Cosmetic Product Listing Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Company Name *Name *FirstLastPhone Number *Email *Submission Type *New listingUpdates to existing listingABBREVIATED RENEWAL (By checking this box, you are certifying that no changes have been made to your product listing since the previous listing wasResponsible Person's nameIs this a facility registration for a small business (optional product listing)? *YesNoResponsible Entity (as mentioned on the product label) *ManufacturerPackerDistributorThe manufacturer, packer, or distributor of a cosmetic product whose name appears on the label of such cosmetic product in accordance with section 609(a) of the FD&C Act or section 4(a) of the Fair Packaging and Labeling ActContact Person Name for Responsible Entity Listed Above *Telephone Number of Responsible Person (Include country and area code) *Parent Company Name (if applicable)Cosmetic Product Listing Number (If already assigned)Product Name(As listed on label) *Product Webpage LinkFragrance or Flavor *--- Select Choice ----Select-FlavorFragranceFlavor and FragranceNAIngredients Information *IS THIS PRODUCT FOR PROFESSIONAL USE ONLY? *YesNoCosmetic Category *01A Babyshampoos-BabyProducts01B Lotionsoilspowdersandcreams-BabyProducts01C Babywipes--BabyProducts01D1 Otherbabyproductsleave-on--BabyProducts01D2 Otherbabyproductsrinse-off--BabyProducts02A Bathoilstabletsandsalts--BatheProducts02B Bubblebaths-BatheProducts02C Bathcapsules-BatheProducts02D Otherbathpreparations-BatheProducts03A Eyebrowpencils-EyeMakeupNonChild03B Eyeliners-EyeMakeupNonChild03C Eyeshadows-EyeMakeupNonChild03D Eyelotions-EyeMakeupNonChild03E Eyemakeupremovers-EyeMakeupNonChild03F Falseeyelashes-EyeMakeupNonChild03G Mascaras-EyeMakeupNonChild03H Eyelashandeyebrowadhesivesgluesandsealants-EyeMakeupNonChild03I Eyelashandeyebrowpreparations(primersconditionersserumsfortifiers)--EyeMakeupNonChild03J Eyelashcleansers-EyeMakeupNonChild03K Othereyemakeuppreparations-EyeMakeupNonChild04A Children’seyeshadows-ChildrenMakeupEye04B Otherchildren’seyemakeup-ChildrenMakeupEye05A Colognesandtoiletwaters-FragrancePreparations05B Perfumes-FragrancePreparations05C Powders(dustingandtalcum)(excludingaftershavetalc)-FragrancePreparations05D Other-FragrancePreparations06A1 Hairconditionersleave-on-Non-coloring06A2 Hairconditionersrinse-off-Non-coloring06B Hairsprays(aerosolfixatives)-Non-coloring06C Hairstraighteners06D Permanentwaves06E Rinses(non-coloring)06F1 Shampoos(non-coloring)leave-on06F2 Shampoos(non-coloring)rinse-off06G Tonicsdressingsandotherhairgroomingaids06H Wavesets06I1 Otherhairpreparationsleave-on06I2 Otherhairpreparationsrinse-off07A Hairdyesandcolors(alltypesrequiringcautionstatementandpatchtest)07B Hairtints07C1 Hairrinses(coloring)leave-on07C2 Hairrinses(coloring)rinse-off07D1 Hairshampoos(coloring)leave-on07D2 Hairshampoos(coloring)rinse-off07E Haircolorsprays(aerosol)07F Hairlightenerswithcolor07G Hairbleaches07H Eyelashandeyebrowdyes07I1 Otherhaircoloringpreparationsleave-on07I2 Otherhaircoloringpreparationsrinse-off08A Blushersandrouges(alltypes)08B Facepowders08C1 Foundationstraditionalapplications08C2 Foundationsairbrushapplications08D1 Legandbodypaintstraditionalapplications08D2 Legandbodypaintsairbrushapplications08E Lipsticksandlipglosses08F1 Makeupbasestraditionalapplications08F2 Makeupbasesairbrushapplications08G Makeupfixatives08H1 Othermakeuppreparationstraditionalapplications08H2 Othermakeuppreparationsairbrushapplications09A Children’sblushersandrouges(alltypes)09B Children’sfacepaints09C Children’sfacepowders09D Children’sfoundations09E Children’slipsticksandlipglosses09F Children’scolorhairsprays09G Otherchildren’smakeup10A Basecoatsandundercoats10B Cuticlesofteners10C Nailcreamsandlotions10D Nailextenders10E Nailpolishesandenamels10F Nailpolishandenamelremovers10G Othermanicuringpreparations11A Dentifrices(aerosolsliquidspastesandpowders)11B Mouthwashesandbreathfresheners(liquidsandsprays)11C Otheroralproducts12A Bathsoapsandbodywashes12B1 Deodorants(underarm)sticksroll-onsgelscreamsandwipes12B2 Deodorants(underarm)sprays12C Douches12D1 Femininedeodorantsleave-on12D2 Femininedeodorantsrinse-off12E Disposablewipes12F1 Otherpersonalcleanlinessproductsleave-on12F2 Otherpersonalcleanlinessproductsrinse-off13A Aftershavelotions13B Beardsofteners13C Men'stalcum13D Pre-shavelotions(alltypes)13E Shavingcreams(aerosolbrushlessandlather)13F Shavingsoaps(cakessticksetc.)13G Othershavingpreparationproducts14A Cleansing(coldcreamscleansinglotionsliquidsandpads)14B Depilatories14C1 Faceandneck(excludingshavingpreparations)leave-on14C2 Faceandneck(excludingshavingpreparations)rinse-off14D1 Bodyandhand(excludingshavingpreparations)leave-on14D2 Bodyandhand(excludingshavingpreparations)rinse-off14E Footpowdersandsprays14F MoisturizingSkinCare14G NightSkinCare14H Pastemasks(mudpacks)14I Skinfresheners14J1 Otherskincarepreparationsleave-on14J2 Otherskincarepreparationsrinse-off15A Suntangelscreamsandliquids15B1 Indoortanningpreparationstraditionalapplications(creamslotionsetc.)15B2 Indoortanningpreparationsairbrushapplications15B3 Indoortanningpreparationssprayapplications15B4 Indoortanningpreparationsprofessionalairbrushtanningapplications15B5 Indoortanningpreparationsprofessionalspraytanningapplications15C Othersuntanpreparations16A Permanenttattooinks16B Temporarytattooinks16C Othertattoopreparations17Otherpreparations(i.e.thosepreparationsthatdonotfitanothercategory)Printed Name Of Submitter * PRODUCT applicable) assigned) ADDITIONAL CONTACT INFORMATION FOR AUTHORIZED AGENTPhone Number (Include Area/Country Code)EmailBilling Address *Street AddressCityCountryAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongo (Congo-Brazzaville)Costa RicaCôte d'IvoireCroatiaCubaCyprusCzechia (Czech Republic)Democratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (fmr. ""Swaziland"")EthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly SeeHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar (formerly Burma)NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorth MacedoniaNorwayOmanPakistanPalauPalestine StatePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabweConfirmation Statement *I AgreeThe data and information in this submission have been reviewed and, to the best of my knowledge, are certified to be true and accurate. I agree to report changes to this information as required under section 607 of the FD&C Act. WARNING: A willfully false statement is a criminal offense, U.S. Code, Title 18, Section 1001.Terns And Conditions *I Accept The terms And ConditionsBy submitting this form, I authorize Pragmatic Compliance Inc (Ihab Grace) and their associates to submit the FEI number on behalf of our firm I agree that all the above information is Truthful and Accurate I am aware that any fee paid is a service charge of the FDA fee and non-refundable unless Pragmatic Compliance Inc (Ihab Grace) fails to provide the requested services. If our firm is unable to provide the requested information in a timely manner, it will not be considered Pragmatic Compliance Inc (Ihab Grace) failure. I understand that the FEI assignment timeline is not under Pragmatic Compliance Inc (Ihab Grace)'s control, and the timeline to obtain the FEI number depends on the FDA's response time. You agree to assume all risk, release Pragmatic Compliance Inc (Ihab Grace) officers, directors, employees, affiliates, and agents from any and all liability in connection with this product, waive all claims, and will hold harmless and indemnify Pragmatic Compliance Inc (Ihab Grace) and its officers, directors, employees, affiliates, and agents from any and all claims in connection with this application.Submit
