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    Annex E Assessment Slip Food

    Uploaded by

    Sunshine Enriquez
    This document appears to be an assessment slip from the Bureau of Food and Drugs for an applicant company seeking registration or renewal of registration for food products. The slip collects information about the applicant such as company details and contact information. It also requests information on the specific food products including brand name, product classification, number of products, and packaging details. Payment and evaluation details are documented. The form is used to assess the application and provides a receipt upon payment.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    Annex E Assessment Slip Food

    Uploaded by

    Sunshine Enriquez
    170 views2 pages
    This document appears to be an assessment slip from the Bureau of Food and Drugs for an applicant company seeking registration or renewal of registration for food products. The slip collects information about the applicant such as company details and contact information. It also requests information on the specific food products including brand name, product classification, number of products, and packaging details. Payment and evaluation details are documented. The form is used to assess the application and provides a receipt upon payment.

    Original Description:

    FDA Assessment

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    This document appears to be an assessment slip from the Bureau of Food and Drugs for an applicant company seeking registration or renewal of registration for food products. The slip collects information about the applicant such as company details and contact information. It also requests information on the specific food products including brand name, product classification, number of products, and packaging details. Payment and evaluation details are documented. The form is used to assess the application and provides a receipt upon payment.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    170 views2 pages

    Annex E Assessment Slip Food

    Uploaded by

    Sunshine Enriquez
    This document appears to be an assessment slip from the Bureau of Food and Drugs for an applicant company seeking registration or renewal of registration for food products. The slip collects information about the applicant such as company details and contact information. It also requests information on the specific food products including brand name, product classification, number of products, and packaging details. Payment and evaluation details are documented. The form is used to assess the application and provides a receipt upon payment.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    PAICS COPY

    Annex

    ACCOUNTING SECTIONS COPY

    E
    Bureau of Food and Drugs
    Policy, Planning, and Advocacy Division
    A S S E S S M E N T S L I P
    FOOD
    DATE:

    Bureau of Food and Drugs


    Policy, Planning, and Advocacy Division
    A S S E S S M E N T S L I P
    FOOD

    RSN:

    Applicant Company
    Address/Tel no.
    LTO No./Validity

    DATE:

    : _______________________________________________________
    : _______________________________________________________
    : _______________________________________________________

    Manufacturer Distributor/Wholesaler
    PRODUCT INFORMATION
    Brand name and Product
    Name
    Product Classification
    (Category/Code)

    Importer

    Exporter

    Wholesaler

    RSN:

    Applicant Company
    Address/Tel no.
    LTO No./Validity

    : _______________________________________________________
    : _______________________________________________________
    : _______________________________________________________

    Manufacturer Distributor/Wholesaler
    PRODUCT INFORMATION

    Importer

    Brand name and Product


    Name
    Product Classification
    (Category/Code)

    List of Products

    List of Products

    Number of Products Applied

    Number of Products Applied

    Packaging Types and Sizes

    Packaging Types and Sizes

    Registration Number (FR)

    : __________________

    Registration Number (FR)

    : __________________

    Applicant Company

    Applicant Company

    Manufacturer

    Manufacturer

    Repacker

    Repacker

    Distributor

    Distributor

    Others (Pls. specify)

    Others (Pls. specify)

    Number of Samples

    : __________________

    Number of Samples

    : __________________

    Validity: ___________________________________

    Loose Labels:_______________________________

    APPLICATION DETAILS
    Application Type
    Initial
    Renewal
    Renewal with Surcharge
    Re-application (OLD RSN:_______________)
    No. of CPR Validity Applied for (year/s)

    OTHER REQUESTS
    Amendment of CPR

    Re-issuance/Reconstruction of CPR

    Referral to ACB

    Category
    I

    Category
    II

    :
    :

    Validity: __________________________________

    Loose Labels:_______________________________

    Bottled
    Water

    Application Type
    Initial
    Renewal
    Renewal with Surcharge
    Re-application (OLD RSN:_______________)
    No. of CPR Validity Applied for (year/s)

    OTHER REQUESTS
    Amendment of CPR

    Re-issuance/Reconstruction of CPR

    Referral to ACB

    Category
    I

    Category
    II

    :
    :
    :
    :

    EVALUATOR
    Fee
    Surcharge
    TOTAL
    Evaluated by

    CASHIER
    Amount
    OR Number
    Date Issued
    Received by

    :
    :
    :
    :

    RECEIPT DETAILS

    Name

    Signature

    Name

    Signature

    KJFSLFJASKFJALDFJLAFJLSKDJFLAKSJDFLJASKDFJALSD

    Food
    Supplement

    Provisional Permit to Market (PPM)


    Export Certificate
    Others, pls. specify

    PAYMENT DETAILS

    RECEIPT DETAILS

    KJFSLFJASKFJALDFJLAFJLSKDJFLAKSJDFLJASKDFJALSD

    Food
    Supplement

    Provisional Permit to Market (PPM)


    Export Certificate
    Others, pls. specify

    CASHIER
    Amount
    OR Number
    Date Issued
    Received by

    :
    :
    :
    :

    Wholesaler

    APPLICATION DETAILS

    PAYMENT DETAILS
    EVALUATOR
    Fee
    Surcharge
    TOTAL
    Evaluated by

    Exporter

    :
    :
    :
    :

    Bottled
    Water

    PAICS COPY

    ACCOUNTING SECTIONS COPY

    Annex

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