Food Business and/or Food Safety Supervisor (FSS) Notification

Food Business and/or Food Safety Supervisor (FSS) Notification
INFORMATION FOR THE PROPRIETOR

Under section 100 of the Food act 2003, food businesses are required to notify the appropriate enforcement agency before operating a food business. Retail premises are required to notify local council. Retail premises include restaurants, cafes, supermarkets, petrol stations, canteens, childcare facilities, mobile businesses, temporary food stalls and home-based businesses. More information on notification is available on the NSW Food Authority website:

https://www.foodauthority.nsw.gov.au/help/licensing

Notification details must include the location of each food premises used by the business.

The notification must be updated if any details change, including:
- Before any new food business or premises starts operation or moves location
- If the nature of the business changes
- If ownership changes
For any enquiries, contact one of Council's Environmental Health Officers on (02)6226 1477 or council@yass.nsw.gov.au
Select Type

Permanent Food BusinessTemporary Food EventFSS NotificationCharity OrganisationMobile Food Van

Section B: Food Safety Supervisor (FSS) Details
Section 106C of the Food Act 2003 requires retail food businesses to appoint a NSW Food Safety Supervisor. Exemptions apply for certain retail premises that do not sell unpackaged potentially hazardous foods. Information on FSS exemptions can be found on the NSW Food Authority website:

https://www.foodauthority.nsw.gov.au/retail/fss-food-safety-supervisors
Name
FSS Certificate Number
Date of Expiry
File Upload

Cancelof

Section C: Declaration and Consent
Personal information in this form may be protected by the Privacy and Personal Information Protection Act 1998. By giving this information, I consent to the information being recorded on a database and stored. I also consent to this information being disclosed to other relevant Australian agencies involved in enforcement of food safety and labelling standards and health for relevant monitoring, compliance and/or investigation purposes. My consent includes interstate agencies as applicable. If any information supplied by me may be considered to be untrue or misleading in any respect, I understand that Yass Valley Council may take such action as it believes necessary including the disclosure of the information to any person or body the Authority considers has a legitimate interest in receiving it, and I consent to such disclosure.
Business Person Name*
Signature*

Clear
Date*

DayMonthYear
Date
Registration Fee

Food businesses based outside of Yass Valley Local Government Area (LGA) are classified as temporary food businesses and are required to pay a registration fee (this includes market stall holders and mobile food vans housed outside of the LGA). Fundraisers and not-for-profits within the LGA are also not required to pay the registration fee.
Please select one of the following:*

I am a mobile food premises, stall holder (based outside of the Yass Valley LGA).I am a home-based food business, mobile food van or fixed commercial food business based in the Yass Valley LGA.I am a not-for-profit or Updating FSS
Intended Operating Location

Routine MarketEvent/Special OrdersNon-routine operationRoadside OperationPrivate Land
Name of Routine Market or Event
Please note if you wish to trade on Council or Crown Land, please contact our Environmental Health Officers on 02 6226 1477 to discuss further.
Food Business Registration Letter or most recent Food Business Inspection Report from the residing council/authority

Cancelof

Food Business Registration Fee

Food Business Registration FeeFSS

$51.25AUD Quantity

Total

$0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty: