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2. Not-For-Profit & Exempt Food Vendor Application

4. -This application must be completed and submitted to the Craven County Health Department (CCHD) no later than 15 days prior to the event. Although you may be exempt from regulation you should use "best practice" during an event to ensure the safety of your patrons. Visit Food Safety | Craven County (cravencountync.gov) for tips.

   G.S. 130A-250(7) states establishments (i) that are incorporated as nonprofit corporations in accordance with Chapter 55A of the General Statutes or (ii) that are exempt for federal income tax under the Internal Revenue Code, as defined in G.S. 105-228.90 or (iii) that are political committees as defined in G.S. 163-278.6(14) and that prepare or serve food or drink for pay no  more frequently than once a month for a period not to exceed two consecutive days, including establishemnts permitted pursuant to this part when preparing or serving food or drink at a location other than the permitted locations.

6. Nonprofit Organizations will need to provide documentation along with this application. Nonprofit Organizations must have a copy of appproved application and tax exempt status form verifying exempt status for your organization to operate & forms must be on site at all times.

8. Please be aware of any legal problems that could result from selling food.

   Selling Food without a permit at an event where a permit is required will result in a Cease and Desist Order being issued and possible legal action taken if it is determined to be a for-profit sale. Event sponsors, organizers, coordinators and vendors will share responsibility if a food borne illness occurs from food sold at the event.

12. Check the type of exemption which you are requesting:*

    1. Chapter55A of the General Statutes Exempt from federal income tax under*
    2. Political Committees as defined in G.S. 163-278.6(14)*
    3. G.S. 105-228.90*
    4. Exempt Food Items Only
13. Sumbit Supporting Documentation:*
15. Facility Type:*
    -- Select One --BoothPushcartMobile Food Unit (MFU)Permanent Building
17. Name of Event:*
18. Date(s) of Event:*
    Date(s) of Event: Start Date

    —

    Date(s) of Event: End Date

    If the event is only one day, enter the same date for both entries.

20. Address of Event*
22. City*
23. State*
24. Zip Code*
28. Name of Person(s) in Charge: *
29. Phone #:*
31. Email:*
33. Person In Charge Mailing Address*
35. City*
36. State*
37. Zip Code*
41. Location of Last Event:
42. Date(s):
    Date(s):
44. Provide a complete list of all food/menu items in the chart below with their source and indicate if the food is prepared in advance, prepared at the event, or both.

    -Advanced Preparation - Includes cutting, seasoning, marinating, cooking, etc. that takes place prior to the event.

    -Prepared at Event - Includes cutting, seasoning, marinating, cooking, etc. that takes place at the event.

46. Food Items/Menu*

    Example:

    -Hamburgers, Smiths market, Both Advanced preparation and Preparation at event.

    -Tomatoes, Smiths market, Preparation at event.

48. I certify that the information in this application is complete and accurate. I understand that:

    -Any deviation without prior approval from CCHD may nullify this exemption.

50. Applicant Signature:*
51. Date:*
    Date:

53. Craven County Health Department

Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field