(Date) ____________
Name of petitioner ____________
Post office address ____________
Subject of the petition ____________
Office of Nutritional Products, Labeling and Dietary Supplements (HFS-800)
Food and Drug Administration,
Department of Health and Human Services,
Washington, DC 20204.
To Whom It May Concern:
The undersigned, ________________________ submits this petition under section 403(r)(4) of the Federal Food, Drug, and Cosmetic Act (the act) with respect to (statement of the claim and its proposed use).
Attached hereto and constituting a part of this petition, are the following:
Yours very truly,
Petitioner ____________
By ____________
(Indicate authority)
(Date)____________
Name of petitioner ____________
Post office address ____________
Subject of the petition ____________
Office of Nutritional Products, Labeling and Dietary Supplements (HFS-800)
Food and Drug Administration,
Department of Health and Human Services,
Washington, DC 20204.
To Whom It May Concern:
The undersigned, ____________ submits this petition under section 403(r)(4) of the Federal Food, Drug, and Cosmetic Act (the act) with respect to (statement of the synonymous term and its proposed use in a nutrient content claim that is consistent with an existing term that has been defined under section 403(r)(2) of the act).
Attached hereto and constituting a part of this petition, are the following:
Yours very truly,
Petitioner ____________
By ____________
(Indicate authority)
(Date)____________
Name of petitioner ____________
Post office address ____________
Subject of the petition ____________
Office of Nutritional Products, Labeling and Dietary Supplements (HFS-800),
Food and Drug Administration,
Department of Health and Human Services,
Washington, DC 20204.
To Whom It May Concern:
The undersigned, ______________________ submits this petition under section 403(r)(4) of the Federal Food, Drug, and Cosmetic Act (the act) with respect to (statement of the implied nutrient content claim and its proposed use in a brand name).
Attached hereto and constituting a part of this petition, are the following:
Yours very truly,
Petitioner ____________
By ____________
21 C.F.R. §101.69