To continue you must fill in all fields marked with an *.
Please leave your contact details
Given Names *
Surname *
Phone number *
Postal address
Email address *
Type of Request *
Name *
Address *
Contact phone *
Email address *
What is the Trading Name where you are working? *
Attachment File 1
Delete File
Attachment File 1 Description
Attachment File 2
Delete File
Attachment File 2 Description
As the licensee, I:
  • advise Logan City Council of our Food Safety Supervisor and their contact details in accordance with Section 88 of the Food Act 2006; and
  • authorise the person nominated as the Food Safety Supervisor to supervise and give directions about matters relating to food safety to persons who handle food in the food business.

I am aware that it is an offence to knowingly provide false and misleading information and declare:.

  • That the information supplied is correct to the best of my knowledge or that I could reasonably obtain.