CCC测试认证申请表CCCApplicationForm

1、CCC测试认证申请表CCC Applicatio n Form首次申请口再次申请匚|First ApplicationSecond Application申请人相关信息(Information of the Applicant)申请人名称仲文)：Name of Applicant(Chinese) :申请人名称(英文)：Name of Applicant(English) :付款人名称：Name of Payer :付款人地址：Address of Payer :申请人地址仲文)：Address(Chinese):申请人地址(英文)：Address(English):申请人组织机构代码：邮政编

2、码：Post Code :国家或地区：所在省市：联系人仲文)：Person to be contacted :联系人(English):Person to be contacted :E-mail :电话仃 elephone):传真(Fax):手机(Mobile Phone):代理机构或中国办事处信息(Agent or Office in China)代理公司名称：Company Name :代理公司地址：Company Address :组织机构代码：代理机构批准编号：邮政编码：Post Code :联系人：Person to be contacted :E-mail :电话仃 elepho

3、ne):传真(Fax):手机(Mobile Phone):制造商相关信息(Information of the Manufacturer)同申请人(same as applicant )制造商名称仲文)：Name ofManufacturer(Chinese):制造商名称(英文)：Name ofManufacturer(English)制造商地址仲文):Address ofManufacturer(Chinese)制造商地址(英文):Address ofManufacturer(English):制造商组织机构代码：邮政编码：Post Code :国家或地区：所在省市：联系人仲文)：Perso

4、n to be contacted :联系人(English):Person to be contacted :E-mail :电话仃 elephone):传真(Fax):手机(Mobile Phone):生产厂相关信息(Information of the Factory)冋申请人(same as applicant)冋制造商(same as applicant)生产厂名称仲文)：Name of Factory(Chinese) :生产厂名称(英文)：Name of Factory(English) :生产厂地址仲文)：Address(Chinese):生产厂地址(英文)：Address(E

5、nglish):生产厂组织机构代码：CCC 工厂编号：国家或地区：所在省市：邮政编码：Post Code :联系人仲文)：Person to be contacted :联系人(English):Person to be contacted :E-mail :电话仃 elephone):传真(Fax):手机(Mobile Phone):申请认证产品相关信息(Information of the Production)产品名称(中文)：Name of Production(Chinese) :产品名称(英文)：Nameof Production(English) :型号规格(中文)：Model

6、andSpecification(Chinese)型号规格(英文)：Model andSpecification(Eglish)商标(中文)：Trade Mark(Chinese):商标(English):Trade Mark(English):产品类别：Product Sort :备注/其它需要说明的情况(Note):1、申请认证产品的 GB 标准号 /GB standard for the equipment to be certified:1.1、安全标准Standard for Safety :1.2、EMC 标准Standard for EMC(如有 /If applicable):

7、2、申请认证的产品是否有CB 测试证书 /Has the applying equipment been awarded the CB Test Certificate:是 /Yes否/No如果有，给出 CB 测试证书的编号和获证日期 /If Yes, give the number and date of the CB Test Certificate:a. CB 证书号 /No. Of CB Certificate:获证日期 /Issued Date:c.颁发 CB 测试证书的认证机构名称 /Name of the NCB issuing the CB Test Certificate:3、 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 thefactory has ever obtained CCC or CCEE or C