Applicant information
Legal name of Operator: _______________________________________________
Registered address: _________________________________________________
Country / Region: _________________________________________________
Contact person (name, role): ________________________________________
Email / Phone: _____________________________________________________
Preferred Certification Body (optional): _______________________________
Operation description
Total eligible agricultural area (ha): ____________
Number of eligible fields (as defined in the platform): ____________
Main production system(s): crops / livestock / mixed (specify): ______________________________
Main crops (last 3 years) and crop rotation description: _____________________________________
Livestock (if relevant): species, herd size, system: _________________________________________
Scope of certification requested
Requested certification scope is the overall farm: __________________________________
Publication in the online register (farms in a certified programme): ☐ Yes ☐ No (can be changed at any time)
Data and platform readiness
Platform account email (AgriPurpose portal): _______________________________________________
Field polygons uploaded for all eligible fields: ☐ Yes ☐ No (If no, planned upload date: ________)
Annual data availability (yields, inputs, energy, etc.) for last year: ☐ Yes ☐ No
RegenerationDialogue
RegenerationDialogue completed for this cycle (where required): ☐ Yes ☐ No
If yes: date(s) performed: ____________________ Facilitator (if any): ____________________
Soil sampling (Annex B + B1)
Provide the annual sampling plan for the current certification year (or attach). The plan must meet Annex B1.
Sampling year: ____________
Total eligible area (ha): ____________
Total eligible fields: ____________
Fields proposed for sampling this year (IDs/names): ________________________________________
Number of sampled fields: ____________
Soil samples (PSLs) per sampled field: ____________ (minimum 3 per sampled field)
Total number of soil samples (PSLs) planned: ____________
Computed ha/sample = total eligible ha / total planned samples: ____________ (must be ≥ 3 unless cap 1b applies)
If cap 1b applies (ha/sample < 3): confirm overall sampling limited to one third of fields: ☐ Yes ☐ N/A
Sampling provider / contractor: ________________________________________
Laboratory name and methods (SOC%, g of soil dry matter per sample, bulk density, pH, P, K): ________________________________________
Other labels, standards and quality assurance programs
List all programs that your farm participates in (f.e. Organic, GlobalGAP, RTRS):
________________________________________________________________________________
Declarations
I declare that all information provided is accurate and complete to the best of my knowledge.
I agree to provide access to records and sites required for certification audits, including an audit when selected under the sampling rules and at least once within the first five years in the programme.
I understand that platform participation is separate from certification and does not itself grant label rights.
I agree to comply with the scheme rules, including logo use rules and soil sampling requirements.
I declare complying with all local laws, particularly in the areas of land ownership and land lease, environmental regulations, water rights, as well as regulations for animal welfare, seed patents and biotechnology, regulations for agricultural work and workers safety. In addition, compliance with food safety regulations and label programs.
Signature
Operator (authorised signatory): __________________________ Date: ____________
Name / Title: ___________________________________________