This form is to be completed by the Applicant/Registrant or their nominated New Zealand Agent/Consultant. Registration (section 21) of a non-exempt ACVM trade name product is required to avoid committing an offence (section 8) under the Agricultural Compounds and Veterinary Medicines (ACVM) Act 1997. Under section 10 of the ACVM Act, you must fill out this form as part of your application to either register a trade name product, provisionally register a trade name product or vary the registration of a trade name product. Send this completed form and all required supporting documentation electronically to approvals@mpi.govt.nz. Refer to the Privacy Act 1993 and Official Information Act 1982 notices at the end of this form regarding collection of information by the Ministry for Primary Industries.

This application is for a company to be registered as a client with the Certification Unit (Dairy Certs).

Application to add product for MPI Multi-Use Number Scheme (AF9)

For the purposes of recording the outcome of an animal health veterinary assessment. To be held by the RCS farm dairy operator as a record for a minimum of 4 years.

Use this form if:

- You are the landowner
a) of pre-1990 forest land as at 20 July 2010; OR
b) of land that was pre-1990 forest land on 31 December 2007 but was deforested in the period from 1 January 2008 to 19 July 2010 (inclusive); AND

- The land to be exempted was owned (as at 1 September 2007) by persons who (along with any associated persons) owned in total less than 50 Ha of pre-1990 forest land