FDA COSMETIC FACILITY REGISTRATION FORM

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Facility Details - Step 1 of 5

Type of submission

Initial
Amended
Biennial renewal
Abbreviated renewal

Is this a facility registration for a small business (optional registration)?

Name of the owner and/or operator of the facility

Facility Name

Facility Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Layout

Phone

FEI Number (Mandatory)

UNITED STATES AGENT - (For Foreign Cosmetic Facilities)
Liberty Management Group Ltd. will be appointed U.S. Agent for this Facility.

Product 1:

Layout

Do you want to add another product (2)?

Product 2

Layout (copy)

Product 3

Layout

Product 4

Layout (copy)

Product 5

For facilities with more than 5 products, please download the Excel form, complete it, and upload it here.

Download Excel Form Here

Upload Form

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Agreement for Cosmetic Facility Registration with the US FDA
We appreciate your decision to select Liberty Management Group Ltd. to register your cosmetic facility with the United States Food and Drug Administration as required by section 607 of the FD&C Act. This Agreement describes the scope of our relationship with your company. By signing below and submitting this form to Liberty Management Group Ltd., your Company agrees to be bound by the terms and conditions listed in this document
1 . Services Provided. Our services will be limited to register your facility with the US FDA. Liberty Management Group Ltd. will be identified as the "U.S. Agent" and "Authorized Agent" for your facility. You understand and agree that the information you provide will not be privileged or confidential. You also understand and agree that the SPL file may be prepared by LMG or its associates.
2 . Client Information. You agree and warrant that all information your company provides to Liberty Management Group Ltd., including but not limited to any information necessary to register your facility and list your cosmetics with the US FDA, is true and accurate. You also agree that you will promptly inform us of any changes in the client information.
3 . Termination Notice. Either Party may terminate the relationship at any time for any reason by providing seven (7) days prior written notice to the other party. In the event of terminating this Agreement by either party, Liberty Management Group Ltd shall not be liable to your company for any reimbursement or damages. In no event shall Liberty Management Group Ltd's liability exceed the amount of the fees paid by your company in any given calendar year.
4. Authorization. You authorize Liberty Management Group Ltd. to prepare and submit the SPL file to the United States Food and Drug Administration on behalf of your Company.
5 . Limitations. Liberty Management Group Ltd. shall not be liable for any delay in performing its obligations under this agreement if such delay is caused by circumstances beyond Liberty Management Group Ltd.'s reasonable control. Liberty Management Group Ltd. will not provide you any guarantee or assurance that the US FDA will accept the data submitted by you. You acknowledge and understand that Liberty Management Group Ltd. will not verify the data submitted by you.

I agree to the above Terms and Conditions

Yes, I agree.

FDA COSMETIC FACILITY REGISTRATION FORM

Product 1:

Product 2:

Product 3:

Product 4:

Product 5:

For facilities with more than 5 products, please download the Excel form, complete it, and upload it here.

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