【正文】
(如屬于企業(yè)申請劃“/”。In the case of enterprise application, please fill “/”.)承諾事項Guarantee我(們)保證:We (personality or the enterprise )guarantee:本申請遵守國家法律法規(guī)規(guī)章和有關(guān)規(guī)定。The application is conducted in accordance with the national law and regulations in involved.所有資料真實有效,有據(jù)可查。All the information submitted in this application is authentic and derived from the reliable source.如有虛假,愿意承擔相應(yīng)的法律責任。Bear the responsibility for all the falsehood of the information submitted and will assume all the lawful liability.申請人(或委托代理人)簽名: Signature of the applicant (or the agent authorized by the applicant) (企業(yè)蓋章)(the seal of the enterprise)日期Date: 年 月 日1. 申請材料真實性的保證聲明應(yīng)由申請人(申辦企業(yè)由法定代表人)簽署生效。委托代表人簽署的,應(yīng)出具由申請人簽署的有效委托書。The signature must be done by himself (or herself). In the case of signature made by the agent the written certificate of authorization must be provided.2. 本表由江蘇省食品藥品監(jiān)督管理局制定。This format is established by Jiangsu Food and Drug Administration.22 / 2