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申請人相關資訊(Information of the Applicant) |
| 1 |
申請人名稱(中文):
Name of Applicant (Chinese): |
| 2 |
申請人名稱(英文):
Company Name (English): |
| 3 |
付款人名稱:
Name of Payer: |
| 4 |
付款人地址:
Address of payer: |
| 5 |
申請人地址(中文):
Applicant Address (Chinese): |
| 6 |
申請人地址(英文):
Applicant Address (English): |
| 7 |
國家或地區/Country or Region: |
| 8 |
郵遞區號/Zip code: |
| 9 |
組織機構代碼/Organization Code: |
| 10 |
E-mail: |
| 11 |
電話/TELEPHONE: |
| 12 |
傳真/FAX: |
| 13 |
聯繫人(填寫2個以上含2個):
Contact Person (2 or more): |
| 代理機構或辦事處名稱、聯繫人姓名，位址，郵編，電子郵件，電話、及傳真/Name of agent or office, its contact person, Address, Zip Code, E-mail, Tel. No. & Fax No. |
| 14 |
代理公司名稱:
Agent Name: |
| 15 |
代理公司位址:
Agent Address: |
| 16 |
郵遞區號/Post code: |
| 17 |
E-mail: |
| 18 |
電話/TELEPHONE: |
| 19 |
傳真/FAX: |
| 20 |
聯繫人/Person to be contacted: |
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製造商/Manufacturer |
| 21 |
生產廠名稱(中文):
Name of Factory(Chinese): |
| 22 |
生產廠名稱(英文):
Name of Factory(English): |
| 23 |
生產廠位址(中文):
ADDRESS(Chinese): |
| 24 |
生產廠位址(英文):
Factory Address(English): |
| 25 |
國家或地區/Country or Region: |
| 26 |
組織機構代碼/Organization Code: |
| 27 |
所在省市/Province： |
| 28 |
E-mail: |
| 29 |
電 話/TELEPHONE: |
| 30 |
傳 真/FAX: |
| 31 |
聯繫人/Person to be contact: |
| 32 |
是否有ISO證書/Has the applying equipment been awarded the ISO Certificate:
是/Yes □ 否/No □ |
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申請認證產品相關資訊(Related Information of the Applied Certification Product) |
| 33 |
產品名稱(中文):
Product Name (Chinese): |
| 34 |
產品名稱(英文):
Product Name (Chinese): |
| 35 |
型號規格(請詳細填寫):
Model/specification (Fill in detail): |
| 36 |
商標(中文):
Trade Mark（Chinese）: |
| 37 |
商標(English):
Trade Mark (English): |
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申請認證產品的GB標準號/GB standard for the product to be certified |
| 38 |
安全標準:
Standard for Safety: |
| 39 |
EMC標準 (如有):
Standard for EMC(If available): |
| 40 |
說明生產廠是否有同類產品獲得過CCC證書或CCEE證書或CCIB證書，如果有，請列出證書編號。Please indicate if the factory has ever obtained CCC, CCEE or CCIB certificates, if the answer is yes, then list the certificate No.. |
| 41 |
申請認證的產品是否有CB測試證書/Has the applying product been awarded the CB Test Certificate:
是/Yes □ 否/No □ |
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備註Note:
申請人授權(簽字/蓋章)Applicant Authorized (Signature/Stamp)：
年(Year) 月(Month) 日(Day) |
