English — reviewed original text

MEDICINES CONTROL AGENCY MCA THE GAMBIA MEDICINES CONTROL AGENCY 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 EXPORT PERMIT FOR MEDICINES AND RELATED PRODUCTS Name of Exporter Name of Recipient Licence number: Postal and Premises Physical Address Postal and Premises Physical Address Tel: Tel: Email: Email: Source of Supply/Consignment Country to be Shipped: Expected Date of Shipment: Port of Exit: Total Value Purpose of Export MCA-F-113/02, version 3 – 18 September 2026 Page 1 of 3

Name* and MCA Product Name and Country of Batch Manufacturing Expiry Unit of Total description of Registration address of Origin: number: Date: Date: issue Quantity product Number: (or Manufacturer indicate if listed) * Brand and generic name, strength & dosage form, where applicable MCA-F-113/02, version 3 – 18 September 2026 Page 2 of 3

Export Permit for Medicines and Related Products MCA The Gambia Name of Supervising Pharmacist or Professional Registration Number Supervisor OFFICIAL STAMP Signature Date Name of business owner or duly authorised person Signature Date CONDITIONS OF PERMIT 1. Products to be exported shall be inspected by authorised officials (inspectors) of the Agency at the point of loading and/or port of exit before export. 2. Three (3) copies of the permit together with three (3) copies of the Supplier’s Invoice, packing list (sea and air transport), and import licence of the importer or its equivalent issued by the relevant regulatory authority or competent institution. 3. At the point of loading, the exporter shall present the approved Export Permit, supplier's invoice(s), packing list, and the import licence of the importer or its equivalent issued by the relevant regulatory authority or competent institution to the MCA Inspector for verification. 4. Permits issued for export of products shall be valid for only one transaction. 5. Where goods are to be sent as different consignments, a new export permit shall be obtained from the Agency for each consignment. FOR OFFICIAL USE ONLY Vetted by (Name) Signature and Date Designation Approved by Signature and Date OFFICIAL STAMP Director of Operations MCA-F-113/02, version 3 – 18 September 2026 Page 3 of 3