/

JISM / Certification Department

/
Complaint / Appeal

:
:
for CT use: Concerned CT employee:
:/
Applicant Name:
: Fax:
: :
Applicant address:
Phone:
:/
Certification scheme:

GLOBALGAP
Conformity certificates
JQM
:
Subject of appeal /complaint:

: Date:

Signature:
Members of
complaint/appeal
committee:

Chairman:

: Date:

: Date of taking action:

Signature:
Is the case closed?
Yes No
In case of arbitration following the appeal:
Name of applicant confident:
Name of CT confident:
Name of chairman:
Decision of arbitration committee:

: Date:

Chairman signature:
Action taken by CT:

Signature:
Is the case closed?
Notes:

/
:
:

Decision of committee:

Chairman signature:
Action taken by CT:

: Date of taking action:

Yes No

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CTqf-141-01,rev.c