EZ Form Nutrition and Label Compliance Software The Expert Solution to USDA Form 7234-1, CFIA Form 1478 Nutrition Facts Panels, Nutrient Content Claims, and Health Claims Take the EZ path to compliance with the new nutrition labeling regulations by purchasing EZ Form for Windows, and joining our subscription program. EZ Form is fully compatible with Microsoft Windows software, making it the most effective tool for coping with federal food labeling regulations. Since 1972, Prime Label Consultants has been accumulating the knowledge and expertise that goes into EZ Form. This expert software system simplifies the labeling process, while at the same time keeping your labels in compliance with the complex USDA, FDA, and Health Canada regulations. Here’s some of what EZ Form can do for you:
Create and print USDA Form 7234-1 and CFIA Form 1478 on plain paper. Access USDA, FDA, and Health Canada labeling regulations, plus USDA policy memos and export regulations Support complex multilevel formulas, support ranges for ingredient values and change the unit of measure at the stroke of a key. Automatically sort the product formula by order of predominance. Spell Check your applications. Create your own database of ingredients from USDA’s National Nutrient Database for Standard Reference (Handbook 8), the Canadian Nutrient File, other databases and information from suppliers. Design a sketch label with EZ Sketch, a built-in graphic label editor. Analyze your products for restricted ingredients. Generate extensive reports to track your labels, as well as ingredients, approvals, plant numbers and other information. Print composite breakdowns for your product formulas.
In addition, EZ Form’s Nutrition Navigator guides you through the process of creating compliant Nutrition Labeling with only a few simple questions. The Nutrition Navigator will:
Analyze your products/recipes using its built-in ingredient database. Calculate serving size and servings per container. Select valid nutrient content claims. Determine valid FDA health claims. Create camera-ready Nutrition Facts Panels/Tables in English, Spanish and French, bilingual or single-language, compliant with current or pre-2016 FDA, USDA, & Canadian regulations.
Other advanced features of Nutrition Navigator include:
Smart Checks to interpret and apply regulations to your product data. Accounting for fat/moisture loss in products. Support for all Nutrition Facts Panel/Table formats. Ability to control the nutrients appearing on Nutrition Facts Panels. Support for Generic Labeling regulations.
Plus, EZ Form’s Subscription Service provides you with quarterly regulatory updates and program enhancements. This vital service provides a comprehensive, cost-effective way to keep abreast of the latest regulatory changes and EZ Form advances. EZ Form’s expert systems help ensure the labels you create are in compliance every time. It’s a food technologist, label consultant and regulatory expert rolled into one all on-call at your desktop. Take advantage of your conference discount and order today.
PAGE _____ 1 of _____ 3 According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collecton of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0583-0092. The time required to complete this information collection is estimated to average 75 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This form has been approved by OMB for web distribution.
U.S. DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE
APPLICATION FOR APPROVAL OF LABELS, MARKING OR DEVICE
1. AGENT NAME, ADDRESS, TELEPHONE NO. (If using an Agent, complete this block, otherwise leave blank.)
FSIS has determined that information provided in items 11, 15, and 16 is exempt from mandatory disclosure under the Freedom of Information Act 5 U.S.C. 552(b)(4).
2. FOR USDA USE ONLY
3. FOR USDA USE ONLY
4. ESTABLISHMENT NO. / FOREIGN COUNTRY (If applicable)
P-1
Prime Label Consultants, Inc. 536 Seventh Street SE P.O.Box 15240 Washington, DC 20003 (202) 546-3333
4a. TYPE OF PRODUCT Egg
X
APPLICANT: See Page 5 for instructions. 5a. NAME OF PRODUCT
Poultry
Meat
X
Other
New Generation Chicken Corn Dog
5b. HACCP PROCESS CATEGORY 03J: Slaughter - all species
(Select One)
6a. TYPE OF APPROVAL REQUESTED
X
03B: Raw Product - ground
SKETCH
7a. AREA OF PRINCIPAL DISPLAY PANEL(Square inches):
48.00
TEMPORARY
EXTENSION OF TEMPORARY
03C: Raw Product - not ground 03D: Thermally processed - commercially sterile
6b. WAS THE LABEL PREVIOUSLY APPROVED?
03E: Not heat treated - shelf stable 03F: Heat treated - shelf stable
X
03G: Fully cooked - not shelf stable
YES
X
NO
7b. TOTAL AVAILABLE LABELING SPACE FOR ENTIRE PACKAGE (Square inches):
Date of approval:
138.00
Prior approval number: Number of labels on hand:
03H: Heat treated but not fully cooked - not shelf stable
Number of days requested:
03I: Product with secondary inhibitors - not shelf stable 8. Does this label include a "USDA-AMS" Child Nutrition Program CN-Logo?
X
YES
9. (FOR USDA-AMS USE ONLY) CN Identification Number Assigned
NO
432167 10. Are there any special claims, guarantees, or foreign language on the label? X Allergen Statements
YES
NO (If yes, check all that apply) Other Claims: Specify
Animal Production/Breed/Raising Grading Terms
Certified/Verified
Guarantees
Environmental/Green
Natural/Organic
Export Only Labels w/deviations from Domestic Requirements Foreign Language Geographic/Undefined Style
.
11. NAME AND ADDRESS OF FIRM (Below and between dots)
X
Nutrition/Health Religious Exemption
.
Prime Label Consultants 536 7th Street SE Washington, DC 20003
. FSIS FORM 7234-1 (11/16/2011)
12. SIGNATURE OF APPLICANT OR AGENT
13. DATE
05/15/2017 14. (FOR USDA USE ONLY) CONDITIONS APPLYING TO USE OF LABELS OR DEVICE
.
AN APPROVED QUALITY CONTROL PROGRAM NEEDED BEFORE LABEL CAN BE USED.
REPLACES FSIS FORM 7234-1 (09/01/2009), WHICH IS OBSOLETE.
PAGE _____ 2 of _____ 3
FSIS FORM 7234-1 (11/16/2011) page 2
PCT
15. PRODUCT FORMULA
FRANKFURTER,CHICKEN Corn dog batter Basic batter Water Flour, white, enriched Cornmeal Cornstarch Salt, table Baking soda TOTAL (pct.)
56.8000 45.4400 99.9000 55.4555 16.3163 16.3163 8.8088 2.2022 0.9009 ———————— 100.0000
ONION POWDER TOTAL (pct.)
See Continuation Sheet
TOTAL
X WEIGHT
0.1000 ———————— 100.0000
(Percent must total 100%)
102.2400 gms.
PAGE _____ 3 of _____ 3
FSIS FORM 7234-1 (11/16/2011) page 3
16. PROCESSING PROCEDURES
(Approval of the sketch does not convey approval of the processing procedures)
Frank: Mix ingredients and cook to internal temperature of 160° F. Cool. Batter: Mix all ingredients. Dip frank in batter, fry at 350°F for 15 minutes. Cool product, pack and freeze. Keep frozen until use. Raw unbreaded weight: Raw breaded weight: Cooked weight:
See Continuation Sheet
2.00 3.61 3.00
Est. P-1 Sketch Scale is 1:1
New Generation Chicken Corn Dog
April 24, 2017 PRINCIPAL Display Panel
New Generation Chicken Corn Dog Nu tr itio n Fa c t s Serving Size 1 corn dog (90g) Servings Per Container 6
INGREDIENTS: CHICKEN FRANKFURTER, WATER, WHITE ENRICHED FLOUR, CORNMEAL, CORNSTARCH, SALT, BAKING SODA, ONION POWDER
Amount Per Serving
Calories 190 Calories from Fat 90 % Daily Value*
Total Fat 10g Saturated Fat 3g Cholesterol 50mg Sodium 1130mg Total Carbohydrate 17g Dietary Fiber less than 1g Sugars 0g Protein 8g Vitamin A 0% Calcium 4% Niacin 10%
15 % 14% 17% 47% 6% 3%
• Vitamin C 0% • Iron 8% • Vitamin B6 15%
Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs: Calories: 2,000 2,500 Total Fat Less than 65 g 80 g Saturated Fat Less than 20 g 25 g Cholesterol Less than 300 mg 300 mg Sodium Less than 2,400 mg 2,400 mg Total Carbohydrate 300 g 375 g Dietary Fiber 25 g 30 g
CN CN
Safe Handling Instructions
432167
This 3.00 oz fully cooked New Generation Chicken Corn Dog provides 2.00 oz equivalent meat for the Child Nutrition Meal Pattern Requirements. (Use of this logo and statement authorized by the Food and Nutrition Service, USDA 04/06.)
This product was prepared from inspected and passed meat and/or poultry. Some food products may contain bacteria that could cause illness if the product is mishandled or cooked improperly. For your protection, follow these safe handling instructions. Keep refrigerated or frozen. Thaw in refrigerator or microwave.
CN
CN
Cook thoroughly. Keep hot foods hot. Refrigerate leftovers immediately or discard.
*
Printed at 9:56 a.m. on 1-Jun-17
Keep raw meat and poultry separate from other foods. Wash working surfaces (including cutting boards), utensils and hands after touching raw meat or poultry.
Good source of Vitamin B6
KEEP FROZEN NET WT 19 oz (1 lb 3 oz) (539g) P-1
Packed by Prime Label Consultants, Washington, DC 20003 Safe Handling Instructions will comply with 9 CFR 381.125(b)
Inspection Legend will comply with 9 CFR 381.96
EZ Form(tm) v2017.10
What’s Different? Title Servings Calories
Fats Cholesterol Sodium Carbohydrates Protein Vitamins & Minerals
Footnote
©2017 Prime Label Consultants, Inc. All rights reserved. Contents may not be reproduced by any means without expressed permission of PLC
Nutrition Panel Formats
©2017 Prime Label Consultants, Inc. All rights reserved. Contents may not be reproduced by any means without expressed permission of PLC
Nutrition Panel Formats
©2017 Prime Label Consultants, Inc. All rights reserved. Contents may not be reproduced by any means without expressed permission of PLC
Nutrition Panel Formats
%
%
©2017 Prime Label Consultants, Inc. All rights reserved. Contents may not be reproduced by any means without expressed permission of PLC
Multi-Column Formats – Dual & Aggregate
©2017 Prime Label Consultants, Inc. All rights reserved. Contents may not be reproduced by any means without expressed permission of PLC
Nutrition Label Reform - Format
©2017 Prime Label Consultants, Inc. All rights reserved. Contents may not be reproduced by any means without expressed permission of PLC
Canadian Food Inspection Agency
Agence canadienne d'inspection des aliments
Processed Products / Produits transformés Processed Meat Products / Produits de viande transformés
REQUEST FOR REGISTRATION OF LABELS, MARKINGS & CONTAINERS
DEMANDE D'ENREGISTREMENT POUR ÉTIQUETTES, MARQUES ET CONTENANTS
- Limit of one class of product per submission - Submit in one (1) copy - Include three (3) labels - Include three (3) copies of the product formula and method of perparation for foreign meat product and two (2) for Canadian product - Do not fill shaded areas
To / À
- Limite d'une catégorie de produit par demande - Soumettre en un (1) exemplaire - Joindre trois (3) étiquettes - Joindre trois (3) copies de la formule du produit et de la méthode de préparation pour les produits de viande étrangers et deux (2) pour les produits canadiens - Ne pas remplir les parties ombrées
From / De
Clerk - Label and Recipe Registration Unit Canadian Food Inspection Agency 1431 Merivale Rd Third Floor Ottawa, Ontario K1A 0Y9
Commis, Section d'enregistrement des étiquettes et des recettes Agence canadienne d'inspection des aliments 1431, chemin Merivale Troisième étage Ottawa (Ontario) K1A 0Y9
Method of payment Mode de paiement
Prime Label Consultants, Inc. 536 Seventh Street SE PO Box 15240 Washington, DC 20003-0240
Proof Épreuve
Wrap
Immediate payment Paiement immédiat
X Telephone: Téléphone : (202)546-3333 X
Packer's Name & Address / Nom et adresse du fabricant
Type of Label - Container Genre d'étiquette - contenant
Fax: Télécopieur : (202)543-4337
Temporary Temporaire
Update Mise à jour
Establishment No. N° d'établissement
U.S.A.
1
12345678 ______________________ Prime Canada
Registration No. N° d'enregistrement
X
Country Pays
Credit Card Carte de crédit CFIA Account No. Compte ACIA N°
Prepared for / Préparé pour
Prime Beef 123 Main Street Washington, DC 20003
Final Finale
Page 1 ___ of / de ___ 1
IMPORTANT If this request is an update to a valid registered label, please indicate on the left the registration number for this label.
Registration No. N° d'enregistrement
s'il s'agit d'une mise à jour, inscrire à gauche le N° d'enregistrement déjà attribué à cette étiquette
Brand Marque
Prod.
Cont.
Best Meats
Product Description and Net Quantity / Description du produit et quantité nette English / Anglais French / Français
Net Quantity
Barbecue Meat Loaf
0.5 kg Quantité nette
pain de viande de barbecue
0.5 kg Print name / Nom en lettres moulées
- Product formula and method of preparation should be submitted in two (2) copies separately on company's letterhead signed and dated
Signature
Date
P. L. Consultant
- La formule du produit et la méthode de préparation doivent être soumises en deux (2) copies séparément sur du papier à en-tête de la compagnie, signées et datées
2017-05-15
Return by (courier company name) / Retour par (nom de l'enreprise de messageries)
Account No. / N° de compte
Federal Express
12-345678-9
Comments / Commentaires
CFIA use only / Réservé à l'ACIA seulement Received / Reçu Yr/An
M/M
Reg. No. / N° d'enrg.
Reply / Réponse
D/J
Yr/An
M/M
D/J
Registration / Enregistrement Update Proof Final Mise à jour Épreuve Finale
Until / Jusqu'au Temp.
Yr/An
M/M
Fees / Frais Number Nombre
D/J
$100.
Cancelled / Annulé
Yr/An
M/M
D/J
Extension until Extension jusqu'à
Yr/An
M/M
D/J
Reviewer Initials Initiales vérificateur(trice)
Please submit two (2) final printed labels with two (2) copies of our response within 120 days as of this date, otherwise, your registration number will be cancelled and your documents destroyed. Prière de soumettre deux (2) étiquettes finales accompagnées de deux (2) copies de notre réponse dans les 120 jours à compter de cette date, sans quoi le numéro d'enregistrement sera annulé et la documentation détruite.
$45. No Charge Sans frais Total: _____________
Comments / Commentaires
Manager, Label and Recipe Registration Unit Gestionnaire Unités D'enregistrement d'étiquettes et recettes CFIA / ACIA 1478 (2011/08) Printed from EZ Form(tm) v2017.100
Conference Special:
Conference Special:
10% off
10% off
EZ FORM ORDER SHEET
Promo Code FLC2017EZF
Promo Code FLC2017EZF
1. Select EZ Form status, circle payment/product option, & calculate quantities & totals: Government agencies are constantly changing their food regulations and processes, so EZ Form® gets updated regularly to remain current. We update the regulation & ingredient databases & reprogram the expert systems, calculators and wizards for up-to-the-minute compliance. Buying EZ Form gives you 2 quarters of free updates. After that, you should purchase an annual subscription to keep your software current.
First time EZ Form purchase or additional licenses: Program Plus 1 Year Plus 2 Year EZ Form Edition: License: Subscription Subscription
Sub-Total:
$899
+ $539
+ $1019
x _____ = ________
EZ Form – Canada $899 (Health Canada foods)
+ $539
+ $1019
x _____ = ________
+ $879
+ $1659
x _____ = ________
(FDA & USDA foods)
EZ Form – Deluxe (FDA, USDA & Canada)
$1469
Current EZ Form owner subscription renewal: 2 Year 1 Year EZ Form Edition: Subscription Subscription EZ Form – US $599 EZ Form – Canada $599 EZ Form – Deluxe $979
Price:
(15% savings)
EZ Form – US
Quantity:
(includes 2 updates) (10% savings)
(10% savings)
(includes 4 updates)
$1079 $1079 $1759
$979 $979
Out-of-date (non-subscription) EZ Form owner: Program Plus 1 Year EZ Form Edition: Update (includes Subscription 1 year subscription) (10% savings)
EZ Form – US $749 EZ Form – Canada $749 EZ Form – Deluxe $1199
Upgrade to Deluxe Edition
+ $539 + $539 + $879
x _____ = ________ x _____ = ________ x _____ = ________
Upgrade to Deluxe Edition (includes 4 updates)
$1199 $1199
2. Email address(es) to which update notifications with download links should be sent (CD ROM available upon request): _____________________________________________________________
x _____ = ________ x _____ = ________ x _____ = ________ Conference Discount:
- $100.00
Total: ____________
_____________________________________________________________ 3. Fill out Contact Information and Method of Payment: Check enclosed (payable to Prime Label Consultants, Inc.) Company: ________________________________________ Visa MasterCard American Express Discover Address: _________________________________________ ___________________________________________________ Exp. Date City: _________________ State: ______ Zip: _________________Card Number Contact: __________________________________________
__________________________________________________ Full Name (as it appears on the card)
Phone: ___________________ Fax: ___________________ E-mail: __________________________________________
_____________________________________________________ Signature (required for credit card orders)
Fax completed form to 202-543-4337 or mail along with check to: Prime Label Consultants, Inc. • (202) 546-3333 536 7th Street SE • Washington, DC 20003
Frederick E. Mosher
Director, Software Development, Prime Label Consultants
Fred Mosher is an independent computer contractor specializing in custom software design for the Windows market. He holds a Bachelor of Arts degree in Physics and Applied Mathematics from the University of California at Berkeley, a Bachelor of Science degree in Mathematics Education and a Master of Arts degree in Applied Mathematics from the University of Maryland at College Park. Mr. Mosher began his career in computers in 1983. Over the years he has taught programming, acted as a technical editor of books on programming, and programmed applications using Pascal, dBase, FoxPro, Visual FoxPro, C, Java, and various versions of Basic. Using these languages, Mr. Mosher has designed and implemented a wide range of applications: a technical word processing system for use by scientists, engineers, and mathematicians; an inventory control, customer database management, purchase order processing, job cost tracking and analysis, billing, and financ ial bookkeeping system for a bath and kitchen remodeling firm; a church membership profiling and reporting system which tracks family and individual vital data, attendance, and giving; a sophisticated membership and financial management system for a national non -profit organization; a sub-contractor booking system for a large catering firm; a project management system handling volunteers, captains, coordinators and supplies for homes being renovated by Christmas in April, Prince George’s County; and a student directory data management and printing system for public schools. In the fall of 1991, Mr. Mosher was hired as a consultant to Prime Label Consultants, Inc., where he became the director of software development. He took a leading role in the design of EZ Form v2.0, intelligent software for the generation of USDA Form 7234-1 (label approval application). In the fall of 1992, Mr. Mosher took charge of the development of EZ Form v3.0, an expert system that completely automates the design of nutrition panels and the selection and verification of nutrient content claims in accordance with the USDA and FDA regulations released in January 1993. Amendments to these regulations and user feedback requesting new program features have involved Mr. Mosher in further enhancements to this expert system, the latest release of which is EZ Form v2017.100. Through his work implementing the nutrition regulations and his numerous queries of FDA and USDA personnel to clarify the same, Mr. Mosher has become an expert in the field of nutrient content claims and nutrition panel design.
