北京百力诺思医疗器械科技有限公司

2011年3月1日

银行名称 FEDERAL RESERVE BANK OF NEW YORK

银行地址 US Department of Treasury

                  TREAS NYC                

                  33 Liberty Street

                  New York, NY 10045 USA

SWIFT代码 FRNYUS33

收款人名称 Food and Drug Administration

地址　　　1350 Piccard Drive, Suite 200A, Rockville, MD 20850 USA

帐号　　　75060099

注：

1. 付款信息中请包含付款识别号(Payment Identification Number)。
2. 请选择汇款人承担国内外费用。

转账方式付款Payments by Wire Transfer
Foreign firms who cannot pay for the device establishment registration fee by credit card, electronic check or a check drawn on a US bank must pay by wire transfer to receive their Payment Confirmation Number (PCN). After generating their Payment Identification Number (PIN), you may send your payment using the following information. Please note that you are responsible for paying all wire transfer fees. You must include your PIN (Payment Identification Number) with your wire transfer. FDA will not be able to process your payment correctly without your PIN and you will not receive your PCN (Payment Confirmation Number) which is necessary for registration.

US Department of Treasury TREAS NYC 33 Liberty Street New York, NY 10045

FDA Deposit Account Number: 75060099

US Department of Treasury routing/transit number: 021030004

SWIFT Number: FRNYUS33

Beneficiary:
FDA
5600 Fishers Lane
Rockville, MD 20857

If needed for accounting purposes, FDA's tax identification number is 53-0196965.