Forms • McLean County Health • CivicEngage

Cottage Food Operation Registration

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Fill out this form only when your computer has access to a printer. Once the form is complete, click "Submit and Print" so your registration is sent to our to our Food Safety Division, and you are sent to a print-friendly screen of your registration.

The print-friendly screen allows you to print the registration form, but does not automatically print for you. You must manually print the following screen. The print-out of this registration form acts as your registration certificate.

If you make a mistake in your registration, please email health@mcleancountyil.gov with corrections.

Business Information

Name of Business*

Name of Business Owner*

Owner phone number (numbers only)*

Owner street address
(no P.O. Boxes)*

City*

State: Illinois*

Zip code*

Email address*

Illinois Food Service Sanitation Managers Certificate Information

Name*

Identification Number*

Expiration Date*

Types of food producing

(choose all that apply)*

	Dry herbs
	Jellies, jams, preserves
	Bread, cakes, cookies

	Fruit butter
	Other

Any other products not previously listed but considered a non-potentially hazardous food must submit lab test results to McLean County Health Department (200 W. Front St., Bloomington, IL 61701) prior to sale at a farmers' market. By selecting "other," you note that your registration is invalid without a copy of lab test results both submitted to the health department and attached to the registration certificate at all times.

With my signature, I agree that I understand the terms of Cottage Foods Industry guidelines as defined by Public Act 097-0393, and hereby claim that I will follow said guidelines to ensure the safety of public health.

Cottage Foods Operation Registration expires 12/31/2018.*

Please choose the "Submit and Print" option below to print your registration form for your records. This selection will bring you to a print-friendly version of your registration, which you must manually print.
The form will not automatically print for you.

* indicates required fields.

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