Halal Ingredient Declaration Form
Product Name
Brand Name
Manufacturer / Supplier
Contact Information
Ingredient Details
List all ingredients (including additives, processing aids, and E-numbers)
Country of Origin
Halal Compliance
Does the product contain any animal-derived ingredients?
Yes
No
If yes, specify the source and if it is Halal certified
Does the product contain alcohol or alcohol-based ingredients?
Yes
No
Is the product or any ingredient genetically modified?
Yes
No
If yes, specify details
Declaration
Name
Position
Date