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ANNEX IAPPLICATION FORM REFERRED TO IN ARTICLE 2(1) AND ADMINISTRATIVE DATA

2.ADMINISTRATIVE DATA OF APPLICANT(S)

Contact details for submitting an application for the authorisation of a feed additive under Regulation (EC) No 1831/2003

(1)Applicant company or person

(a)

Name of the applicant or company

(b)

Address (street, number, post code, city, country)

(c)

Telephone

(d)

Fax

(e)

E-mail (if available)

(2)Contact person (for all correspondence with Commission, Authority and CRL)

(a)

Name of contact person

(b)

Position

(c)

Address (street, number, post code, city, and country)

(d)

Telephone

(e)

Fax

(f)

E-mail (if available)