In order to process this shipment the following information will need to be
       provided for submition to FDA.

       (   )     Copy of invoice

       (   )       Adequate description fo the imported articles.

       (   )     Complete name and adress for:

                   (   )     Consignee
                   (   )      Importer of Record
                   (   )      Manufacturer/Shipper

        (   )      Medical Device Registration Number for consignee (Initial Distributer)

        (   )      Medical Device Listing Number for the foreign manufacturer

        (   )      Medical Device 510K Number

        (   )      Investigational Device Exemption Number (IDE)

        (   )      Description lacks a drug:

                    (   )      NDC Number (National drug Code)
                    (   )      IND Number (investigational)
                    (   )      NDA Number (New Drug Application)

        (   )       FD2877 (Radiological Health Declaration Form)

        (   )       Radiological Health Accession Number

        (   )       LACF/Acidified food information

                    (   )       Food Canning Establishment Number (FCE)
                    (   )       Scheduled process identification number
                    (   )       Container dimensions

         (   )      Impact-Resistant Lens certificate for sunglasses

         (   )      Labeling

         (   )      Reason for Return

         (   )      Other:________________________________________________________