Service *— choose —U.S. Agent representation — 12-month service termU.S. Agent representation — 24-month service termsee the "services" section of this schema
Legal company name *use the legal name, not the trade name
Country *use MX for Mexico, CO for Colombia
Contact name *a person, not a department
Contact email *the confirmation and the payment link are sent here
Contact phoneinclude the country code
FDA registration number (FEI), if you already have oneleave empty if the facility is not registered yet
Current U.S. Agent, if anyleave empty if there is none
Product categoriesfor example: cosmetics, food, beverages
Notesanything we should know before we reply
We never ask for or accept card details on this form.
