Appendix 4 Lampiran 4: IFCC Certificate Reporting Form Formulir Pelaporan Sertifikat IFCC

Appendix 4 / Lampiran 4: IFCC Certificate Reporting Form / Formulir Pelaporan Sertifikat IFCC

Chain of Custody Certificate Reporting Form /
Formulir Pelaporan Sertifikat Lacak Balak
(to be completed for every certificate and every site covered by a multisite certificate / akan dilengkapi untuk setiap sertifikat dan setiap lokasi
yang tercakup oleh sertifikat multi-lokasi)

Contact Details / Rincian Kontak:
Organisation Name (certificate
holder) / Nama Organisasi
(pemegang sertifikat)
Organisation’s representative /
Perwakilan Organisasi
Street, No. /
Jalan, No.
Address
City / Kota
/ Alamat
Country / Negara
Contact Person / Nama Kontak
Telephone / Telepon

E-mail

Zip / Kode pos

Fax. / Faks
Http.

Certificate Information / Informasi Sertifikat:
Certification Body Name /
Nama Lembaga Sertifikasi
Certificate Number /
Nomor Sertifikat
Subcertificate number (if applicable) /
Nomor Sub-sertifikat (jika tersedia)
Certificate Issuance Date /
Tanggal Penerbitan Sertifikat
Certificate Expiry Date /
Tanggal Masa Berlaku Sertifikat
Accreditation Body Name /
Nama Badan Akreditasi

Accreditation Number /
Nomor Akreditasi
Certified entity turnover for the last year (Rp) /
Omset tahun lalu dari Entitas Bersertifikat (Rp)
Documents required for the Application Processing / Dokumen yang Diperlukan untuk Memproses
Aplikasi:

Copy of the certificate
Salinan Sertifikat

Copy of the publicly summary report
Salinan ringkasan laporan yang dapat dipublikasi

Document confirming the turnover for the last year
Dokumen yang menjelaskan omset untuk tahun terakhir

Appendix 4 / Lampiran 4: IFCC Certificate Reporting Form / Formulir Pelaporan Sertifikat IFC

Certified Product Information / Informasi Produk Tersertifikasi:


Product Name /
Nama Produk

Product
category
code* / Kode
Kategori
Produk *

Product description* / Deskripsi Produk*

Species code
(can include more
than one) / Kode
Spesies (dapat
mencakup lebih
dari satu)

* See the next page for codes of product categories and species. If the product includes species of more than one
category (e.g. 1 - coniferous and 3 - non-coniferous), please type all the appropriate codes into the column. /

silahakan melihat halaman berikutnya untuk kode atas kategori produk dan spesies. Jika produk mencakup lebih
dari satu kategori spesies (contoh 1 - konifera dan 3 – bukan konifera), mohon mengetik semua kode yang
sesuai dengan informasi di dalam kolom.

Appendix 4 / Lampiran 4: IFCC Certificate Reporting Form / Formulir Pelaporan Sertifikat IFCC

Code

Product categories

01000

Roundwood

01010
01020
01030
01040
01050
02000


Sawlogs and veneer logs
Pulpwood
Chips and particles
Wood residues
Other industrial roundwood

03010
03020
04000

05010
05020
05030
05031
05032
05040
05041
05042
05043

05043
05044
06000

Sawnwood and sleepers
Railway sleepers
Sawnwood
Engineered wood products
Laminated Lumber Products
Finger Jointed Lumber
Glue Laminated Products
(Glulam)
Laminated Veneer Lumber (LVL)
Parallel Strand Lumber (PSL)
I-Joists / I-Beams
Trusses & Engineered Panels
Other
Wood based panels
Veneer sheets
Plywood

Particle board

07010
07011
07012
07013
07014
07020
07030
07031
07032

Wrapping papers
Other papers mainly for
packaging
Other paper and paperboard
Converted paper products
Printed matter
Wood manufacturers
Packaging, cable drums, pallets

Packaging and crates
Cable drums
Pallets
Furniture
Builders carpentry
Windows
Doors
Shingles and shakes
Floors
Others
Decorative wood
Tools and turned wood
Tools
Children toys
Sport goods
Musical instruments
Other
Other
Exterior products


09010
09020
OSB
Other particle board

Fibreboard
MDF
HDF
Softboard
Hardboard
Insulating board
Pulp

06010
06020
06030
06040
06041
06042
06043

06044
06050
07000

08010
08011
08012
08013
08020
08030
08031
08032
08033
08034
08035
08040
08050
08051
08052
08053

08054
08055
08060
09000

Fuelwood (incl chips, residues,
pellets, brickets, etc.)
Charcoal

04010
04020
04030
04040
04050
04060
04070
04080
05000

07040
07050
07060
08000

Fuelwood and charcoal

02010
02020
03000

07033
07034

Mechanical
Semichemical
Dissolving
Chemical
Unbleached sulphite pulp
Bleached sulphite pulp
Unbleached sulphate (kraft)
pulp
Bleached sulphate (kraft) pulp
Recovered paper

09021
09022
09023
09030
11000
11010
11020
12000
13000
14000

Buildings and their parts
Garden Furniture/Outdoor
Products
Garden furniture
Playground equipment
Decking
Other
Cork and cork products
Natural cork and cork waste
Cork manufactures
Energy
Non-wood products
Other

List of species
1

Coniferous

2

Non-coniferous tropical

3

Non-coniferous other

4

Not specified

Paper and paper board
Graphic papers
Newsprint
Uncoated mechanical
Uncoated woodfree
Coated papers
Household and sanitary paper
Packaging materials
Case materials
Folding boxboards

All woods derived from trees classified botanically as Gymnospermae - e.g. fir
(Abies), parana pine (Araucaria), deodar (Cedrus), ginkgo (Ginkgo), larch (Larix),
spruce (Picea), pine, chir, kail (Pinus), etc. These are generally referred to as
softwoods.
All woods derived from trees classified botanically
Non-coniferous woods
as Angiospermae - e.g., maple (Acer), alder
originating from tropical
(Alnus), ebony (Diospyros), beech (Fagus), lignum
countries.
vitae (Guiaicum), poplar (Populus), oak (Quercus),
Non-coniferous woods
sal (Shorea), teak (Tectona), casuarina
originating from countries
(Casuarina), etc. These are generally referred to as
other than tropical.
broadleaved or hardwoods.

Appendix 4 / Lampiran 4: IFCC Certificate Reporting Form / Formulir Pelaporan Sertifikat IFCC
Appendix 4 / Lampiran 4: IFCC Certificate Reporting Form / Formulir Pelaporan Sertifikat IFCC

Forest Management Certificate Reporting Form /
Formulir Pelaporan Sertifikat Pengelolaan Hutan
(to be completed for every certificate and every site covered by a multi-site certificate / akan
dilengkapi untuk setiap sertifikat dan setiap lokasi yang tercakup oleh sertifikat multi-lokasi)
[Note: Depending on the national situation, especially when a high number of smal scale forest owners are participating
in group Forest Management certification, the registration of forest owners participating in group certification can be
registered by IFCC itself, or even by a third party. In this case the data requested in this reporting needs to be collected
by IFCC or the third part from the forest owners directly, and not from the certification body.]
[Catatan: Disesuaikan dengan kondisi nasional, terutama ketika sebagian besar pemilik hutan skala kecil berpartisipasi
dalam kelompok sertifikasi Pengelolaan Hutan, pendaftaran partisipasi pemilik hutan dalam sertifikasi kelompok dapat
didaftarkan oleh IFCC, atau bahkan oleh pihak ketiga. Dalam hal ini, data yang diminta dalam pelaporan ini perlu
dikumpulkan oleh IFCC, atau pihak ketiga dari pemilik hutan secara langsung, dan bukan dari lembaga sertifikasi.]

Contact Details / Rincian Kontak:
Organisation Name (certificate
holder) / Nama Organisasi
(pemegang sertifikat)
Organisation’s representative /
Perwakilan Organisasi
Street, No. /
Jalan, No.
Address
City / Kota
/ Alamat
Country / Negara
Contact Person / Nama Kontak
Telephone / Telepon
E-mail

Zip / Kode pos

Fax. / Faks
Http.

Certificate information / Informasi Sertifikat:
Certification Body Name /
Nama Lembaga Sertifikasi
Certificate Number /
Nomor Sertifikat
Subcertificate number (if applicable) /
Nomor Sub-sertifikat (jika tersedia)
Certificate Issuance Date /
Tanggal Penerbitan Sertifikat
Certificate Expiry Date /
Tanggal Masa Berlaku Sertifikat
Accreditation Body Name /
Nama Badan Akreditasi
Accreditation Number /
Nomor Akreditasi
Scope of the certificate (total area in hectares) /
Cakupan Sertifikat (Total Area dalam Hektar)
Documents required for the Application Processing / Dokumen yang Diperlukan untuk Memproses
Aplikasi:

Copy of the certificate
Salinan Sertifikat

Copy of the publicly summary report
Salinan ringkasan laporan yang bisa dipublikasi

Appendix 4 / Lampiran 4: IFCC Certificate Reporting Form / Formulir Pelaporan Sertifikat IFCC
Appendix 4 / Lampiran 4: IFCC Certificate Reporting Form / Formulir Pelaporan Sertifikat IFCC

Scope of Group forest certificate information / Informasi Ruang lingkup
sertifikat hutan berkelompok :
#

Participant in Group
Certification /
Peserta dalam
Sertifikasi Grup

Forest management
unit / Unit Manajemen
Hutan

Area / Areal (ha)

Type of forest / Tipe
Hutan *

* 1 Primary, 2 natural, 3 semi-natural/planted or 4 forest plantation
1 Primer, 2. alam, 3. semi – alami/ditanam atau 4. hutan tanaman

Certified Product Information / Informasi Produk Tersertifikasi:

Product Name /
Nama Produk

Product
category
code* / Kode
Kategori
Produk *

Product descritpion* / Deskripsi Produk*

Species code
(can include more
than one) / Kode
Spesies (dapat
mencakup lebih
dari satu)

* See the next page for codes of product categories and species. If the product includes species of more than one
category (e.g. 1 - coniferous and 3 - non-coniferous), please type all the appropriate codes into the column. /
silahakan melihat halaman berikutnya untuk kode atas kategori produk dan spesies. Jika produk mencakup lebih
dari satu kategori spesies (contoh 1 - konifera dan 3 – bukan konifera), mohon mengetik semua kode yang
sesuai dengan informasi di dalam kolom.

Appendix 4 / Lampiran 4: IFCC Certificate Reporting Form / Formulir Pelaporan Sertifikat IFCC

Code

Product categories

01000

Roundwood

01010
01020
01030
01040
01050
02000

Sawlogs and veneer logs
Pulpwood
Chips and particles
Wood residues
Other industrial roundwood

03010
03020
04000

05010
05020
05030
05031
05032
05040
05041
05042
05043
05043
05044
06000

Sawnwood and sleepers
Railway sleepers
Sawnwood
Engineered wood products
Laminated Lumber Products
Finger Jointed Lumber
Glue Laminated Products
(Glulam)
Laminated Veneer Lumber (LVL)
Parallel Strand Lumber (PSL)
I-Joists / I-Beams
Trusses & Engineered Panels
Other
Wood based panels
Veneer sheets
Plywood
Particle board

07010
07011
07012
07013
07014
07020
07030
07031
07032

Wrapping papers
Other papers mainly for
packaging
Other paper and paperboard
Converted paper products
Printed matter
Wood manufacturers
Packaging, cable drums, pallets
Packaging and crates
Cable drums
Pallets
Furniture
Builders carpentry
Windows
Doors
Shingles and shakes
Floors
Others
Decorative wood
Tools and turned wood
Tools
Children toys
Sport goods
Musical instruments
Other
Other
Exterior products

09010
09020
OSB
Other particle board

Fibreboard
MDF
HDF
Softboard
Hardboard
Insulating board
Pulp

06010
06020
06030
06040
06041
06042
06043
06044
06050
07000

08010
08011
08012
08013
08020
08030
08031
08032
08033
08034
08035
08040
08050
08051
08052
08053
08054
08055
08060
09000

Fuelwood (incl chips, residues,
pellets, brickets, etc.)
Charcoal

04010
04020
04030
04040
04050
04060
04070
04080
05000

07040
07050
07060
08000

Fuelwood and charcoal

02010
02020
03000

07033
07034

Mechanical
Semichemical
Dissolving
Chemical
Unbleached sulphite pulp
Bleached sulphite pulp
Unbleached sulphate (kraft)
pulp
Bleached sulphate (kraft) pulp
Recovered paper

09021
09022
09023
09030
11000
11010
11020
12000
13000
14000

Buildings and their parts
Garden Furniture/Outdoor
Products
Garden furniture
Playground equipment
Decking
Other
Cork and cork products
Natural cork and cork waste
Cork manufactures
Energy
Non-wood products
Other

List of species
1

Coniferous

2

Non-coniferous tropical

3

Non-coniferous other

4

Not specified

Paper and paper board
Graphic papers
Newsprint
Uncoated mechanical
Uncoated woodfree
Coated papers
Household and sanitary paper
Packaging materials
Case materials
Folding boxboards

All woods derived from trees classified botanically as Gymnospermae - e.g. fir
(Abies), parana pine (Araucaria), deodar (Cedrus), ginkgo (Ginkgo), larch (Larix),
spruce (Picea), pine, chir, kail (Pinus), etc. These are generally referred to as
softwoods.
All woods derived from trees classified botanically
Non-coniferous woods
as Angiospermae - e.g., maple (Acer), alder
originating from tropical
(Alnus), ebony (Diospyros), beech (Fagus), lignum
countries.
vitae (Guiaicum), poplar (Populus), oak (Quercus),
Non-coniferous woods
sal (Shorea), teak (Tectona), casuarina
originating from countries
(Casuarina), etc. These are generally referred to as
other than tropical.
broadleaved or hardwoods.

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