第二類醫(yī)療器械經(jīng)營備案憑證變更-授權(quán)委托書(中英文)

V:1.0精細(xì)整理，僅供參考第二類醫(yī)療器械經(jīng)營備案憑證變更-授權(quán)委托書(中英文)日期：20xx年X月授權(quán)委托書(行政審批事項)委托人：吉明工作單位：職務(wù)：聯(lián)系電話： 被委托人： 工作單位：職務(wù)：聯(lián)系電話：茲委托在北京市海淀區(qū)食品藥品監(jiān)督管理局辦理第二類醫(yī)療器械經(jīng)營備案憑證變更事宜。授權(quán)范圍：1、接受行政機關(guān)依法告知的權(quán)利。2、代為提交申請材料、更正、補正、補充材料的權(quán)利。3、代理申請人行政許可審查中的陳述和申辯的權(quán)利?！獭?、簽收行政許可批件的權(quán)利?！?、其他權(quán)利。委托期限自2016年12月08日至2017年01月08日。(委托人單位公章)被委托人：年月日 年月日注：已授權(quán)的請在□中打“√”，未授權(quán)的請在□中打“×”。

《授權(quán)委托書》填表說明1、申請單位到市食品藥品監(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》到市食品藥品監(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)實填寫。3、“茲委托①在北京市食品藥品監(jiān)督管理局②處（分局）辦理③事宜?！雹伲禾顚懕晃腥诵彰?。②：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。③：填寫具體辦事內(nèi)容，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“×”?！昂炇张臋?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（Administrativelicenseitems）Consignor：Workunit：Duty：Phonenumber：Consignee:Workunit：Duty：Phonenumber：Atpresentconsign_____________totransact______________________________________________________________________________mattersconcernedatthe____________department(substation),BeijingDrugAdministration(BDA).Scopeofauthority:□1、Beentitledtoaccepttheexecutivenotificationpursuanttolaw.□2、Beentitledtosubmit、correct、redress、reinforceapplicationmaterialsonconsignor’sbehalf.□3、Beentitledtostateanddefendintheadministrativelicensecensoringonconsignor’sbehalf.□4、Beentitledtosign&acceptauthorizeddocument(s)like______________________________________________________________.□5、Anyotherentitlement(s)___________________________________.Termofconsignation:Consignee:(theofficialsealofconsignor’sworkunit) Annotation:mark“√”inthe□beforetheconsignedauthority,otherwise,mark“×”.Authorization（Administrativelicenseitems）Consignor：XxLiWorkunit：Co.xxDuty：GeneralmanagerPhonenumber：Consignee:XxLuoWorkunit：Co.xxDuty：BusinesspersonnelPhonenumber：Atpresentconsign_xxLuo_totransactalteringlegalrepresentativeofMedicalDevicesDistributionEnterpriseLicensemattersconcernedattheAcceptingdepartment(substation),BeijingFoodandDrugAdministration(BDA).Scopeofauthority:□1、Beentitledtoaccepttheexecutivenotificationpursuanttolaw.□2、Beentitledtosubmit、correct、redress、reinforceapplicationmaterialsonconsignor’sbehalf.□3、Beentitledtostateanddefendintheadministrativelicensecensoringonconsignor’sbehalf..□4、Beentitledtosign&acceptauthorizeddocument(s)like:originalandduplicateofMedicalDevicesDistributionEnterpriseLicense.□5、Anyotherentitlement(s).Termofconsignation:January20,2005-January22,2005 Consignee:XxLuo(theofficialsealofconsignor’sworkunit)January20,2005January20,2005Annotation:mark“√”inthe□beforetheconsignedauthority,otherwise,mark“×”.InstructiontofillintheAuthorization1、Iftheapplicant/transactorisn’tthelegalrepresentativeorisn’ttheprincipal,he/shemusthavetheAuthorizationconsignedbythelegalrepresentative/theprincipalqualifyingtheconsignee’sauthority,toapplyadministrativelicensesmattersinBeijingDrugAdministration(BDA)TheapplicanttransactsrelevantmattersintheAcceptingHallofBDA,withtheAuthorization,ifnecessary.2、Fillinthenameofthelegalrepresentativeortheprincipalinthe“consignor”item;Fillinthenameofthetransactorinthe“consignee”item.Fillinthefollowingitemsbytheveryfact.3、Atpresentconsign______①______totransact____②_mattersconcernedatthe③___department(substation),BeijingFoodandDrugAdministration(BDA).①:thenameoftheconsignee.②:concretematterstobehandled,suchas“drugsupplylicense”.③:thecorrespondingresponsibledepartment,suchas“AcceptanceDepartment”、“DrugRegistrationDepartment”、“DrugSafetyandInspectionDepartment”、“MedicalDevicesDepartment”etc.4、“Scopeofauthority”,accordingtoexactauthorizedsituation,mark“√”inthe“□”beforeauthorizeditemsandmark“×”ifunauthorized.“Beentitledtosign&acceptauthorizeddocument(s)like______”,fillinthenameofthecertificate(s)、authorizeddocument(s)and/orrelevantmaterial(s)abovetheunderline,suchas“original、duplicateoftheDrugManufacturingCertificate”.5、(theofficialsealofconsignor’sworkunit):“toaffixtheofficialsealofconsignor’sworkun