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|   | E |                        |    |   |   |             |   |             |
|   | S |                        |    |   |   |             |   |             |
|   | S |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | ( |                        |    |   |   |             |   |             |
|   | 1 |                        |    |   |   |             |   |             |
|   | 2 |                        |    |   |   |             |   |             |
|   | - |                        |    |   |   |             |   |             |
|   | 4 |                        |    |   |   |             |   |             |
|   | 6 |                        |    |   |   |             |   |             |
|   | ) |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
| * | C |                        | ST |   | Z |             | C |             |
| * | I |                        | AT |   | I |             | O |             |
| 1 | T |                        | E\ |   | P |             | U |             |
| 1 | Y |                        | *( |   | C |             | N |             |
| 3 | * |                        | 37 |   | O |             | T |             |
| * | ( |                        |  - |   | D |             | R |             |
| * | 1 |                        | 38 |   | E |             | Y |             |
|   | 2 |                        | )* |   | * |             | * |             |
|   | - |                        |    |   | ( |             | ( |             |
|   | 3 |                        |    |   | 3 |             | I |             |
|   | 6 |                        |    |   | 9 |             | f |             |
|   | ) |                        |    |   | - |             | o |             |
|   | * |                        |    |   | 4 |             | t |             |
|   |   |                        |    |   | 3 |             | h |             |
|   |   |                        |    |   | ) |             | e |             |
|   |   |                        |    |   | * |             | r |             |
|   |   |                        |    |   |   |             | t |             |
|   |   |                        |    |   |   |             | h |             |
|   |   |                        |    |   |   |             | a |             |
|   |   |                        |    |   |   |             | n |             |
|   |   |                        |    |   |   |             | U |             |
|   |   |                        |    |   |   |             | S |             |
|   |   |                        |    |   |   |             | A |             |
|   |   |                        |    |   |   |             | ) |             |
|   |   |                        |    |   |   |             | ( |             |
|   |   |                        |    |   |   |             | 4 |             |
|   |   |                        |    |   |   |             | 4 |             |
|   |   |                        |    |   |   |             | - |             |
|   |   |                        |    |   |   |             | 7 |             |
|   |   |                        |    |   |   |             | 2 |             |
|   |   |                        |    |   |   |             | ) |             |
|   |   |                        |    |   |   |             | * |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
| * | * | OTHER BUSINESS TRADING |    |   |   |             | T |             |
| * | ( | NAMES (14 - 48)        |    |   |   |             | Y |             |
| 2 | 1 |                        |    |   |   |             | P |             |
| 2 | 2 |                        |    |   |   |             | E |             |
| 0 | - |                        |    |   |   |             | O |             |
| * | 1 |                        |    |   |   |             | F |             |
| * | 3 |                        |    |   |   |             | A |             |
|   | ) |                        |    |   |   |             | C |             |
|   | * |                        |    |   |   |             | T |             |
|   |   |                        |    |   |   |             | I |             |
|   |   |                        |    |   |   |             | O |             |
|   |   |                        |    |   |   |             | N |             |
|   |   |                        |    |   |   |             | * |             |
|   |   |                        |    |   |   |             | ( |             |
|   |   |                        |    |   |   |             | 4 |             |
|   |   |                        |    |   |   |             | 8 |             |
|   |   |                        |    |   |   |             | - |             |
|   |   |                        |    |   |   |             | 7 |             |
|   |   |                        |    |   |   |             | 2 |             |
|   |   |                        |    |   |   |             | ) |             |
|   |   |                        |    |   |   |             | * |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | 0 |                        |    |   |   |             |   |             |
|   | 1 |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | 0 |                        |    |   |   |             |   |             |
|   | 2 |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | 0 |                        |    |   |   |             |   |             |
|   | 3 |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | 0 |                        |    |   |   |             |   |             |
|   | 4 |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | 0 |                        |    |   |   |             |   |             |
|   | 5 |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | 0 |                        |    |   |   |             |   |             |
|   | 6 |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
|   | * |                        |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
| * |   | TYPED NAME AND TITLE   |    |   |   |             | D |             |
| * |   | OF AUTHORIZED          |    |   |   |             | A |             |
| S |   | INDIVIDUAL             |    |   |   |             | T |             |
| I |   |                        |    |   |   |             | E |             |
| G |   |                        |    |   |   |             | C |             |
| N |   |                        |    |   |   |             | O |             |
| A |   |                        |    |   |   |             | M |             |
| T |   |                        |    |   |   |             | P |             |
| U |   |                        |    |   |   |             | L |             |
| R |   |                        |    |   |   |             | E |             |
| E |   |                        |    |   |   |             | T |             |
| B |   |                        |    |   |   |             | E |             |
| L |   |                        |    |   |   |             | D |             |
| O |   |                        |    |   |   |             | * |             |
| C |   |                        |    |   |   |             | ( |             |
| K |   |                        |    |   |   |             | 7 |             |
| * |   |                        |    |   |   |             | 3 |             |
| * |   |                        |    |   |   |             | - |             |
|   |   |                        |    |   |   |             | 8 |             |
|   |   |                        |    |   |   |             | 0 |             |
|   |   |                        |    |   |   |             | ) |             |
|   |   |                        |    |   |   |             | * |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
|   |   |                        |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+
|   |   | SIGNATURE OF           |    |   |   |             |   |             |
|   |   | AUTHORIZED INDIVIDUAL  |    |   |   |             |   |             |
+---+---+------------------------+----+---+---+-------------+---+-------------+

**INSTRUCTIONS FOR COMPLETING FORM FDA 2511**

Complete the form as described below. Indicate the type of submission by
checking the appropriate box. Items not covered in these Instructions
are self-explanatory. Type all entries in CAPITAL LETTERS. Use standard
abbreviations wherever possible. Omit all punctuation. Complete a
separate Form FDA 2511 for each establishment location. Leave completed
and signed form intact and forward to:

**DEPARTMENT OF HEALTH AND HUMAN SERVICES\
FOOD AND DRUG ADMINISTRATION\
Office of Cosmetics and Colors\
Voluntary Cosmetic Registration Program (HFS-125)\
5100 Paint Branch Parkway College Park, MD 20740-3835**

**SPECIFIC INSTRUCTIONS**

+-------+-------+------------------------------------------------------+
| >     | > C   | ITEM                                                 |
|  CARD | OLUMN |                                                      |
| >     | >     |                                                      |
| >     | >     |                                                      |
| NO(S) | NO(S) |                                                      |
+-------+-------+------------------------------------------------------+
|       |       |                                                      |
+-------+-------+------------------------------------------------------+
| > ALL | > 1-8 | REGISTRATION NUMBER. This number will be assigned by |
|       |       | FDA. Firms having more than one location\            |
|       |       | will have a different number for each location. This |
|       |       | number will appear on the validated copy which is\   |
|       |       | returned to the establishment. ***(Correspondence    |
|       |       | with FDA concerning this Registration must           |
|       |       | reference\                                           |
|       |       | the Registration Number.)***                         |
+-------+-------+------------------------------------------------------+
|       |       |                                                      |
+-------+-------+------------------------------------------------------+
| > 110 | >     | ESTABLISHMENT NAME. Enter the name under which the   |
|       | 12-46 | establishment is to be registered at this one\       |
|       |       | general physical location under one management. If   |
|       |       | the company is a subsidiary to a parent company,\    |
|       |       | e.g. Donald Duck and Company, Division of Walt       |
|       |       | Disney, Incorporated, enter DONALD DUCK & CO in\     |
|       |       | CARD 110. Columns 12-46, and DIV WALT DISNEY INC in  |
|       |       | CARD 111, Columns 12-46.                             |
+-------+-------+------------------------------------------------------+
|       | >     | KIND OF BUSINESS. Check appropriate box or           |
|       | 47-48 | combination of boxes.                                |
+-------+-------+------------------------------------------------------+
| > 111 | >     | NAME OF PARENT COMPANY *(if any)*. A second line has |
|       | 12-46 | been provided for the name of the parent\            |
|       |       | company of the establishment as shown in the example |
|       |       | in CARD 110, Columns 12-46.                          |
+-------+-------+------------------------------------------------------+
| > 112 | >     | STREET ADDRESS. Enter establishment physical street  |
|       | 12-46 | location. A P.O. Box number may only be added\       |
|       |       | as additional information for postal communications. |
+-------+-------+------------------------------------------------------+
| > 113 | >     | STATE. Use Official Post Office 2 letter State Code. |
|       | 37-38 |                                                      |
+-------+-------+------------------------------------------------------+
| > 220 | >     | OTHER BUSINESS TRADING NAMES. Defined as subsidiary  |
|       | 14-48 | or related firm names used on a cosmetic\            |
|       |       | product label, which are owned by the cosmetic       |
|       |       | manufacturer or packer, but different from the       |
|       |       | principal\                                           |
|       |       | name under which the cosmetic product manufacturer   |
|       |       | or packer is registering or is registered. If you\   |
|       |       | require more than 6 Other Business Trading Names,    |
|       |       | use a second form. Complete entries in CARD 110,\    |
|       |       | Columns 12-46; CARD 112, Columns 12-46; CARD 113,    |
|       |       | Columns 12-72; then continue to enter Other\         |
|       |       | Business Trading Names in CARD 220, Columns 14-48.   |
|       |       | Also, complete pagination at bottom of the form\     |
|       |       | when there are more than 6 Other Business Trading    |
|       |       | Names.                                               |
+-------+-------+------------------------------------------------------+

INSTRUCTIONS FOR AMENDED OR CANCELLED SUBMISSIONS

  -----------------------------------------------------------------------
  Changes in the information on a validated Form FDA 2511 must be entered
  on a NEW Form FDA 2511 as an AMENDMENT within 30 days of such changes.
  This includes notification to cancel the registration or to delete any
  part of the information in the original file. Check the amended or
  cancelled Submission box at the top of the form and enter the
  Registration Number in the place provided. (The Registration Number is
  found in the upper right corner of the validated copy and must be
  entered exactly as it appears including the leading zeros.)

  -----------------------------------------------------------------------

> CANCELLATION OF REGISTRATION When Establishment no longer conducts
> business under this name or when Establishment name is changed,
> complete:
>
> Type of Submission. Check CANCELLATION box.\
> CARD 110, Columns 12-46\
> Signature Block
>
> CHANGE OF ADDRESS Self-explanatory. Complete:
>
> Type of Submission. Check AMENDMENT box.\
> CARD 110, Columns 12-46\
> CARD 112, Columns 12-46\
> CARD 113\
> Signature Block
>
> ADDITIONS OR DELETIONS TO Any change in Other Business Trading Name is
> handled as either an\
> OTHER BUSINESS TRADING NAMES addition or deletion. Describe Type of
> Action as either ADD or DELETE. Complete:
>
> Type of Submission. Check AMENDMENT box.\
> CARD 110, Columns 12-46\
> CARD 220, one or more items, ALL Columns\
> Signature Block

**Public reporting burden for this collection of information** is
estimated to average 25 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing reviewing the collection of
information. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for
reducing this burden, to:

> DEPARTMENT OF HEALTH AND HUMAN SERVICES An agency may not conduct or
> sponsor, and a person is not required to respond to, a\
> FOOD AND DRUG ADMINISTRATION collection of information unless it
> displays a currently valid OMB control number.\
> Office of Cosmetics and Colors
>
> Voluntary Cosmetic Registration Program (HFS-125)\
> 5100 Paint Branch Parkway\
> College Park, MD 20740-3835