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FDA Forms Distribution Page for
Center for Drug Evaluation and Research (CDER)

The forms provided by this web site are available in several formats. These formats include:

PDF Adobe Acrobat Portable Document Format (PDF) *
MS WORD Microsoft Word
EXCEL Microsoft Excel
WordPerfect WordPerfect
XML Extensible Markup Language
HTML Hypertext Markup Language (HTML)
Fillable Filler Forms

FDA Form # Date Title Format Paper Copy or Contact Info.
356h 04/03 Application to Market a New Drug, Biologic or an Antibiotic Drug for Human Use PDF

WORD
Pamela Pope
301-827-9540
1571 01/03 Investigational New Drug Application {Instructions} PDF

WORD
Mia Prather
Mia.Prather@fda.hhs.gov
1572 01/03 Statement of Investigator {Instructions} PDF

WORD
Mia Prather
Mia.Prather@fda.hhs.gov
2252 04/02 Transmittal of Annual Report for Drugs for Human Use PDF

WORD
Mia Prather
Mia.Prather@fda.hhs.gov
2253 07/02 Transmittal of Advertisements and Promotional Labeling for Drugs and Biologics for Human Use PDF

WORD
Mike Wade
301-827-2828
2567 09/02 Transmittal of Labels and Circulars PDF

WORD
Pamela Pope
301-827-9540
2626 07/04 New Drug Application/Biologic Licensing Application (Blue Folder) Archival Not Yet Electronic GPO
2626a 07/04 New Drug Application/Biologic Licensing Application (Red Folder) Chemistry Not Yet Electronic GPO
2626b 07/04 New Drug Application/Biologic Licensing Application (Yellow Folder) Pharmacology Not Yet Electronic GPO
2626c 07/04 New Drug Application/Biologic Licensing Application (Orange Folder) Pharmacokinetic Not Yet Electronic GPO
2626d 07/04 New Drug Application/Biologic Licensing Application (White Folder) Microbiology Not Yet Electronic GPO
2626e 07/04 New Drug Application/Biologic Licensing Application (Tan Folder) Clinical Data Not Yet Electronic GPO
2626f 07/04 New Drug Application/Biologic Licensing Application (Light Green Folder) Statistics Not Yet Electronic GPO
2626h 07/04 New Drug Application/Biologic Licensing Application (Maroon Folder) Field Submission Chemistry Not Yet Electronic GPO
2656 09/03 Registration of Drug Establishment/Labeler Code Assignment {Instructions} THIS FORM MUST BE SUBMITTED IN TRIPLICATE PDF

WORD
OTCOM
301-827-4573
2657 08/04 Drug Product Listing {Instructions} PDF

WORD
OTCOM
301-827-4573
2658 08/04 Registered Establishments Report of Private Label Distributors {Instructions} PDF

Word
OTCOM
301-827-4573
2675 07/84 Investigational New Drug Folder (Red) Not Yet Electronic GPO
2675a 07/84 Investigational New Drug Folder (Green) Not Yet Electronic GPO
2675b 07/84 Investigational New Drug Folder (Orange) Not Yet Electronic GPO
2914 10/01 Radioactive Drug Research Committee (RDRC) Report/Research Use of Drug Membership Summary PDF

WORD
Ray Farkas & Richard Fekla
301-827-7482
2915 10/01 Radioactive Drug Research Committee (RDRC) Report on Research Use of Radioactive Drug Study Summary PDF

WORD
PPF
3316 08/85 Folder, Drug Master File (Red) Not Yet Electronic GPO
3316a 08/85 Folder, Drug Master File (Blue) Not Yet Electronic GPO
3331 02/03 NDA Field Alert Report PDF

WORD
Juliaette Johnson
301-827-8930
3397 12/03 User Fee Cover Sheet PDF

WORD
Mike Jones
301-594-2041
3437 06/95 CDER Pediatric Use Supplement PDF CDR
301-827-4210
3454 02/03 Certification: Financial Interest and Arrangements of Clinical Investigators PDF

WORD
Leah W. Ripper
301-827-5921
3455 02/03 Disclosure: Financial Interest and Arrangements of Clinical Investigators PDF

WORD
Leah W. Ripper
301-827-5921
3500 09/03 MedWatch: FDA Medical Product Reporting Program {Instructions} PDF

Fillable
MEDWATCH
1-800-FDA-1088
3500A 09/03 MedWatch: FDA Medical Products Reporting Program - Mandatory {Instructions} PDF MEDWATCH
1-800-FDA-1088
3542 07/03 Patent Information Submitted Upon and After Approval of An NDA or Supplement PDF

WORD
Mary Ann Holovac
301-827-5846
3542a 07/03 Patent Information Submitted With the Filing of An NDA, Amendment, or Supplement PDF

WORD
Mary Ann Holovac
301-827-5846
3543 12/03 Certificate of a Pharmaceutical Product PDF Jocelyn V. Lewis
301-827-8983

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Edition: September 30, 2004

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