Canned Mature Beans
Product Submission
Company Name
*
Contact Person
*
E-mail
*
Street Address
*
City
*
State
*
Zip Code
*
Phone Number
-
Area Code
Phone Number
Enter product information below:
All products must meet current CA WIC Standards
How many products you want to add?
*
Please Select
1
2
3
4
5
Product #1
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name as named on Package
*
Container Size
*
(15-16 ounce)
Salt Content
*
Please Select
Regular
Low Sodium
I certify that this product is not Organic
*
Please Select
Yes (required)
Suggested Retail Price Per Unit
*
Suggested Retail Price must be filled to be considered.
Comments
Upload image of product label including:
front label, Nutrition Facts, legible Ingredients list and UPC Please shrink image size
Name image using the 12 digit UPC.
*
Upload a File
Max upload file size is 5000 KB; preferred file type is PDF but, will also accept doc, xls, jpg, or jpeg.
Cancel
of
I verify that this product is distributed in California.
*
check here
Submit Form
Print Form
Product #2
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name as named on Package
*
Container Size
*
(15-16 ounce)
Salt Content
*
Please Select
Regular
Low Sodium
I certify that this product is not Organic
*
Please Select
Yes (required)
Suggested Retail Price Per Unit
*
Suggested Retail Price must be filled to be considered.
Comments
Upload image of product label including:
front label, Nutrition Facts, legible Ingredients list and UPC Please shrink image size
Name image using the 12 digit UPC.
*
Upload a File
Max upload file size is 5000 KB; preferred file type is PDF but, will also accept doc, xls, jpg, or jpeg.
Cancel
of
I verify that this product is distributed in California.
*
check here
Submit Form
Print Form
Product #3
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name as named on Product
*
Container Size
*
(15-16 ounce)
Salt Content
*
Please Select
Regular
Low Sodium
I certify that this product is not Organic
*
Please Select
Yes (required)
Suggested Retail Price Per Unit
*
Suggested Retail Price must be filled to be considered.
Comments
Upload image of product label including:
front label, Nutrition Facts, legible Ingredients list and UPC Please shrink image size
Name image using the 12 digit UPC.
*
Upload a File
Max upload file size is 5000 KB; preferred file type is PDF but, will also accept doc, xls, jpg, or jpeg.
Cancel
of
I verify that this product is distributed in California.
*
check here
Submit Form
Print Form
Product #4
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name as named on Package
*
Container Size
*
(15-16 ounce)
Salt Content
*
Please Select
Regular
Low Sodium
I certify that this product is not Organic
*
Please Select
Yes (required)
Suggested Retail Price Per Unit
*
Suggested Retail Price must be filled to be considered.
Comments
Upload image of product label including:
front label, Nutrition Facts, legible Ingredients list and UPC Please shrink image size
Name image using the 12 digit UPC.
*
Upload a File
Max upload file size is 5000 KB; preferred file type is PDF but, will also accept doc, xls, jpg, or jpeg.
Cancel
of
I verify that this product is distributed in California.
*
check here
Submit Form
Print Form
Product #5
UPC Code
*
(12 digits and no space)
Brand Name
*
Product Name as named on Package
*
Container Size
*
(15-16 ounce)
Salt Content
*
Please Select
Regular
Low Sodium
I certify that this product is not Organic
*
Please Select
Yes (required)
Suggested Retail Price Per Unit
*
Suggested Retail Price must be filled to be considered.
Comments
Upload image of product label including:
front label, Nutrition Facts, legible Ingredients list and UPC Please shrink image size
Name image using the 12 digit UPC.
*
Upload a File
Max upload file size is 5000 KB; preferred file type is PDF but, will also accept doc, xls, jpg, or jpeg.
Cancel
of
I verify that this product is distributed in California.
*
check here
Submit Form
Print Form
California Department of Public Health
Should be Empty: