Kosher Ingredient Substitution Approval
Date:
Requesting Department:
Product Name:
Current Ingredient Details
Current Ingredient
Manufacturer
Supplier
Kosher Status
Proposed Substitute Ingredient Details
Proposed Ingredient
Manufacturer
Supplier
Kosher Certificate Attached
Reason for Substitution:
Kosher Certification Agency of Substitute Ingredient:
Additional Comments:
Rabbinic Authority Approval
Name:
Signature:
Date: