Cottage Food Production Waiver

Business Name/Entity (if applicable)

First Name

Last Name

Address
Street address (Number, Street Name, Type of Street)

City

State

Zip Code

Phone Number

Email Address

Name of the Company or Organization

IRS Tax ID of the Company/Organization or SSN

Select all the following to comply with requirements

Business is operated from a residence located in the City of St. Louis, using the primary home kitchen located in the residence.
(Section 196.298.1, Mo. R.S.)

Food prepared or processed in a home kitchen shall be restricted to non-potentially hazardous foods, as listed in the Cottage Food Production documentation in the information page.
(1-201.10(B) Food Establishment (3) (h), Missouri Food Code 2013).

The food is sold at a stand (i.e., fair, festival, farmer’s market, etc.).
(Section 196.298.1, Mo. R.S.)

The seller is the individual producing the food or an immediate family member residing in the producer’s household with extensive knowledge about the food.
(1-201.10 (B) Food Establishment (3) (h), Missouri 2013 Food Code)

The seller only sells the food directly to the consumer.
(1-201.10 (B) Food Establishment (3) (h), Missouri 2013 Food Code)

The food prepared in a private home cannot be sold or given to any food establishment for distribution.
(Section 3-201.11 Compliance with Food Law (B))

All food produced in the home kitchen shall comply with the label requirements as listed in the Cottage Food Production documentation in the information page.

During the sale of the home produced food to customer, a placard shall be displayed in a prominent location stating :"This product has not been inspected by the City of St. Louis Department of Health"

Note: Foods prepared or processed in a home kitchen cannot be sold through the internet unless both the cottage food production operation and the customer are located in the state of Missouri (HB1697)

Before offering your product for sale in another jurisdiction, you must contact their local health department to see if your product complies with their requirements.

List all foods items to be prepared and include all ingredients in each food item.
For example: [Food Item - Gooey Butter Cookies], [Ingredients - Butter, Cream Cheese, Vanilla, Egg, Cake Box Mix]

Print Full Name Below:
Please print the full name as an electronic signature and acknowledgement.

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