Application for Registration of Category 2 Scheduled Substances Applications are made in accordance with the following legislation: Commission Delegated Regulation (EU) 2015/1011, supplementing Regulation (EC) 273/2004 of the European Parliament and of the Council on drug precursors and Council Regulation (EC) 111/2005, lays down rules for the monitoring of trade between the Union and third countries in drug precursors, and repeals Commission Regulation (EC) 1277/2005. Commission Implementing Regulation (EU) 2015/1013 lays down rules in respect of Regulation (EC) 273/2004 of the European Parliament and of the Council on drug precursors, and Council Regulation (EC) 111/2005 lays down rules for the monitoring of trade between the Union and third countries in drug precursors. Council Regulation (EC) No. 273/2004, as amended, lays down the basic rules governing the monitoring of intra-Community trade. Council Regulation (EC) No. 111/2005, as amended, lays down rules for the monitoring of trade between the Community and third countries in drug precursors. 1.1 SECTION 1: APPLICANT DETAILS Applicant contact details Name: Address: Company registered address (if different): Company registration number: Telephone: Fax: E-mail: 2.1 SECTION 2: RESPONSIBLE OFFICER (See Note 2) Responsible Officer contact details Name: Address: Telephone: Fax: E-mail: AUT-F0269-4 1/5 2.2 Description of the position and tasks of the Responsible Officer SECTION 3: PREMISES 3.1 Business premises address 3.2 Description of all places of production, manufacture and/or intermediary activities involving scheduled substances (attach separate document if necessary) 3.3 Measures taken to prevent the unauthorised removal of scheduled substances from the places listed in point 3.2 (attach separate document if necessary) 4.1 SECTION 4: ACTIVITIES Purpose for which registration is required (State briefly e.g. manufacturing, wholesale dealing, import, export, placing on the market and/or intermediary activities. Sufficient information should be supplied in order to justify registration). AUT-F0269-4 2/5 SECTION 5: TYPE OF REGISTRATION REQUIRED (Indicate with a tick the drugs and primary activities for which registration is required) Type of Registration Scheduled Substance (including their salts wherever such exist) Acetic anhydride CN Code as per Annex I to Regulation (EC) No 273/2004 To produce base drug (including salts) preparations (a) (b) To supply or offer to supply (c) Possess/end user (d) 2915 24 00 Anthranilic acid 2922 43 00 N/A Phenylacetic acid 2916 34 00 N/A Piperidine 2933 32 00 N/A Potassium permanganate 2841 61 00 N/A Note: This includes the salts of these substances whenever the existence of such salts is possible. Operators are exempt from registration where the quantities supplied or placed on the market within the EU do not exceed those indicated below, over the period of one year. Please inform the Controlled Drugs section of any recipients exceeding these annual thresholds. Substance Annual threshold Acetic anhydride Potassium permanganate Anthranilic acid and its salts Phenylacetic acid and its salts Piperidine and its salts 100 litres 100 kg 1 kg 1 kg 0.5 kg Annual estimated quantity Please note this exemption does not apply to the above scheduled substances when involved in external trade (i.e. imports, exports and/or intermediary activities outside the EU). Import, export or intermediary activities Summary of intended import, export or intermediary activities involving the above scheduled substances (Please tick the relevant activities below and give a summary of the activities) Import (‘Import’ means any entry of scheduled substances having the status as noncommunity goods into the customs territory of the Community, including temporary storage, the placing in a free zone or free warehouse, the placing under a suspensive procedure and the release for free circulation) Export (‘Export’ means any departure of scheduled substances from the customs territory of the Community, including the departure of scheduled substances that requires a customs AUT-F0269-4 3/5 declaration and the departure of scheduled substances after their storage in a free zone of control type I or free warehouse) Intermediary activities (‘Intermediary activities’ means any activity to arrange purchase and sale or supply of scheduled substances carried out by any natural or legal person who aims to obtain agreement between two parties or to do so through acting on behalf of at least one of these parties without taking these substances into its possession or taking control of the carrying out of such transaction; this definition shall also include any activity carried out by any natural or legal person established in the Community involving purchase and sale or supply of scheduled substances without these substances being introduced into the Community customs territory) Scale of usage Anticipated annual scale of usage of the scheduled substance(s): Preparations produced List any preparations or other products to be produced under the authority of the registration for which application is made: Control of supplies Details of the precautions to be taken to prevent supply of scheduled substance(s) to unauthorised persons: SECTION 6: DECLARATION In the event of the registration being granted, I undertake to ensure fulfilment of the obligations arising by virtue of the terms and conditions of the registration and declare that the above particulars are, to the best of my knowledge and belief, correct. Signature: ____________________________________________ Date: (Applications must bear the signature of the Responsible Officer) Notes: 1. This application should be sent to: Licensing Section Compliance Department Health Products Regulatory Authority Kevin O’Malley House Earlsfort Terrace Dublin 2 2. Operators are exempt from registration where the quantities supplied or placed on the market within the EU do not exceed those indicated below, over the period of one year. Please inform the Controlled Drugs section of any recipients exceeding these annual thresholds. AUT-F0269-4 4/5 Substance Acetic anhydride Potassium permanganate Anthranilic acid and its salts Phenylacetic acid and its salts Piperidine and its salts Annual threshold 100 litres 100 kg 1 kg 1 kg 0.5 kg Please note this exemption does not apply to the above scheduled substances when involved in external trade (i.e. imports, exports and/or intermediary activities outside the EU). AUT-F0269-4 5/5