MCA-F-411/02, Version 2 — Application for Licensing as Importer of Related Products
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Contents
MEDICINES CONTROL AGENCY
MCA
THE GAMBIA
Application for Licensing as Importer
of Related Products
Off OIC Highway, Sukuta, West Coast Region, P.O. Box 3162, The Gambia, 97XW+8HH
Website: www.mca.gm; E-mail: info@mca.gm; Tel. No.: +2204380632
☐ New licence ☐ Renewal Licence No.
PARTICULARS OF APPLICANT & SUPERVISOR
Name of
Entity
Name of
Head/Owner
Physical
Address of
entity
Contact
Details Telephone No.
Email
Website
Name of
Supervisor
Registration No
of Supervisor
with Statutory
Body (if
applicable)
Contact
Details of Telephone No.
Supervisor
Email
FOR NEW LICENCES ONLY
Date of
Incorporation of
Company
Business
Registration
number
MCA-F-411/02, Version 2 – 18 September 2026 Page 1 of 2
Original PDF page 1 — retained source fields, tables and layout.
Application for Licence as Importer of Related Products MCA The Gambia
ITEMS TO BE IMPORTED (Tick all as appropriate)
☐ For Human use ☐ For Veterinary use
Products
☐ Medical Device ☐ Diagnostics ☐ Cosmetics
☐ Other (Please specify)
Attach the documents as follows:
☐ Proof of payment of application fee (MCA receipt)
☐ a copy of valid for identification
☐ a copy of the registration of the business by the Registrar of Companies in The
Gambia
☐ a copy of the annual return certificate from the Registrar of Companies in The
Gambia
☐ a copy of the academic and professional registration certificate of the RPI from
the relevant statutory body
☐ Other
DECLARATION
We, the undersigned, hereby declare that all information contained herein is correct
and true.
Supervisor OFFICIAL STAMP
Signature
Date
Head/Owner of Entity
Signature
Date
MCA-F-411/02, version 2 - 18 September 2026 Page 2 of 2
Original PDF page 2 — retained source fields, tables and layout.
