"Certificate of Free Sale With Invoice Number" - Illinois

Certificate of Free Sale With Invoice Number is a legal document that was released by the Illinois Department of Public Health - a government authority operating within Illinois.

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CERTIFICATE OF FREE SALE # ______________
FOOD
This is to certify that ________________________________________________________________________ operates a _______________ products plant located
MANUFACTURED
at ___________________________________________________, Illinois, U.S.A., in which among other items, the following products are ___________________ :
Product description
Quantity
These products are freely sold within Illinois and other states of the
United States. In manufacturing, processing, packaging, warehousing
and distributing them in the United States, the above company is
subject to the statutes and regulations of the Illinois Food, Drug and
Cosmetic Act enforced by the Illinois Department of Public Health,
and said company is subject to the jurisdiction of this agency. As of
the current date, no violations of the above mentioned regulations or
statutes requiring legal action have been found by this agency.
Product end is intended for human use. This certificate covers only
currently existing conditions and should not be interpreted as a
This company has attested to the Illinois Department of Public Health that the food products listed
guarantee, explicit or implied, for all products of the said company at
above and on invoice #___________ are to be exported and are of the same quality as those freely
all times in the future; neither should it be used for advertising
sold in Illinois and other states of the United States of America and are fit for human consumption.
purposes.
Firm Representative Signature ______________________________________________________
Printed Name _______________________________________________ Date _______________
Daniel Campbell -Export Program Officer
April Caulk - Export Program Officer
State of Illinois
)SS
Michael Crumly - Export Program Officer
County of Sangamon
Melissa Estes – Export Program Officer
Jessica McAnelly - Export Program Officer
Subscribed and sworn before me this _____ day of _________________________, 201____
Division of Food, Drugs and Dairies
by ___________________________________.
Department of Public Health
State of Illinois
United States of America
______________________________________
NOTARY PUBLIC
CERTIFICATE OF FREE SALE # ______________
FOOD
This is to certify that ________________________________________________________________________ operates a _______________ products plant located
MANUFACTURED
at ___________________________________________________, Illinois, U.S.A., in which among other items, the following products are ___________________ :
Product description
Quantity
These products are freely sold within Illinois and other states of the
United States. In manufacturing, processing, packaging, warehousing
and distributing them in the United States, the above company is
subject to the statutes and regulations of the Illinois Food, Drug and
Cosmetic Act enforced by the Illinois Department of Public Health,
and said company is subject to the jurisdiction of this agency. As of
the current date, no violations of the above mentioned regulations or
statutes requiring legal action have been found by this agency.
Product end is intended for human use. This certificate covers only
currently existing conditions and should not be interpreted as a
This company has attested to the Illinois Department of Public Health that the food products listed
guarantee, explicit or implied, for all products of the said company at
above and on invoice #___________ are to be exported and are of the same quality as those freely
all times in the future; neither should it be used for advertising
sold in Illinois and other states of the United States of America and are fit for human consumption.
purposes.
Firm Representative Signature ______________________________________________________
Printed Name _______________________________________________ Date _______________
Daniel Campbell -Export Program Officer
April Caulk - Export Program Officer
State of Illinois
)SS
Michael Crumly - Export Program Officer
County of Sangamon
Melissa Estes – Export Program Officer
Jessica McAnelly - Export Program Officer
Subscribed and sworn before me this _____ day of _________________________, 201____
Division of Food, Drugs and Dairies
by ___________________________________.
Department of Public Health
State of Illinois
United States of America
______________________________________
NOTARY PUBLIC