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Power of Attorney

näidis -- an example



The undersigned company
name
address
phone and telefax

hereby authorizes the citizen of the Republic of Estonia
name
profession
company
address
phone and telefax

to operate in the Republic of Estonia on our behalf vis-à-vis the State Agency of Medicines (Estonian drug regulatory authority) in connection with registration of pharmaceutical products including the following procedure: to communicate information between the State Agency of Medicines and the applicant (=future marketing authorization holder).

The products shall be registered in the name of: (name of the applicant).

In case of the authorized person has not been able to deal with matters of registration, we would like to receive the relevant correspondence at the given address: (contact person, full address, phone, telefax and e-mail).

We declare that we shall be bound by everything our representative will lawfully undertake or refrain from doing on the basis of the present power of attorney.

This power of attorney shall come into force on the date hereof and shall remain in force until further notice. In case of cancelling the agreement or making any changes in the present document, the regulatory authority must be notified about it at least one month in advance by registered mail.

(place and date of issue) (signature and name of the person
authorized to sign and issue the power
of attorney on behalf of the applicant)

________________________________________________________________
Notes: * Power of Attorney should be issued on the official form of the company. The original of the document is required.
**The text in italic should be replaced by the actual data.


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