & Africa


New Business Record Information

Do you wish to receive a programme information packet?* If yes, please mark here.
*Information on audit costs, criteria (i.e., Consolidated Standards), training materials, etc.


Name of Person Completing this Form:


Name of Company to be Inspected:


Physical Address of Company to be Inspected:

Street Address #1

Street Address #2

City

State or Province

ZIP Code or Postal Code

Country


Mailing Address of Company to be Inspected:

Same as Physical Address

PO Box

City

State or Province

ZIP Code or Postal Code

Country


Telephone Number:


Fax Number:


E-mail Address:


Company VAT No.:


What Type of Facility is this?

(Products produced: bread, pet food, boxes, packaging film, etc. or is it a flour mill, distribution center, etc.)


What Size is this Facility?

(Square Footage/Square Meters)


Supplier to?

(Name of company(s) that facility supplies that require a third party audit - PLEASE BE SPECIFIC)


Please Specify Time Frame of Inspection:

(Month or processing season)


Number of Audits per Year: (1, 2 or more)

(Audits will occur on a yearly basis until AIBI is notified to discontinue)


Is this Audit:


Announced (ONLY the notification person listed below will be informed of the audit date.)
Unannounced (Audit date will NOT be provided to anyone.)


Notification Person Name:

If the audit is ANNOUNCED, who should be informed of the date of the audit?
If the audit is UNANNOUNCED, please list a primary contact for the audit.
(Include name, title, mailing address, phone/fax numbers, e-mail address, if different from above.)


Facility Contact Name:


Facility Contact Title:


Who is Responsible for the Invoice?

(Include name, title, mailing address, phone/fax numbers, e-mail address, if different from above.)



Purchase Order Number:

(MUST be included if YOUR company requires a PO# to pay the invoice.)


Who Within Your Company Should Receive a Copy of the Report?

(Include name, title, mailing address, phone/fax numbers, e-mail address, if different from above.)


Method of Receiving Report

E-mail
First Class Mail/Courier

If e-mail, please indicate address to be used:


Please list any customer(s) that should receive a copy of the report. An authorization form for each customer listed will be sent to the notification person indicated on this form. The authorization form must be signed and returned to AIBI before the audit report will be sent to your customer.


Company name and location as you want it to appear on your certificate:

Name:


City, Country:

Nearest Airport to Facility:



Name of Local Hotel with Telephone and Fax Numbers:


All personal information provided on this form will be stored and only disclosed in accordance with relevant data protection legislation. Any person(s) listed in the above sections has/have the right to access relevant personal information held by AIB International. In the event thatany of the personal information is or becomes incorrect, then the relevant person may request AIB International to amend such information.

For the purposes of data protection legislation, the data controller of any personal data processed as a result of processing or storage of this form is AIB International.

From time to time we may wish to make available information and promotional offers to your organisation/company via the contact details provided above. Please tick this box if you do not want AIB International to use your personal information for this purpose.



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