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Product Certification Questionnnaires

Company Name

Company Address

Company Contact

Name
Telephone
Fax
Email

Manufacturer Name

Manufacturer Address

Manufacturer Contact

Name
Telephone
Fax
Email

Factory Name

Factory Address

Factory Contact

Name
Telephone
Fax
Email

Local Representative Name

Local Representative Address

Loca Representative Contact

Name
Telephone
Fax
Email

Product Description

Name
Trade Mark
Model
Specifications
Specifications
Material

Telecom Interfaces

Type No Type No

Radio Frequency

Frequency Range Bandwidth Output Power

Applicable Standards

Safety
EMC
RF/Wireless
Telecom

Power Supply

Internal External Vac Vdc

Does this product have CB Test Report? Yes

If yes, CB Certification No
CB Issued Date
CB Issued By

Has the factory been inspected for producing this type of products? Yes

If yes, Factory Inspection Report No

Factory Inspection Date

Is this factory ISO 9000 or equivalently Certified? Yes

If yes, ISO 9000 or equivalent stardard's version

ISO 9000 or equivalently Certified by

Please indicate which country or countries you're applying for the Product Certification

United States	Philippines
Canada	Sri Lanka
Austria	South Africa
Belgium	Latvia
Denmark	Poland
Finland	Lithuania
France	Hungary
Germany	Russia
Greece	Slovenia
Iceland	Bulgaria
Ireland	Estonia
Italy	Israel
Liechtenstein	Belarus
Luxembourg	Czech Republic
Norway	Morocco
Portugal	Slovak Republic
Spain	Ukraine
Sweden	Bahrain
Switzerland	Jordan
UK	Oman
Netherlands	Qatar
Crotia	Saudi Arabia
Japan	Kuwait
Australia	Egypt
New Zealand	UAE
India	Brazil
Hong Kong	Mexico
South Korea	Chile
Singapore	Colombia
Thailand	Venezuela
Taiwan	Argentina
PR China	Ecuador
Malaysia	Peru
Indonesia
URL of Product Brochure(if any)

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