Get Self-reporting Form - Market Surveillance Administrator

This guide provides comprehensive instructions on how to effectively complete the SELF-REPORTING FORM - Market Surveillance Administrator online. By following these steps, users can ensure that all necessary information is accurately reported.

Follow the steps to successfully complete the self-reporting form.

1. Press the ‘Get Form’ button to access the form and open it in the designated editor.
2. Begin by entering your MSA file number in the first field. This number is essential for identifying your specific submission.
3. Input the registered entity name in the appropriate section, ensuring the name is spelled correctly to reflect the organization involved.
4. Indicate the reliability standard applicable to your report. This includes selecting the relevant code that aligns with your submission.
5. For the self-report section, choose 'YES' or 'NO' to indicate if you or your organization is submitting a self-report.
6. In the requirement section, specify the requirement designation that your report addresses.
7. Indicate whether an accepted mitigation plan is applicable by selecting 'YES' or 'NO'.
8. Fill in the date of the referral/self-report from the documentation you have, making sure to use the correct format.
9. Provide the date of contravention that is relevant to your submission.
10. Enter the specified penalty amount in the designated field.
11. Detail the event findings in the designated area, summarizing the circumstances leading to the report.
12. Review all information entered for accuracy and completeness.
13. Once satisfied with your entries, save the changes. You may then have the option to download, print, or share the form as needed.

Complete your self-reporting form online to ensure compliance and accurate reporting.