Schedule 3—Certificate of analysis
Food (Forms and Registration) Regulations 2015
CERTIFICATE OF ANALYSIS
I, [ full name ]
of [ address ],
a person authorized under the Food Act 1984 to undertake this type of analysis, certify the matters set out below.
(1) On [date of receipt of sample] , I
received
from [name and address of person submitting
sample ]
a sample—
*sealed and with seal intact
*with seal broken
*unsealed
and marked [ insert marking ].
(2) I have *analysed the sample/supervised the analysis of the sample.
(3) The result of the analysis is as follows:
[ insert analytical results ].
*(4) I am of the opinion that no change has taken place in the constitution of the sample which would affect the proportion of any constituent set out above.
[ If there is a prescribed apparatus to be used or method to be observed, insert the following: ]
*I declare that I have used the prescribed apparatus or observed the prescribed method. [Insert details of prescribed apparatus or method. ]
Signature of analyst:
Laboratory:
Date:
*Strike out words not applicable.