AI-assisted research summary: This form records an admitted offence and allows the officer to compound it by ordering payment of a stated sum, with listed exhibits forfeited to the Government.
25. Scope extension (if it involves site visit) 100 400 400 400 400 800 1,000 500 200 300 200 500 100 500 26 Tanzania Medicines and Medical Devices (Fees and Charges) GN. NO. 686 (Contd.) __________ FIFTH SCHEDULE __________ (Made under regulation 12(3)) COMPOUNDING FORM TMDA No.................. Station .................... Date ....................... I, ....................................................................................................................... (name) of ......................................................................................................................... (address) do hereby admit that I have contravened section/regulation .............................. by ..................................................................................................................... (state the provision of law contravened) (state particulars of offence) ............................................................................................... and hereby declare that rather than being prosecuted for the commission of the aforementioned offence, on my own free will, I admit that the said offence be compounded under regulation 11 of the Tanzania Medicines and Medical Devices (Fees and Charges) Regulations, 2021 by ........................................................................................................................... (name of officer compounding the offence) AND I,...................................................................................... (the name and designation of officer compounding the offence .............................................., in exercise of the power conferred upon me by regulation 11 of the Tanzania Medicines and Medical Devices (Fees and Charges) Regulations, 2021, hereby order that................................................................................................................... (name of the offender) to pay the sum of ....................... Tanzania shillings (TZS. ..............) by way of compounding and that the following exhibit(s) are hereby forfeited to the Government. (List products forfeited) ............................................................................................................................. ............................................................................................................................. Dated this ........................................ day of ..........................................., 20........ ..................................................... (Signature of offender) ................................................................. (Signature of officer compounding offence) ................................................................. .................................................... (witness) (witness) 27 Tanzania Medicines and Medical Devices (Fees and Charges) GN. NO. 686 (Contd.) The payment of the said sum of ..................................Tanzania shillings has been made vide control No. ........................ Dated........................which has been issued to the offender. .............................................................. (Signature of Officer compounding offence) This form shall be issued in triplicate and the original copy shall be served to the offender. A duplicate copy shall be forwarded to the accountant, and the triplicate copy to the Director General. Dodoma 6th September, 2021 DOROTHY O. GWAJIMA Minister for Health, Community Development, Gender, Elderly and Children 28