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
Number
Classification of Notification
*1
Name
Prior Notification /
Address
Planned Import
(Telephone Number)
Code of Importer
Registration Number of
Importer Responsible
for Food Sanitation
Name and Code of
Country of Production
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
Name and Code of
Port of Discharge
Date of Loading
_______(Month) _______(Day) _______(Year)
Date of Arrival
_______(Month) _______(Day) _______(Year)
Name and Code of
Warehouse
Date of Storage
_______(Month) _______(Day) _______(Year)
Date of Notification
_______(Month) _______(Day) _______(Year)
Marks and Numbers of
Cargo
Accident
Ship Name or Flight
Number of Aircraft
Name and Code of
Submitter
Classification of
Cargo
Brief Explanation (if Yes)
Food / Food Additive /
Apparatus /
Container-Package/ Toy
Continuous
Import
YN
Item Code
Description of Article
Shipped Volume
(Number of Units)
Shipped Volume
(Weight )
Usage and its Code
Kind of Package and
its Code
Registration Number 1
Registration Number 2
Registration Number 3
kg
Yes
No
Sanitary Certificate
Number
If the cargo includes
processed food,
describe its ingredients
and their codes.
If the cargo includes
apparatuses,
container/packages or
toys, describe the raw
materials and their
codes.
If the cargo includes food
with additives, describe
the names and codes of
additives.
If the cargo includes
manufacturing agents in
the additives, describe
the names and codes of
additives.
(Additives used as
flavoring agents are
excluded for either case.)
*2
*2
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
Cargo
Food / Food Additive /
Apparatus /
Container-Package/ Toy
Continuous
Import
YN
Item Code
Description of Article
Shipped Volume
(Number of Units)
Shipped Volume
(Weight )
kg
Usage and its Code
Kind of Package and
its Code
Registration Number 1
Registration Number 2
Registration Number 3
Sanitary Certificate
Number
If the cargo includes
processed food,
describe its ingredients
and their codes.
If the cargo includes
apparatuses,
container/packages or
toys, describe the raw
materials and their
codes.
If the cargo includes food
with additives, describe
the names and codes of
additives.
If the cargo includes
manufacturing agents in
the additives, describe
the names and codes of
additives.
(Additives used as
flavoring agents are
excluded for either case.)
*2
*2
If the cargo includes
processed food,
describe the method of
manufacturing or
processing, and its
code.
Remarks
Classification of
Cargo
Stamp for Receiving Notification
Food / Food Additive /
Apparatus /
Container-Package/ Toy
Continuous
Import
YN
Item Code
Description of Article
Shipped Volume
(Number of Units)
Shipped Volume
(Weight )
Usage and its Code
Kind of Package and
its Code
Registration Number 1
Registration Number 2
Registration Number 3
kg
Sanitary Certificate
Number
If the cargo includes
processed food,
describe its ingredients
and their codes.
If the cargo includes
apparatuses,
container/packages or
toys, describe the raw
materials and their
codes.
If the cargo includes food
with additives, describe
the names and codes of
additives.
If the cargo includes
manufacturing agents in
the additives, describe
the names and codes of
additives.
(Additives used as
flavoring agents are
excluded for either case.)
*2
*2
If the cargo includes
processed food,
describe the method of
manufacturing or
processing, and its
code.
Remarks
Stamp for Receiving Notification
