Fillable FDA Product Data Sheet: Tobacco (Livingston)

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FDA Product Data Sheet: Tobacco (Livingston)

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FDA: Tobacco US Brokerage, 09/2015
FDA Product Data Sheet: Tobacco
Account Number
Account Name
DUNS Number (if available)
Client Part Number*
Description of Product (as complete as possible)
Government Agency Processing Code
Select One
Tariff Number
FDA Product Code (if known)
Country of Origin**
FDA Country of
Production**
Cargo Storage Status
Intended Use
If Intended Use is INV, investigational, please provide name and address for lab or clinical site
* Part number as shown on Customs document to identify the product (item number, SKU, etc.)
** U.S. Customs considers the country of origin to be the country where the product last underwent a “substantial transformation” (resulting in an
increase in value.) The FDA considers the country of origin to be that of the actual manufacturer. Actual manufacturer is defined as the last party
involved in the production process.
FDA Actual Manufacturer
Company Name
City
State/Province
Zip/Postal Code
Country
DUNS Number (if available)
FDA Shipper (As shown on Customs document, BOL or airway bill)
Company Name
City
State/Province
Zip/Postal Code
Country
DUNS Number (if available)
Select one
Select one
Select one
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FDA Product Data Sheet: Tobacco (Livingston)

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Completed 23 September 2021

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