Self Assessment Form For Sales Promo Permit

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Republic of the

Department of Health
FOOD AND DRUG ADMINISTRATION

CENTER FOR DRUG REGULATION AND RESEARCH


INITIAL ( ) / AMENDMENT ( )
SELF-ASSESSMENT FORM FOR SALES PROMO PERMIT
APPLICANT NAME
APPLICANT
ADDRESS
DTN
O.R. No. / Ref.No.
Amount Paid
Sales Promo Permit
No.
Directions:
Fill out the form by ticking the applicable column. Provide remarks on the client’s column
when necessary.
REMARKS
DOCUMENTARY Y N
es o
REQUIREMENTS:
1. Integrated Application Form
 Is the application form properly filled
out?
2. Intent Letter
 Is the request clear and within the scope
of sales promo?
 Is the letter signed by the applicant’s
approving authority?
3. List of Participating Products
 Is the list of participating products (Sheet 3)
provided in excel format?
4. Copy of valid CPR/CPN Registration
 Are all the participating products duly
registered or in the process of renewal?
 Is/are there participating product/s with
CPRs/CPNs that will expire soon or
within 6 months?
 Identify, if applicable.
5. Information Sheet
 Is the promo title not offensive, obscene,
scandalous, against public moral and/or
misleading?
 Is the requested promo duration Initial Amendment
acceptable?
 Is the promo coverage clearly indicated Initial Amendment
and within acceptable venue?
 Is the promo mechanic acceptable or Amendment, if applicable:
compliant with existing rules and
regulations?
6. Collateral/ Promo Materials
 Is/are there collateral material/s used? Initial Amendment

 Is/are the collateral material/s


misleading, vague, and not compliant
with existing rules and regulations?
--- To be filled out by CDRR Personnel ---
Decision: Remarks: Remarks:
Approval
Denial
Clarification
1
Name & Evaluator: Supervisor:
Signature:
Date:

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