Loa_frontend - About_us - French

Submission Details
Country Of Submission*
Are you working for a third party customer?
We offer our customers the alternative to submit individual request upon third parties Letter of Authorization (LoA) application in China. Please kindly direct your request to Dr. Karen Liu (Karen.liu@schott.com)
Company requesting to issue a LOA
Company Name*
Company Name China
(In China, only relevant to China submission. If there is no
corresponding Chinese translation of your Company Name
or there is no Company Name in Chinese, please use your
English Company Name)*
Address 1
(Please provide Postal address in English)*
Address 2
Ville*
State/Province*
Zip/Postal Code*
Pays*
First Name*
Last Name*
Title
Tél.*
E-mail*
E-Mail Confirmation
Company for whom the LOA is being issued
Is the company for whom the LOA is being issued the same as the requesting company?
If not, please add additional company by clicking the button below.

SCHOTT Product Details
SCHOTT Product Manufacturing Facility*
SCHOTT Product Group*
SCHOTT Product Description (e.g. pen cartridge 20ml)*
SCHOTT Article No. (7-digit starting with 1... )
specification/model*
(Please kindly enter the format or
size of the container(s) used, e.g. 2 mL)
Information of Drug to be applied at the NMPA in China (China Submission),
(Should be identical to the name given in the submission dossier to NMPA)
Name of the drug (in English)*
Name of the drug (in Chinese)*
(If there is no corresponding Chinese translation or Chinese Name
of the Drug, please enter Name of the Drug in English into this
field)
Route of administration (in English)*
Route of administration (in Chinese)*
Comments
Comments
Please enter the numer of originals of the
requested China LoA; if no hard copy is needed,
please enter ’No original/hard copy is required’
in this field.*
* = champ obligatoire