HAR §4-162-6. Applications

(a) Each applicant for a food safety certification costs grant shall submit a signed, complete, accurate, and legible application, on a form provided by the department, which shall include the following: (1) The applicant’s name, and business name if different, mailing address, farm or ranch’s physical address, phone number, and if applicable, electronic mail address; (2) If the applicant is an individual or partnership, the date of birth of the individual or partners; (3) Proof of compliance with the State’s business registration, tax, and labor laws; (4) A photocopy of the applicant’s general excise tax license; 162-6 4-162-6 (5) A completed W-9 tax information form signed by the applicant; (6) Evidence of the implementation of farm food safety plan and practices, including photographs of equipment and their use; (7) Proof of third party audit of good agricultural practices or good handling practices; and (8) The applicant’s agricultural operation details, including but not limited to: (A) Acreage in production; (B) Crops produced; (C) Agricultural production experience; (ID) Food safety plan information; (B) Farm size; (F) Good agricultural practices certifications, if any; and (G) Applicable income categories, as specified by the FSMA. (b) The application shall also include applicant’s acknowledgment and agreement to the following terms and conditions: (1) The applicant has the legal authority to authorize, and by submitting an application does authorize, the department to enter the applicant’s place of business at reasonable times to inspect records, facilities, and the premises either in the processing of the application or in the administration of the grant; (2) The applicant certifies that all information and documents submitted in support of the application are correct and complete to the best of the applicant’s knowledge; (3) The applicant has all licenses, permits, and other approvals required by federal, state, or county governmental entities to conduct its operations and implement the practices for which the grant is intended; (4) The applicant shall comply with all applicable federal and state laws prohibiting discrimination against any 162-7 4-162-8 person on the basis of race, color, national origin, religion, creed, sex, age, sexual orientation, or disability; and (5) The applicant shall allow the State full access to its records, files, and other related documents for the purpose of measuring the effectiveness, and ensuring the proper expenditures, of the grant. (c) The department may require additional documentation to verify compliance with this chapter. Any incomplete application for a grant shall be denied. [Eff ] (Auth: HRS §141-12.5) (Imp: FIRS §141-12.5)