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Get Acknowledgement Signature

Electronic Signature Acknowledgement Form and Signature Log Boehringer Ingelheim Fremont Inc. Name Last Name First Name MI please print Date Department Initials Staff Type FTE Supplemental Worker Supervisor Name BI ID Number BI Start Date for Supplemental Workers only INTRODUCTION On August 20 1997 the FDA Final Rule of 21 CFR Part 11-Electronic Records certifying that all electronic signatures executed to electronic records required by predicate rules in Drug Administration regulations are intended to be the legally binding equivalent of traditional handwritten signatures. SCOPE This Acknowledgement Form applies to electronic signatures executed for regulatory documents defined under FDA 21 CFR Part 11. AGREEMENT By signing this Electronic Signature Acknowledgment Form I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature it has the same validity and meaning as my handwritten signature. I will not at any time in the future repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding. By signing below I accept the conditions of this agreement. Signature Witness Signature Witness printed name When Complete please return to BIFI Learning Development. SCOPE This Acknowledgement Form applies to electronic signatures executed for regulatory documents defined under FDA 21 CFR Part 11. AGREEMENT By signing this Electronic Signature Acknowledgment Form I agree that my electronic signature is the legally binding equivalent to my handwritten signature. AGREEMENT By signing this Electronic Signature Acknowledgment Form I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature it has the same validity and meaning as my handwritten signature. Whenever I execute an electronic signature it has the same validity and meaning as my handwritten signature. I will not at any time in the future repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding. I will not at any time in the future repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding. By signing below I accept the conditions of this agreement. Signature Witness Signature Witness printed name When Complete please return to BIFI Learning Development. SCOPE This Acknowledgement Form applies to electronic signatures executed for regulatory documents defined under FDA 21 CFR Part 11. AGREEMENT By signing this Electronic Signature Acknowledgment Form I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature it has the same validity and meaning as my handwritten signature. AGREEMENT By signing this Electronic Signature Acknowledgment Form I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature it has the same validity and meaning as my handwritten signature. I will not at any time in the future repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding..

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