【正文】
of Imported Drugs): This agency is responsible for payment Chinese Name: English Name: Organization Code: Legal Representative: Position: Registered Address: Zip Code: Contact Address: Zip Code: Head of an Application for Registration: Position: Contact: Position: Phone : Fax : Email: phone: Legal Representative (Signatures): (Department Official Seal) Month Day, Year 31 Commissioned Research Institutions: 32 Declaration: material 4 material 7 material 8 material 16 material 28 Authorities After reviewed, the table is in line with the form with the request. Authorities: Reviewer (Signatures) Date: