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Get Tx Ef23-12957 2009-2026

To: Texas Department of State Health Services, RLU, Food & Drug Licensing, P.O. Box 12008, Austin, Texas 78711 For assistance in completing this application call (512) 834-6727 PSEUDO 2510 BUDGET: ZZ114 FUND 996 LICENSE # Name Under Which Business is Conducted (DBA): Physical Address to be Licensed: City, County, State, Zip Code: Telephone # at address: ( ) List of All Health Care Products, By Type, Sold At The Business Address Listed Above. Attach Additional Sheet If Necessary: Name(s), A.

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How to fill out the TX EF23-12957 online

Navigating the TX EF23-12957 form can be straightforward with the right guidance. This document serves as a comprehensive guide to help users complete the Minor Amendment License Application effectively and efficiently.

Follow the steps to complete the TX EF23-12957 form online.

  1. Click the 'Get Form' button to obtain the form and open it in the designated editor.
  2. Begin by entering the name under which the business is conducted (DBA) in the specified field.
  3. Fill in the physical address to be licensed, including city, county, state, and zip code.
  4. Provide the telephone number for the business address. Ensure it is accurate for future communication.
  5. List all health care products by type sold at the business address. Use additional sheets if necessary.
  6. Include the names, addresses, and contact persons of your wholesale distributors. Attach an additional sheet if needed.
  7. Indicate where products containing ephedrine, pseudoephedrine, or norpseudoephedrine will be stored. Choose either behind a sales counter or in a locked case within 30 feet of a staffed sales counter.
  8. Attach all required additional documentation, which includes a list of inventory of regulated products, a description of employee training, and written procedures for product storage.
  9. Select the purpose of the application and mark the appropriate box to indicate any changes in the status of your firm.
  10. Fill in the required details of the responsible individual in charge at the physical address.
  11. Complete the billing information section, including the name, address, and contact details of the application preparer.
  12. Review all sections to ensure accuracy and completeness before signing and dating the application.
  13. Save changes to your form, and download or print the completed application for submission.

Complete your TX EF23-12957 document online to ensure a smooth filing process.

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