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Organization Information California corporation number/California Secretary of State file number FEIN Name of organization as shown in the organization s creating document Web address - Street address suite room or PMB no. State City Telephone Second telephone ZIP code Fax Representative Information Name of representative Email address Part I Entity Information* See instructions. 1 Has the Franchise Tax Board FTB previously revoked the entity s tax-exempt status. 1 m Yes m No If Yes STOP. ...

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Where do I send 3500A?

Mail form FTB 3500A and a copy of the federal determination letter to: EXEMPT ORGANIZATIONS UNIT, MS F120, FRANCHISE TAX BOARD, PO BOX 1286, RANCHO CORDOVA CA 95741-1286.

What is FDA 3500A form?

Form FDA 3500A - Mandatory Reporting and Instructions for Completing Form FDA 3500A. Mandatory reporting For use by IND reporters, manufacturers, distributors, importers, user facilities personnel.

What is the difference between Form 3500 and Form 3500A?

Form 3500A is an abbreviated two-pages, in comparison to the rather lengthy Form 3500 previously required.

What is Form FDA 3500b?

Form FDA 3500 may be used by health professionals or consumers for VOLUNTARY reporting of adverse events, product use/medication errors, product quality problems, and therapeutic failures for: Prescription and over-the-counter medicines including those administered in a hospital or outpatient infusion centers.

Where do I send 3500A?

Mail form FTB 3500A and a copy of the federal determination letter to: EXEMPT ORGANIZATIONS UNIT, MS F120, FRANCHISE TAX BOARD, PO BOX 1286, RANCHO CORDOVA CA 95741-1286.

form 3500a

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What is a MedWatch form 3500A?

The MedWatch form, also known as Form FDA 3500A, is used for mandatory reporting of medical device adverse events by manufacturers, user facilities and importers. Form FDA 3500, a condensed version of 3500A, is used for voluntary reporting of adverse events by healthcare professionals, consumers and patients.

Who is exempt from California Franchise Tax?

California law generally imposes a minimum franchise tax of $800 on every corporation incorporated, qualified to transact business, or doing business in California. A corporation that incorporates or qualifies to do business in California is exempt from paying the minimum franchise tax in its first taxable year.

Where do I send my FDA Form 3500A?

Reporting can be done through our online reporting portal or by downloading, completing and then submitting FDA Form 3500 (health professional) or 3500B (consumer/patient) to MedWatch: The FDA Safety Information and Adverse Event Reporting Program.

Who can file 3500A?

Incorporated or unincorporated organizations that want to obtain California tax-exempt status must file form FTB 3500A. See General Information B, What and Where to File, for more information. An unincorporated organization that has tax-exempt status and then incorporates must reapply for California tax-exempt status.

What is the FDA MedWatch program?

An important FDA program called "MedWatch" allows health care professionals and consumers to report serious problems that they believe may be associated with the medical products they prescribe, dispense, or use. These reports, along with follow-up investigations, can help to identify important safety concerns.

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