In Section III, under “Submission Format and Comments”, click the boxes indicating you do not have any documents that relate to health, toxicological, behavioral or physiologic effects and that you do not plan to have this information in the near future.
In Section IV under “Confirmation of Statement”, read the statement and select the “Agree” box if you agree to the statement. Sign the form, put your name and title in the box, include the date, and check the box in front of “Submitter.” Leave Sections V, VI, and VII blank.
Make a copy of FDA Form 3743 for your records and mail pages 1-4 of the form to the FDA by Nov. 8, 2017 to the following address:
Food and Drug Administration
Center for Tobacco Products
Document Control Center
Building 71, Room G335
10903 New Hampshire Avenue
Silver Spring, MD 20993-0002
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