REGISTER OF ENTRIES

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As part of your company's FDA FSVP Importer program, the following information is respectfully requested.

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- Required

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- Information

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ex. "012-3456789-1/11/11"  or  "N/A"

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ex. "Product Name from ABC Inc."

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only required if two entries were made

only required if three entries were made

only required if four entries were made

only required if five entries were made

only required if six entries were made

only required if seven entries were made

only required if eight entries were made

only required if nine entries were made

only required if ten entries were made

Entry Summary / Customs Invoice

Please feel free to upload relevant entry documents

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Upload

for example: "ABC Customs Brokerage Inc."

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for example: "Jane Smith, LCB"

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  

                                                                              THANK YOU FOR YOUR SUBMISSION                                                                              

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  

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CERTIFICATION: By my certification below, I attest that the information I provide on, and in connection with, this form is true, accurate, and complete to the best of my knowledge.

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