GMP CERTIFICATE - DOC

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					FEDERAL AGENCY FOR MEDICINES AND HEALTH PRODUCTS EUROSTATION, Bloc 2, Office 8D268, Victor Hortaplein 40 bus 40, 1060 BRUSSELS (BELGIUM) Telephone number : 32 2 524 82 97 – Fax number : 32 2 524 83 01

GOOD MANUFACTURING PRACTICE CERTIFICATE
The Federal Agency for Medicines and Health Products herewith certifies that the firm fill in the name & address of your firm/company ; has obtained, in accordance with the Royal Decree of 14 december 2006 concerning medicines for human and veterinary use, the authorisation number fill in authorisation number of your firm/company to perform batch release by a qualified person. The undersigned certifies that the batch release plant is subject to inspections at suitable intervals and that the batch release conforms to the requirements for Good Practices in the Manufacture and Quality Control of pharmaceutical products as recommended by the World Health Organisation. This certificate is valid only for the medicinal products for which a “certificate for a pharmaceutical product” has been issued according to the prevailing administrative arrangements of the World Health Organisation. This certificate is valid only for the following medicinal product: < fill in the name and pharmaceutical form of the product >, registered under the number: < fill in the registration number of the product > This certificate may not be reproduced and is solely destined to the Governmental Authorities of fill in the name of the country which requires the certificate. BRUSSELS,

Xavier DE CUYPER Chief Executive Officer Number of certificate: ________________________