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Get Fda 3602 2019-2025

1001 and other applicable federal statutes. Signature of person making this Small Business Certification Request must be signed by the person identified in item Date of this Small Business Certification Request MM/DD/YYYY FORM FDA 3602 8/18 Page 1 of 2 EF a. Name of Affiliate b. Taxpayer ID Number c. Gross Receipts or Sales Total Gross Receipts or Sales of All Affiliates sum of lines 1 through 15 sum of lines 16 and 17 PRIVACY ACT NOTICE This notice is provided pursuant to the Privacy Act of 1974 5 U.S.C. 552a. The collection of this information is authorized by 21 U.S.C. 379i and 379j. FDA will use the information to assess qualification as a small business collect and process user fee payments and facilitate debt collection under the Debt Collection Improvement Act. OMB Number 0910-0508 DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Expiration Date June 30 2019 PRA Statement See next page. MDUFA SMALL BUSINESS CERTIFICATION REQUEST Application for FY 20 For a Bu....

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How to fill out the FDA 3602 online

The FDA 3602 form is essential for businesses seeking to certify their status as small businesses under the Medical Device User Fee Amendments (MDUFA). This guide will provide clear, step-by-step instructions on how to effectively complete the FDA 3602 online.

Follow the steps to complete the FDA 3602 form online.

  1. Click ‘Get Form’ button to obtain the form and open it in your preferred electronic document software.
  2. Identify the fiscal year for which you are requesting the Small Business Certification. Clearly indicate this in the upper right section of the form header.
  3. In Section I, provide the name of your business as it appears on your Federal tax form.
  4. Enter your business's Federal Employer Identification Number (EIN) in the specified field, ensuring it matches your tax documentation.
  5. Provide the physical address where your business operates, including details necessary for someone to locate the business.
  6. List the name and contact details of the person responsible for this certification. Include their position in the business.
  7. In the field for affiliate information, indicate if your business has affiliates. If yes, confirm that they are listed in Section II.
  8. Complete the certification statement at the end of Section I. Check the correct response box regarding your affiliates and gross receipts.
  9. Proceed to Section II to list any affiliates, providing each entity's name, Taxpayer ID number, and total gross receipts or sales.
  10. Calculate the total gross receipts for all listed affiliates, as well as the gross receipts for your business, ensuring they meet the qualification criteria.
  11. Once you have filled in all required fields accurately, print the completed form. Sign and date it before submission.
  12. Submit your completed FDA 3602 form, along with required supporting documents, to the designated FDA mailing address.
  13. If assistance is needed while filling out the form, contact the Division of Industry and Consumer Education.

Start completing your FDA 3602 form online today to take advantage of the benefits available for small businesses.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232