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申请人相关信息(Information of the Applicant) |
| 1 |
申请人名称(中文):
Name of Applicant (Chinese): |
| 2 |
申请人名称(英文):
Company Name (English): |
| 3 |
付款人名称:
Name of Payer: |
| 4 |
付款人地址:
Address of payer: |
| 5 |
申请人地址(中文):
Applicant Address (Chinese): |
| 6 |
申请人地址(英文):
Applicant Address (English): |
| 7 |
国家或地区/Country or Region: |
| 8 |
邮政编码/Zip code: |
| 9 |
组织机构代码/Organization Code: |
| 10 |
E-mail: |
| 11 |
电话/TELEPHONE: |
| 12 |
传真/FAX: |
| 13 |
联系人(填写2个以上含2个):
Contact Person (2 or more): |
| 代理机构或办事处名称、联系人姓名，地址，邮编，电子邮件，电话、及传真/Name of agent or office, its contact person, Address, Zip Code, E-mail, Tel. No. & Fax No. |
| 14 |
代理公司名称:
Agent Name: |
| 15 |
代理公司地址:
Agent Address: |
| 16 |
邮政编码/Post code: |
| 17 |
E-mail: |
| 18 |
电话/TELEPHONE: |
| 19 |
传真/FAX: |
| 20 |
联系人/Person to be contacted: |
|
制造商/Manufacturer |
| 21 |
生产厂名称(中文):
Name of Factory(Chinese): |
| 22 |
生产厂名称(英文):
Name of Factory(English): |
| 23 |
生产厂地址(中文):
ADDRESS(Chinese): |
| 24 |
生产厂地址(英文):
Factory Address(English): |
| 25 |
国家或地区/Country or Region: |
| 26 |
组织机构代码/Organization Code: |
| 27 |
所在省市/Province： |
| 28 |
E-mail: |
| 29 |
电 话/TELEPHONE: |
| 30 |
传 真/FAX: |
| 31 |
联系人/Person to be contact: |
| 32 |
是否有ISO证书/Has the applying equipment been awarded the ISO Certificate:
是/Yes □ 否/No □ |
|
申请认证产品相关信息(Related Information of the Applied Certification Product) |
| 33 |
产品名称(中文):
Product Name (Chinese): |
| 34 |
产品名称(英文):
Product Name (Chinese): |
| 35 |
型号规格(请详细填写):
Model/specification (Fill in detail): |
| 36 |
商标(中文):
Trade Mark（Chinese）: |
| 37 |
商标(English):
Trade Mark (English): |
|
申请认证产品的GB标准号/GB standard for the product to be certified |
| 38 |
安全标准:
Standard for Safety: |
| 39 |
EMC标准 (如有):
Standard for EMC(If available): |
| 40 |
说明生产厂是否有同类产品获得过CCC证书或CCEE证书或CCIB证书，如果有，请列出证书编号。Please indicate if the factory has ever obtained CCC, CCEE or CCIB certificates, if the answer is yes, then list the certificate No.. |
| 41 |
申请认证的产品是否有CB测试证书/Has the applying product been awarded the CB Test Certificate:
是/Yes □ 否/No □ |
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备注Note:
申请人授权(签字/盖章)Applicant Authorized (Signature/Stamp)：
年(Year) 月(Month) 日(Day)
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