Radio equipment evaluation procedure application form
JET project no.
Date:
To: Director of Japan Electrical Safety & Environment Technology Laboratories
(Applicant's) / Zip code:Address:
Corporation name:
Representative, position:
Responsible person, division
(Seal or signature)
Applicant agree with all Stipulations for Entrusted Test and all statements in the attached Agreement for Entrusted Test application, and hereby apply for Entrusted test for the following product.
１．Electrical Product Name:
２．Model of electrical product to be tested (Catalog number, etc.)：
３．Product Ratings (Frequency, modulation scheme, RF output, etc.)：
４．Test standard & test items: Ex.) Radio law, “Certificate of Conformity with technical Regulations”
3 sets, “1set:Measurement unit(Zigbee),Interface box(Zigbee,Wi-fi) and PDA(Wi-fi,BT)”
５．Test Report : Ex.) For the Radio Law, unnecessary
６. Confirmation on disassembly of test samples: Depending on Test items, test samples may be disassembled
and damage may be occurred because of the sample disassembling
□ Applicant agree to disassemble the test samples (test may not be proceeded without Applicant agreement)
７．Contacting person for the application (for contacting affairs, addressee of invoice, test report. In case the contacting person is same as applicant, it is not necessary to fill in here)
Address:
Company Name:
Contacting person’s name & working Division:
TEL FAX e-mail
８. others (for different invoice addressee, or other request about application)
AGREEMENT
Applicant agree with the following statements and apply for Entrusted test to JET.
1．The contact person for the application shall take full responsibilities for the entrusted test. It should inform JET immediately if contacting person changes during test.
2．The applicant shall deliver or receive test samples/revised samples to one of the following Lab. The applicant shall take full responsibilities for sample delivery.
Japan Electrical Safety & Environment Technorogy Laboratories
■ Yokohama Lab/12－30, Motomiya 1－chome, Tsurumi－ku, Yokohama－shi, Kanagawa
3．The applicant shall pay test expense in advance.
4．The applicant shall take action immediately after JET inform test samples have damage .
5．JET will send Revising Notice to applicant in case test samples don’t comply with Technical Requirements. The applicant should arrange payment immediately in case there is any short payment to the test expense.
6．If JET find major defects on the samples during test and judge that the samples with such defect won’t comply with Technical Requirements, JET will treat the application as follows:
1) □ Sending revising notice to applicant or 2) □Recommending withdrawal of application while sending Revising Notice to applicant
7． Tested samples will be returned to applicant at the condition being disassembled or damaged after test. JET take no responsibility for damage or disassembly of the samples due to test.
8．The applicant shall choose handling of tested samples.
1) □ The applicant takes away the samples. 2) □ Discard tested samples at JET.
The applicant shall take away tested samples within 60 days after issuance of the test report, etc. If the applicant does not take away them during that period, JET will discard the tested samples. In this case, applicant should pay the disposing fee occurred accordingly.
9． If the applicant are going to use the report of entrusted test as a part of information for certification, the applicant shall comply with the requirements for certification and shall submit necessary product information for certification test.
10.
Applicant will bear the responsibility for all the contents described in the application form.
If it is determined that there is doubt in the application documents, JET is possible to find a re-submission of application documents.
The contents technology the applicant's specific information they have learned in business, such as information about the application and the contents of the application form the applicant to submit, finance, production, sales, etc., JET is obliged to perform the retention of its confidentiality.
If it is determined that when JET has been requested from the Ministry of Internal Affairs and Communications, and there is a need for JET to disclose the contents of the application form, JET will disclose the information to the Ministry of Internal Affairs and Communications.
However, JET will be notified in advance to the applicant.
Contents of the application documents to disclosure is the content of the required minimum.
Retention period of the secret about the contents of the application form is one year.
However, JET does not refuse to be extended by written notice to this period.
11.
If there is a falsehood to the description of the submitted application documents applicant, JET is not responsible for that at all.
If after the JET has performed authentication, change the number of facilities the applicant has received the authentication, configuration, etc., and add or remove, to admit JET is not the same facts and authentication, JET is the responsibility of the absolutely it does not take.
The conditions presented for the applicant when the JET has performed authentication,
For problems caused by did not reflect equipment the applicant has obtained the certification,
JET is not responsible for that at all.
Modulation section and the high-frequency portion excluding the antenna system declares that (can not be modified easily) that can not be opened easily and a structure to application equipment.
However, it is limited to the radio equipment that is required by law.
Applicant: ______(signature)
Signed person’s name:
Date: