Requirements
Module 2: Administrative Requirements
I. Application Form
II. Letter of Authorization
III. Certifications
PRESENTATION OUTLINE
Part I: Administrative Data and
Product Information 3
Integrated Application Form
For locally-manufactured
I. Application Form
6
• Correct name and address of applicant consistent with
LTO
• Correct name and address of manufacturer consistent
with LTO/CPP
• Correct generic name consistent with WHO INN
• Correct details of the product consistent with the
submitted sample(s)
• Correct name and address of drug substance(s)’
manufacturer(s)
Hereby appoint
__________________________________________________________
Applicant’s Name and Address
With the Drug Regulatory Authority in (state country) on our behalf . They will be
the marketing authorization holder of the registration certificate and be responsible
for all matters pertaining to the regulation of this product.
Signature : __________________
Date : 13
1. For contract manufacturing
2. For manufacturing “under-license”
3. For locally manufactured products (excluding
the above)
4. For imported products
III. Certifications
14
a. License of pharmaceutical industries and
contract manufacturer
b. Contract manufacturing agreement
c. GMP certificate of contract manufacturer