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Name   of   the   Organisation

Legal Status  ( Tick )

Proprietor  / Partner  / LLP /  Pvt Ltd   /   Ltd   /   Govt .

Industry  Classification  ( Tick)

Manufacture  / Service  Provider / Trading  / Govt

Whether  part of  large  group.

If Yes , Name :

Address (Mailing)

Address  (Site)

Management Representative

Telephone / Fax / e-mail

Tel: 

Fax:

e-mail:

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Location /s

 1

 2

No. Employees : Permanent /
Temporary/Contract / Seasonal

No. of  Shifts

Area :

Products  / Services 

Core Processes  for
scope of Certification

Out sourced  Processes

If Yes , Name :

Certification  Required QMS / EMS /  FSMS / OHSAS

Standard :  ISO 9001

S
Y
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Processe/s  or  ISO clause  excluded from the  Certification   Scope?

ÖYes  / No

If yes,  name

Justification  for  Exclusion : 

Legal /Regulatory requirments

Desired Scope of  Certification

Do you have a System Manual?

Number of Procedures

System  Implemented  from :

Has a full Internal
Audit  been done?

Has a Management
Review been held

Approximate dates  for

Document Review

 Stage 1 Audit : 

Stage 2 Audit : 

Consultant, if any, engaged  for  system  development / implementation / internal  audit  / training.
Yes / No , If yes name  :

If  previously  certified, please  enclose  copy of   certificate.

Place :

Date  :                                                                                                                            Signature of  Client  (CEO / MR)

NB :     For Multisite certification  information relating to sites  and system  should be provided    
             separately.

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Q
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Within  Scope:

Yes  / No

Resources                                Available   /  Not  available

Technical    Area 

IAF  #

Bettter than IAF / 3 digit  NACE  :- 

Conflict of Interest ,if any

Mitigation

Auditor  Man-Days

Certification :
Stage 1

Stage 2

Surveillance : 

Application Registration No.   

C.B  Approval :

 Signature :

Cert Mgr Signature :        
Date: