Register FDA | Food Facility Registration Form

Please do not use this form when your facility is located outside the USA. You can use this form instead: Registration and US Agent
Submitter Information
Your Name*
Prefix First Last
Phone Number (Include Area Code)*
Email*

Facility Information
Facility Name*
Facility Name Suffix
Other
Address*
Street Address Address Line 2 City State ZIP Code
Please do not use this form when your facility is located outside the USA. You can use this form instead: Registration and US Agent
Email Address*
Phone Number (Include Area Code)*
Fax (Include Area Code)
Emergency Contact Information
Contact Name*
Prefix First Last
Contact Phone (Include Area Code)*
Contact Email*

Certification Statement*
By submitting this form to register-FDA, or by authorizing an individual to submit this form to register-FDA, the owner or operator in charge of the facility certifies that the above information is true and accurate. The owner or operator in charge of the facility also authorizes register-FDA to submit the registration on the facility's behalf and FDA will be permitted to inspect the facility at the time and in the manner permitted by the Federal Food, Drug, and Cosmetic Act. Our Terms & Conditions apply.
- I agree.*
Terms and Conditions*
- I have read and agree to the Terms and Conditions.
Terms and Conditions

Food Facility Registration Form