Form 8947 - Report Of Branded Prescription Drug Information Page 4

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4
Form 8947 (Rev. 10-2011)
Page
Schedule C
Branded Prescription Drug Information Orphan Drug Changes—Previously Reported NDCs (do not include National Drug Codes (NDCs) or
orphan drug information reported on Schedule B - see instructions)
Entity name
If you have more orphan drug changes to report than can be shown on this page,
complete and attach as many Schedules C as you need to list them all, numbering
Employer identification number (EIN).
Page
of
each page (for example, Page C1 of C5).
(c)
(e)
(a)
Latest tax year section
Date of FDA approval
(b)
(d)
Controlled group member
45C orphan drug credit
for non-orphan drug marketing,
NDC
Name of section 45C orphan drug, if applicable
EIN
allowed, if applicable
if applicable
(yyyy)
(mmddyyyy)
8947
Form
(Rev. 10-2011)

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