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r-o -E(42sh <br />111 Dried or Dehydrated <br />Vegetables <br />Sweet Sorghum <br />Syrup <br />Dried Vegetarian - LI El Vegetable and Potato Chips Based Soup Mixes <br />Roasted Coffee <br />(Beans/Grounds) IN Chocolate Covered Nonperishable Food <br />111 Other: <br />* Do not contain eggs, cream, or cream cheese <br />*" If preparing jams, jellies or fruit butters, include a list of ingredients (attach separate page if needed). These items <br />must comply with standards described in Part 150 of Title 21 of the Code of Federal Regulations <br />http://www.accessdata.fda.qov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br />Food Descriptions: Chocolate covered pretzels, cupcakes, cakes, chocolate covered strawberries, sheer khorma, cake pops <br />Q- loc--Q oNre.‘ pl(-ty-9 — <br />\)•.) erv-o,re -Ervyr), <br />EHD 16-27 6/29/2015 2 CFO REG/PERMITTING FORM