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FDA Product Application Authorization

This authorization letter allows [Name of QPIRA Applicant] to represent [Name of Company] in matters relating to product applications and signing documents for the Food and Drug Administration. [Name of Company Owner/General Manager] authorizes [Name of QPIRA Applicant] to act on behalf of [Name of Company] until further written notice. Additionally, [Name of Company] does not object to [Name of QPIRA Applicant] representing other companies listed on this authorization form.

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Cha Gabriel
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82 views1 page

FDA Product Application Authorization

This authorization letter allows [Name of QPIRA Applicant] to represent [Name of Company] in matters relating to product applications and signing documents for the Food and Drug Administration. [Name of Company Owner/General Manager] authorizes [Name of QPIRA Applicant] to act on behalf of [Name of Company] until further written notice. Additionally, [Name of Company] does not object to [Name of QPIRA Applicant] representing other companies listed on this authorization form.

Uploaded by

Cha Gabriel
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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AUTHORIZATION LETTER

Civic Drive, Filinvest Corporate City, Alabang, City of Muntinlupa 1781 Philippines
*
Date of Applied
dd MMMM yyyy

ROLANDO ENRIQUE D. DOMINGO, MD., DPBO


Name of the current Director

Director General
Food and Drug Administration
Civic Drive, Filinvest Corporate City, Alabang
City of Muntinlupa 1781 Philippines

Attention: Dr. OSCAR G. GUTIERREZ


Officer-In-Charge
Policy and Planning Office
FDA Academy

I, the undersigned, hereby authorize _________________________________________


(Name of the Company Owner/ General Manager) ( Name of QPIRA Applicant)

to act/ represent on our behalf in all manners relating to product application, including signing of all documents relating to these matters.
Any and all acts carried out by ________________________________________ on our behalf shall have the same affect as acts of our own.
( Name of QPIRA Applicant)

This authorization is valid until further written notice from __________________________________.


(Name of Company)

Company Owner/ General Manager


Signature over Printed Name

for more than 1 authorized company

I, the undersigned, hereby authorize _________________________________________


(Name of the Company Owner/ General Manager) ( Name of QPIRA Applicant)

to act/ represent on our behalf in all manners relating to product application, including signing of all documents relating to these matters.
Any and all acts carried out by ________________________________________ on our behalf shall have the same affect as acts of our own.
( Name of QPIRA Applicant)

This authorization is valid until further written notice from __________________________________.


(Name of Company)

Furthermore, our company, _________________________ interposes no objection for __________________________ to represent other company
(Name of the Company) ( Name of QPIRA Applicant)

included in this form.

Company Owner/ General Manager


Signature over Printed Name

I, the undersigned, hereby authorize _________________________________________


(Name of the Company Owner/ General Manager) ( Name of QPIRA Applicant)

to act/ represent on our behalf in all manners relating to product application, including signing of all documents relating to these matters.
Any and all acts carried out by ________________________________________ on our behalf shall have the same affect as acts of our own.
( Name of QPIRA Applicant)

This authorization is valid until further written notice from __________________________________.


(Name of Company)

Furthermore, our company, _________________________ interposes no objection for __________________________ to represent other company
(Name of the Company) ( Name of QPIRA Applicant)

included in this form.

Company Owner/ General Manager


Signature over Printed Name

For QPIRA Applicants only a


FDAA-Form 2013-02/ Effectivity: 02 May- Rev. 0

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