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Status concerning Marketing Authorization<br />

Marketing Authorization (MA) has been approved in<br />

the following countries 1) :<br />

Date of approval:<br />

MA application has been submitted in the following<br />

countries 1) :<br />

Date of submission::<br />

A MA application has not yet been submitted, but is planned (date):________, in the following<br />

countries:____________________________________________________________________<br />

A MA application has not yet been submitted, and the time for submission is not yet decided.<br />

Documentation should be enclosed (in English only). Electronic versions of all enclosures should be<br />

forwarded to the Centre. Please note that no paper copies are required when the application is<br />

submitted electronically followed by our automatic receipt. Application for ATC/DDD is free of<br />

charge.<br />

Date/Signature: Position:<br />

1) If the approved or applied indications in any of these countries differ from those given on the first page, please<br />

describe these differences in a separate enclosure.

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