Division 1.1 Identification and characterisation of additive

Additive name (characterisation of the active substance(s) or agent(s) as defined in the subsections 2.2.1.1 and 2.2.1.2 of Annex II):

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Trade name (if appropriate for the authorisations linked to the holder):

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under the category/ies and functional group/s of additives^f1 (list):

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target species:

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Name of the authorisation holder: (Article 9(6) of Regulation (EC) No 1831/2003)

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This additive is already authorised in feed legislation by Directive …/…/(E)EC or Regulation (EC) No …/… under number … as (additive category)

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This additive is already authorised in food legislation by Directive …/…/(E)EC or Regulation (EC) No …/… under number … as

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for use in

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If the product consists of, contains or is produced from a Genetically Modified Organism (GMO), please provide the following information:

1. 

   unique identifier (Commission Regulation (EC) No 65/2004^f2 (where appropriate):

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2. 

   either the details of any authorisation granted in accordance with Regulation (EC) No 1829/2003 of the European Parliament and of the Council^f3:

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3. 

   or the details of any pending application for authorisation under Regulation (EC) No 1829/2003:

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