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Get Fda Form 2877 2011-2024

Est is attached. 3. Request will be submitted within 60 days. SIGNATURE OF IMPORTER OF RECORD WARNING: Any person who knowingly makes a false declaration may be fined not more than $10,000 or imprisoned not more than 5 years or both, pursuant to Title 18 U.S.C. 1001. Any person importing a non-compliant electronic NAME AND TITLE OF RESPONSIBLE PERSON product may also be subject to civil penalties of $1000 per violation, up to a maximum $300,000 for related violations pursuant to Title 21 U.S.C.

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