Nut-Free Facility Ingredient Declaration
Company Name:
Product Name:
Product Code (if any):
List of All Ingredients (including sub-ingredients):
Are any nut ingredients (tree nuts or peanuts) present in the product or facility?
No
Yes
If Yes, please provide details:
Are there any possible cross-contact risks with nuts in your facility?
No
Yes
If Yes, describe the risk and controls:
Prepared by:
Title:
Date:
Signature: