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| FDA Form # | Date | Title | Format | Paper Copy or Contact Info. |
|---|---|---|---|---|
| 2096 | 03/04 | Regulation Certification for New Employee | |
Vincent Tolino 301-827-5514 |
| 2097 | 01/03 | Regulation Certification for Separating Employees | |
Vincent Tolino 301-827-5514 |
| 2098 | 11/02 | Regulation Certification for Special Government Employees | |
Vincent Tolino 301-827-5514 |
| 3410 | 10/01 | Confidential Financial Disclosure Report | |
Vincent Tolino 301-827-5514 |
| 3454 | 04/06 | Certification: Financial Interest and Arrangements of Clinical Investigators | |
Leah W. Ripper 301-796-1282 |
| 3455 | 04/06 | Disclosure: Financial Interest and Arrangements of Clinical Investigators | |
Leah W. Ripper 301-796-1282 |
| 3463 | 07/00 | EDI Gateway Training Partner Agreement | Not Yet Electronic | Bill Taylor 301-827-6504 |
| 3500 | 02/06 | MedWatch: The FDA Safety Information and Adverse Event Reporting Program {Instructions} |
|
MEDWATCH 1-800-FDA-1088 |
| 3500A | 02/06 | MedWatch: The FDA Safety Information and Adverse Event Reporting Program - Mandatory {Instructions} |
|
MEDWATCH 1-800-FDA-1088 |
| 3539 | 04/06 | Review/Approval of Free Attendance at Widely Attended Gatherings (WAG) | |
Vincent Tolino 301-827-5514 |
| 3542 | 07/03 | Patent Information Submitted Upon and After Approval of An NDA or Supplement | |
Mary Ann Holovac 301-827-5846 |
| 3542a | 07/03 | Patent Information Submitted With the Filing of An NDA, Amendment, or Supplement | |
Mary Ann Holovac 301-827-5846 |
| 3671 | 11/07 | Common EMEA/FDA Application for Orphan Medicinal Product Designation |
|
Kathy Needleman 301-827-3666 |
| 3674 | 11/08 | Certification of Compliance, under 42 U.S.C. , 282(j)(5)(B), with Requirements of ClinicalTrials.gov Data Bank (42 U.S.C., 282(j)) |
|
Jarilyn Dupont 301-827-3360 |
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Edition: January 8, 2009