Name & Address of Recalling Company : 

Contact Officer :
(Position) :

Telephone :                      

Date of report/complaint to Company :

Date of notification to Food and Environmental Hygiene Department :

Description of Food 

Food Type :

 Weight/Count :

Brand Name :

Product/Pack Size:

Date Marking :

Batch/Number code:

Quantity/ No. of Product Affected :

Origin/ Name, Address & Tel. No. of Local/ Overseas Manufacturer :

Name & Tel. No. of person and post reporting the problem:

Date of reporting:

Has any testing been undertaken :

Nature of problem :

Results :

Hong Kong :

Overseas :

Other Relevant Information  (Please attach extra sheets if space is insufficient)