藥監(jiān)局授權(quán)委托書格式

1、授權(quán)委托書我公司奧林巴斯（北京）銷售服務(wù)有限公司成都分公司 茲委托 四川歐依洛醫(yī)療器械有限公司 在南充市藥品監(jiān)督管理局 醫(yī)療器械 處（分局）辦理 內(nèi)窺鏡攝像系統(tǒng)、電切鏡附件、電外科手術(shù)器械、超聲內(nèi)窺鏡專用水囊和水囊外鞘管、氣腹機(jī)第二類醫(yī)療器械經(jīng)營備案憑證的相關(guān)事宜。 奧林巴斯（北京）銷售服務(wù)有限公司成都分公司 2015 年 05 月21日授權(quán)書茲授權(quán) 鄧衛(wèi)兵 身份證我公司代表，負(fù)責(zé)關(guān)于辦理 內(nèi)窺鏡攝像系統(tǒng)、電切鏡附件、電外科手術(shù)器械、超聲內(nèi)窺鏡專用水囊和水囊外鞘管、氣腹機(jī)經(jīng)營許可的相關(guān)事宜，請予以接洽。 授權(quán)公司：四川歐依洛醫(yī)療器械有限公司法定代表人簽字

2、：被授權(quán)人簽字：日 期：2015年05月21日授權(quán)委托書填表說明1、申請單位到市藥品監(jiān)督局辦理行政許可事項時，申請人不是法定代表人或負(fù)責(zé)人時，須由法定代表人或負(fù)責(zé)人開具授權(quán)委托書給申請人，列明授權(quán)范圍和委托期限。申請人憑授權(quán)委托書到市藥品監(jiān)督局受理大廳辦理相關(guān)事宜。2、“委托人”，填寫法定代表人或負(fù)責(zé)人姓名?！氨晃腥恕?，填寫具體辦事人員姓名?！肮ぷ鲉挝弧?、“職務(wù)”、“聯(lián)系電話”，據(jù)實(shí)填寫。3、“茲委托 在北京市藥品監(jiān)督管理局 處（分局）辦理 事宜?！保禾顚懕晃腥诵彰?。：根據(jù)申辦事宜內(nèi)容填寫對應(yīng)的主管處室名稱，如“受理辦”、“藥品注冊處”、“安全監(jiān)管處”、“醫(yī)療器械處”等。：填寫具體辦事內(nèi)容

3、，如“藥品經(jīng)營許可”。4、“授權(quán)范圍”，根據(jù)具體授權(quán)情況，已授權(quán)的在“”中打“”，未授權(quán)的在“”中打“”?！昂炇?批件的權(quán)利”，在橫線上填寫需領(lǐng)取的證件、批件或有關(guān)材料名稱，如“藥品生產(chǎn)許可證正本、副本”。5、(委托人單位公章)：“加蓋委托人所在單位的公章” 被委托人：“由具體辦事人員簽字”6、在辦理藥品注冊事項時，如委托人為二人以上的，須分別列明委托人有關(guān)情況，并在對應(yīng)位置，分別簽字、加蓋公章。示 范Authorization（Administrative license items）Consignor： Work unit： Duty： Phone number：Consignee: Wo

4、rk unit： Duty： Phone number： At present consign _ _ to transact _ _ _ _ _ _ _ _ _ _ _ _ _ matters concerned at the _ _ department (substation), Beijing Drug Administration (BDA).Scope of authority: 1、Be entitled to accept the executive notification pursuant to law.2、Be entitled to submit、 correct 、r

5、edress、 reinforce application materials on consignors behalf. 3、Be entitled to state and defend in the administrative license censoring on consignors behalf. 4、Be entitled to sign & accept authorized document(s) like _ _ _ _ _ _ _ _ _ _.5 、Any other entitlement(s) _ _ _ _ _.Term of consignation:Cons

6、ignee:(the official seal of consignors work unit) Annotation: mark“” in the before the consigned authority, otherwise, mark “”.Authorization（Administrative license items）Consignor：Xx Li Work unit：Co. xx Duty：General manager Phone number： Consignee: Xx Luo Work unit：Co. xx Duty：Business personnel Pho

7、ne number： At present consign _ xx Luo_ to transact altering legal representative of Medical Devices Distribution Enterprise License matters concerned at the Accepting department (substation), Beijing Drug Administration (BDA).Scope of authority: 1、Be entitled to accept the executive notification pu

8、rsuant to law.2、Be entitled to submit、 correct 、redress、 reinforce application materials on consignors behalf. 3、Be entitled to state and defend in the administrative license censoring on consignors behalf. 4、Be entitled to sign & accept authorized document(s) like: original and duplicate of Medical

9、 Devices Distribution Enterprise License.5、Any other entitlement(s) .Term of consignation: January 20,2005 - January 22 , 2005 Consignee: Xx Luo(the official seal of consignors work unit)January 20 , 2005 January 20 , 2005Annotation: mark“” in the before the consigned authority, otherwise, mark “”.I

10、nstruction to fill in the Authorization1、If the applicant/transactor isnt the legal representative or isnt the principal, he/she must have the Authorization consigned by the legal representative/the principal qualifying the consignees authority, to apply administrative licenses matters in Beijing Dr

11、ug Administration(BDA) The applicant transacts relevant matters in the Accepting Hall of BDA, with the Authorization, if necessary.2、Fill in the name of the legal representative or the principal in the “consignor” item; Fill in the name of the transactor in the “consignee” item. Fill in the followin

12、g items by the very fact.3、At present consign _ to transact _matters concerned at the _department( substation), Beijing Drug Administration(BDA).: the name of the consignee.: concrete matters to be handled, such as “drug supply license”.: the corresponding responsible department, such as “Acceptance

13、 Department”、“Drug Registration Department”、“Drug Safety and Inspection Department”、“Medical Devices Department”etc. 4、“Scope of authority”, according to exact authorized situation, mark “” in the “” before authorized items and mark “” if unauthorized.“Be entitled to sign & accept authorized documen

14、t(s) like _”, fill in the name of the certificate(s)、authorized document(s) and/or relevant material(s) above the underline, such as“original、duplicate of the Drug Manufacturing Certificate”. 5、(the official seal of consignors work unit): “to affix the official seal of consignors work unit”Consignee:“signed by the personnel who hand affairs practically (contr