''Sunset Clause'' -
Request for an Exemption from the invalidation of a Marketing Authorisation
The Marketing Authorisation(s) for the below-mentioned product(s) will become invalid in Malta in accordance with Articles 24(4) and 24(5) of Directive 2001/83 as amended. The product(s) has/have not been marketed in any presentation since the Marketing Authorisation(s) was/were granted.
Name of medicinal product(s):
Marketing Authorisation number(s):
Marketing Authorisation Holder name and address:
Date of issue of the Marketing Authorisation(s):
Please consider allowing the Marketing Authorisation(s) to remain valid for an additional
years.
An exemption may be requested for a minimum of one and a maximum of three years.
Justification for the request for exemption(s):
Further documentation may be attached to this form in support of the request.
I declare that the above information is correct and that any changes will be communicated to the Medicines Authority with immediate effect.
F-LI02-01 (October 2015)
Page 1 of 2
Position within the company:
If the signatory is not the Marketing Authorisation Holder, please attach a letter of authorisation on his behalf
Date:
Kindly fill in the Declaration form at the following link http://www.medicinesauthority.gov.mt/onlineapplications
A Declaration form should be submitted for each signatory.
F-LI02-01 (October 2015)
Page 2 of 2