The information required is as follows:
- NDA number
- Name of NDA sponsor
- Trade name of new drug
- Active ingredient(s) of new drug
- Strength(s) of new drug
- Dosage form of new drug
- Approval date of NDA or supplement
- patent number, issue date, and expiration date of patent submitted
- The patent owner's name, full address, phone number and, if available, fax number and e-mail address
- The name, full address, phone number of an agent or representative who resides or maintains a place of business within the United States authorized to receive notice of patent certification
- Information on whether the patent has been submitted previously for the new drug application
- Information on whether the expiration date is a new expiration date if the patent had been submitted previously for listing
- Information on whether the patent is a product-by-process patent in which the product claimed is novel
- Information on the drug substance (active ingredient)
-Information on the drug product (composition/formulation)
- Information on each method-of-use
- Whether there are no relevant patents that claim the approved drug substance (active ingredient), the approved drug product (formulation or composition) or approved method(s) of use and with respect to which a claim of patent infringement could reasonably be asserted if a person not licensed by the owner of the patent engaged in the manufacture, use, or sale of the drug product
- A signed verification
- Information on whether the authorized official signed the form; the name of the person; and the full address
This relates to the CDT as much of this information is required for a submission in CDT format. Specifically, name of Sponsor, active ingredients, strength(s) of new drug, and dosage information.