Right to Sell Drugs Fee Remission Request and Attestation Form
DO NOT enter information on Drug Identification Numbers (DINs) which do NOT qualify for a fee remission or DINs for which discontinuation has been requested.
Calendar Year End Date:
- DIN Footnote 1
- Actual Gross Sales ($CDN)
Applicants must be prepared to present supporting documentation for their fee remission.
Created : May 1998
Revised : May 2011
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