| Dokumendiregister | Ravimiamet |
| Viit | FIN-2/5244-1 |
| Registreeritud | 06.10.2026 |
| Sünkroonitud | 09.10.2026 |
| Liik | Taotlus riigilõivu tagastamiseks |
| Funktsioon | FIN Eelarvestamine ja finantsaruandlus |
| Sari | FIN-2 Riigilõivu tagastamise taotlused ja otsused |
| Toimik | FIN-2/2026 |
| Juurdepääsupiirang | Avalik |
| Adressaat | |
| Saabumis/saatmisviis | |
| Vastutaja | Jevgenija Tamm (RA, Meditsiiniseadmete osakond) |
| Originaal | Ava uues aknas |
| Taotle dokumendi eemaldamist või parandamist |
Qmed Consulting A/S • Koebmagergade 53, 1. • DK 1150 Copenhagen K • Tlf.: +45 5664 1010 • Fax: +45 5665 3842 Mail: [email protected] • Bank: Reg.nr. 4865 Kontonr. 10182026 • VAT.No. DK-30564278 Page 1 of 1
State Agency of Medicines Nooruse 1 Tartu 50411 Estonia 29 July 2026
Study title Abbott Structural Heart Device Registry (Abbott SH Registry) – The ENDURE Study
Protocol number ABT-CIP-10415 Sponsor Sponsor: Abbott Medical, 5050 Nathan Lane N, Plymouth, MN
55442, USA Sponsor address in EU
St. Jude Medical Coordination Center BV, Corporate Village Da Vincilaan 1, F1 1935 Zaventem, Belgium
Eetikakomitee taotluse 398/T-10 otsus CIV CIV-EE-25-04-052499
Request for a refund Dear Sir/Madam We would like to request a refund for the State Fee that we have paid in error. We make this request according to § 12-15 of Statutory Fees Act. We have mistakenly paid 210 euros on 20 July 2026 instead of waiting for an invoice from you to pay the correct amount of money. The money was paid for the above mentioned study, where we are requesting an approval for a substantial modification. We attach the proof of payment of the 210 euros paid in error. Could you kindly refund the money to: Qmed Consulting A/S Reference 360.029 Danske Bank Erhverv, Bernstorffsgade 40, 1577 Copenhagen V. Denmark IBAN: DK59 3000 4869 6338 60 SWIFT: DABADKKK We look forward to hearing from you. Kind regards Stephanie John [email protected] +41 79 651 3268
BankDanske
Danske Bank A/S CVR-nr. 61 12 62 28 - København
Danske Bank Business København Bernstorffsgade 40 1577 København V Telefon 45127200 Telefax 45149893 SWIFT-BIC: DABADKKK www.danskebank.dk
Betalingstype: Overf»rsel til udlandet Afsender
Afsenders konto: Qmed EUR 4869633860 EUR
Tekst p} afsenders kontoudskrift: Estonian Compentent Modtager
Modtagers konto: EE932200221023778606 Kontoen f»res i: EE Modtagers navn og adresse: Estonian Compentent Authority Meddelelse til modtager: reference no. 2900083031 Modtagers bank
BIC/SWIFT-adresse: HABAEE2X Navn og adresse: SWEDBANK AS
LIIVALAIA STREET 34 KESKLINNA DISTRICT EE-15040 TALLINN
Bel»b: 210,00 EUR Overf»rselstype: SEPA Instant overf»rsel Ekspeditionsdato: 20.07.2026 Omkostninger: Deles Yderligere oplysninger om betalingen
Gebyr, som afsender skal betale:
Gebyr i alt: 0,13 EUR
Statusoplysninger
Betalingsstatus: Ekspederet
Betalingshistorik
Oprettet: 20.07.2026 af 4A8762 Godkendt: 20.07.2026 af 4A8762 Godkendt: 20.07.2026 af 6F1700
Tekniske referencer
Bankens arkivreferencenummer: 3943609287
Udskrift fra Business Online (CET) 14:15 - 20.07.2026 af 4A8762 - JANNIE MATTSSON
13 59
P
Certificate Of Completion Envelope Id: D91724F1-79B2-85AD-80CA-F1A4423F6B3D Status: Completed
Subject: Complete with Docusign: CRD 1032 SH Registry Cover Letter_refund state fee_29JUL2026.pdf
Source Envelope:
Document Pages: 2 Signatures: 1 Envelope Originator:
Certificate Pages: 5 Initials: 0 Dr. Stephanie John
AutoNav: Enabled
EnvelopeId Stamping: Disabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
Baldershøj 17B
Ishøj, Sjælland 2635
IP Address: 217.79.195.251
Record Tracking Status: Original
7/29/2026 1:51:45 AM
Holder: Dr. Stephanie John
Location: DocuSign
Signer Events Signature Timestamp Dr. Stephanie John
Senior Principal advisor
Qmed Consulting A/S
Security Level: Email, Account Authentication (Required), Logged in
Signature Adoption: Pre-selected Style
Signature ID:
AF9CA9FA-387B-418F-9792-9D54F9382F81
Using IP Address: 217.79.195.251
With Signing Authentication via Docusign password
With Signing Reasons (on each tab):
I have reviewed this document
Sent: 7/29/2026 1:54:51 AM
Viewed: 7/29/2026 1:55:03 AM
Signed: 7/29/2026 1:55:18 AM
Electronic Record and Signature Disclosure: Accepted: 10/16/2023 6:33:08 AM ID: 65691f0c-b8ad-4399-8713-86e15313a13c
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 7/29/2026 1:54:51 AM
Certified Delivered Security Checked 7/29/2026 1:55:03 AM
Signing Complete Security Checked 7/29/2026 1:55:18 AM
Completed Security Checked 7/29/2026 1:55:17 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Qmed-Consulting A/S (we, us or Company) may be required by law to
provide to you certain written notices or disclosures. Described below are the terms and
conditions for providing to you such notices and disclosures electronically through the DocuSign
system. Please read the information below carefully and thoroughly, and if you can access this
information electronically to your satisfaction and agree to this Electronic Record and Signature
Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to
use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign
system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. You will have the ability to download and print documents we send
to you through the DocuSign system during and immediately after the signing session and, if you
elect to create a DocuSign account, you may access the documents for a limited period of time
(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a
$0.00 per-page fee. You may request delivery of such paper copies from us by following the
procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to
receive required notices and consents electronically from us or to sign electronically documents
from us.
All notices and disclosures will be sent to you electronically
Electronic Record and Signature Disclosure created on: 2/11/2022 5:13:37 AM Parties agreed to: Dr. Stephanie John
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through the DocuSign system all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact Qmed-Consulting A/S:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: [email protected]
To advise Qmed-Consulting A/S of your new email address
To let us know of a change in your email address where we should send notices and disclosures
electronically to you, you must send an email message to us at [email protected] and in the
body of such request you must state: your previous email address, your new email address. We
do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your
account preferences.
To request paper copies from Qmed-Consulting A/S
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an email to [email protected] and in the body of
such request you must state your email address, full name, mailing address, and telephone
number. We will bill you for any fees at that time, if any.
To withdraw your consent with Qmed-Consulting A/S
To inform us that you no longer wish to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your signing session, and on the subsequent page,
select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an email to [email protected] and in the body of such request you must state your
email, full name, mailing address, and telephone number. We do not need any other information
from you to withdraw consent.. The consequences of your withdrawing consent for online
documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The
current system requirements are found here: https://support.docusign.com/guides/signer-guide-
signing-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please confirm that you have
read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for
your future reference and access; or (ii) that you are able to email this ERSD to an email address
where you will be able to print on paper or save it for your future reference and access. Further,
if you consent to receiving notices and disclosures exclusively in electronic format as described
herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before
clicking ‘CONTINUE’ within the DocuSign system.
By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm
that:
You can access and read this Electronic Record and Signature Disclosure; and
You can print on paper this Electronic Record and Signature Disclosure, or save or send
this Electronic Record and Disclosure to a location where you can print it, for future
reference and access; and
Until or unless you notify Qmed-Consulting A/S as described above, you consent to
receive exclusively through electronic means all notices, disclosures, authorizations,
acknowledgements, and other documents that are required to be provided or made
available to you by Qmed-Consulting A/S during the course of your relationship with
Qmed-Consulting A/S.
| Nimi | K.p. | Δ | Viit | Tüüp | Org | Osapooled |
|---|---|---|---|---|---|---|
| Otsus riigilõivu tagastamiseks | 06.10.2026 | 3 | FIN-2/5244-2 | Otsus riigilõivu tagastamiseks | ra |