Form 3489 Request for a Meeting or Teleconference

Guidance
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
Center for Veterinary Medicine

Export Data

Import Data

Request For A Meeting
Or Teleconference

Reset Form

Form Approved: OMB No. 0910-0452
Expiration Date: 03/31/2007

PAPERWORK REDUCTION ACT STATEMENT: A Federal agency may not conduct or sponsor, and a person is not required to respond to, a collection of information,
unless it displays a current valid OMB control number. The public reporting burden for the collection of information is estimated to vary from 15 minutes to 2 hours, with an
average of 60 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the necessary information, and
completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information to the Food and
Drug Administration, Center for Veterinary Medicine, 7500 Standish Place, Rockville, MD 20855.

Submit this notice electronically to:
Food and Drug Administration
Center for Veterinary Medicine, HFV7500 Standish Place
Rockville, Maryland 20855
(E-mail:[email protected])

A1. DATE:
A2. MULTIPLE DOCUMENTS:
A3. DOCUMENT ID:

The sponsor,
teleconference. This information is submitted in electronic form.

, submits a request for a meeting or

Meeting/Teleconference:

I.
1.

NAME(S) OF DRUG(S):

2.

SPECIES OF ANIMALS:

3.

PROPOSED DATE(S) AND TIME(S):

PRODUCTION CLASS:

9:00 am

Alternative Dates:
4.

PURPOSE OF MEETING:

5.

SPONSOR PARTICIPANTS:

6.

REQUESTED CVM PARTICIPANTS:

7.

TYPE OF MEETING:
In Person Conference

Teleconference

Video Teleconference

Overhead

Computer Projection

Other (Specify):

8.

AUDIO-VISUAL REQUIREMENTS:
Slides
Other (Specify):

9.

MEETING REQUEST PREVIOUSLY SUBMITTED TO CVM:
If Yes,

II.

9a. Date Submitted to CVM:

YES

NO
9b. CVM Submission Identifier:

Comments:
If you have additional comments that you would like to include in this submission please press the
Insert Comments button below. All comments must be included within a PDF document.
Insert Comments

FORM FDA 3489 (10/2005)
Version 4.1

Page 1

III.

Meeting Agenda:
Please press the Insert Agenda button to include your proposed meeting agenda. All meeting
agendas must be included within a PDF document.
Insert Agenda

IV.

Sponsor Information:

1.
2a.
2b.
2c.
2e.

Name:
Address:
Address 2:
City:
Country:

3.
4.
5.
6.

Contact Name:
Contact Phone Number:
Contact Fax Number:
Contact E-Mail Address:

1a. FEI #:

2d. State/Prov:
2f. Postal Code:

USA

1 - Validate

FORM FDA 3489 (10/2005)
Version 4.1

2 - Add Password

Page 2

3 - Save

4 - Signature

5 - Send to CVM