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FDA Forms

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NOTIFICATION OF CANCELLATION OR DISSOLUTION OF BUSINESS

STATE OF ILLINOIS

COUNTY OF COOK

)

)

For office use only

Certificate #

Submit completed form and a check for $1.50 payable to:

Cook County Clerk David Orr

Bureau of Vital Statistics

Attn: Assumed Name Registration Unit

P.O. Box 642570

Chicago, IL 60602-2570

Let it be known that the Business

has cancelled or dissolved as of

Location of Business:

The undersigned (print names of all owners, using reverse for additional names)

was/were the proprietor(s) of the Business.

Dated this day of

Signature

Signature

Signature

I,

a Notary Public in Cook County, IL, do hereby certify that [record owner(s) name(s) below]

is/are personally known to me to be the same person(s) whose name(s) subscribed to the foregoing instrument appeared before me this day in person and acknowledged that he/she read and signed the instrument and that the statements therein contained, and each thereof, are true.

Notary Public

(signature)

My commission expires on the day of

Enter text

What FDA Forms Are and when they apply

FDA Forms are the standardized documents used to communicate regulatory information to the U.S. Food and Drug Administration across product categories including drugs, medical devices, biologics, food, and tobacco. They cover submissions such as investigational applications, premarket notifications, adverse event reports, establishment registrations, and labeling updates. Properly completed FDA Forms establish a clear administrative record, support regulatory review, and help meet statutory filing requirements. Organizations must follow the form instructions, applicable CFR provisions, and any FDA guidance to avoid processing delays or noncompliance findings during inspections or submissions.

Why accurate FDA Forms matter

Accurate FDA Forms reduce review delays, demonstrate regulatory compliance, and provide an auditable record for inspections. Completing forms correctly minimizes the risk of refusal, enforcement action, or costly resubmissions and supports traceability across the product lifecycle and quality systems.

Why accurate FDA Forms matter

Who prepares and signs FDA Forms

Regulatory, quality, and clinical teams typically prepare and submit FDA Forms within regulated organizations.

  • Manufacturers and distributors responsible for registrations, adverse event reports, and establishment listings.
  • Clinical investigators and sponsors filing investigational submissions and amendments for trials.
  • Regulatory affairs, quality assurance, and in-house counsel overseeing compliance and inspection readiness.

Step-by-step: completing an FDA Form

Follow a sequential approach to complete FDA Forms accurately, verify supporting documents, and confirm authorized signatures before submission.

  • 01
    Prepare: Gather product data, lot numbers, and required attachments before starting the form.
  • 02
    Complete: Enter required fields precisely using MM/DD/YYYY for dates and full legal names.
  • 03
    Review: Cross-check entries against quality and regulatory records; correct discrepancies.
  • 04
    Submit: Send via FDA electronic gateway or designated portal and retain receipt.

Common questions about signing, submitting, and retaining FDA Forms

Answers to frequent questions about eSignatures, submission methods, retention, and common filing pitfalls for FDA Forms.


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How common eSignature vendors compare for FDA Forms

Comparison of common eSignature vendors for signing and submitting FDA Forms; signNow appears first per vendor alignment and compliance features.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies Varies Yes, limited Yes, limited
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies Varies Varies

Electronic versus digital signatures — key contrasts

Key distinctions between electronic signatures and cryptographic digital signatures to guide FDA Form authentication and compliance decisions.

Criteria Electronic Signature Digital Signature
Definition broad legal category pki-based cryptographic method
Legal status esign/ueta accepted pki often required
Non-repudiation audit trail evidence cryptographic non-repudiation
Typical use general filings high-assurance regulatory

Security and compliance essentials for submission systems

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest
Certifications: SOC 2 Type II; ISO 27001; PCI DSS
HIPAA: BAA available for covered entities
21 CFR Part 11: Compliant controls for FDA-regulated records
Audit Trail: Complete timestamps, IP, and action log
Accessibility: WCAG 2.0 Level AA compliance

Penalties and risks when FDA Forms are incorrect

Tax Filing Penalties: $60–$330+ per form under IRC §6721
Intentional Disregard: $660+ per form, no cap
I-9 Violations: $281–$2,789 per violation
Submission Rejection: Incomplete forms cause processing delays
Enforcement Action: Warning letters, fines, or recalls
Data Breach Risk: HIPAA/CCPA fines and remediation costs

Real examples of regulated organizations using eSign workflows

Two real-world examples show how secure eSignature workflows supported compliant submissions and streamlined signature collection for regulated organizations.

Optica Ventures

Optica Ventures needed a straightforward method to collect signatures from investors and service providers for regulatory acknowledgements.

  • Interface simplicity reduced signer friction.
  • Brian Fitzgibbons, COO, said: "The interface is simple and easy-to-use for our team; more importantly, it is just as easy for our customers." This helped accelerate form completion while preserving a clear audit trail for review.

Fertility Centers of Illinois

Fertility Centers of Illinois required reliable signed consent forms and API integration to streamline patient workflow across clinics and EMR systems.

  • API reliability and responsive support were decisive.
  • John Butler, Founder, praised the team's responsiveness and API, stating: "The airSlate SignNow team has been exceptional, responsive, the API has been great, and we're extremely happy that we chose airSlate SignNow as a company." Integration reduced manual retrieval and audit friction.

Practical best practices to reduce errors and delays

Follow these best practices to improve accuracy, speed, and compliance when preparing and submitting FDA Forms.

Verify Signatory Authority
Confirm the person signing is authorized by corporate delegation. Maintain a board resolution or delegation document and attach it when required to prevent challenges to signature validity.
Standardize Templates
Use validated, version-controlled templates with required fields locked. Templates reduce entry mistakes, ensure consistent wording for attestations, and speed batch processing for high-volume submissions.
Use Appropriate Authentication
Match authentication strength to risk: email-only for routine filings, KBA or SSO for high-assurance regulatory attestations. Document the chosen method to support auditability.
Preserve Complete Audit Trails
Retain signed document copies, access logs, timestamps, and IP addresses. Ensure records are reproducible to satisfy ESIGN retention and agency inspection requests.

Typical eSubmission workflow at a glance

A concise workflow for preparing, authenticating, and submitting FDA Forms electronically, including receipt confirmation and audit capture.

  • Upload: Add the finalized document to the platform.
  • Place Fields: Insert signature, date, and data fields for signers.
  • Authenticate: Confirm signer identity via email, SMS, KBA, or SSO.
  • Archive: Capture certificate of completion and store signed copies.

Integration and technical considerations for eSubmission

Common platform requirements and integrations to consider when enabling eSignature and eSubmission for FDA Forms include secure storage and certified audit trails.

  • Integrations: Salesforce, NetSuite, Google Workspace
  • Formats: PDF, DOCX, HTML supported
  • Authentication: Email, SMS, KBA, SSO options

Recommended workflow settings for FDA Forms

Suggested workflow settings when configuring an electronic FDA Form: authentication, file types, routing, and retention policies.

Field Configuration
Authentication Level Email link default; KBA or SSO for high assurance
File Types PDF and DOCX preferred; preserve fonts and signatures
Bulk Send Enable where mass distribution required; monitor usage
Audit Trail Retention Retain signed audit logs for at least six years
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