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CE认证申请书
Our reference 申请书编号 Date 申请日期
Applicant name
申请人名称:
Applicant address
申请人地址:
Tel. 电话号 Fax传真号 E-mail电子邮箱
Contact person name/ Tel./E-mail
联系人姓名/电话/ E-mail
Manufacturer’s name
制造商名称
Manufacturer’s address
制造商地址
Tel. 电话号 Fax 传真号 E-mail 电子邮箱
Product name 产品名称
Trade mark产品商标
Model and specification 型号规格
Technical data 技术参数
Directive指令号
Relevant Standard 标准号/及增补件
Has the applying equipment been awarded the CCC/CQC/CB Test Certificate. If yes, please fill in the Certification’s number and the name of the test Lab:
申请认证的产品是否有CCC/CQC/CB测试证书.如果是，请填写证书号及检测机构名称：
The country which the product will be export to
拟出口国家:
Components/spare parts and materials used in the appliance
整机的安全元器件及材料清单:
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Object/part
元器件名称 |
Manufacturer
Trade mark
制造厂/商标 |
Type/ model
型号规格 |
Technical data
技术数据 |
Standard
采用标准 |
Mark of
conformity
认证标志 |
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Other information of value to the CQCs (see applicant’s notice) (preferably in quadruplicate)
提供给CQC的其它有价值的信息（见申请人须知）作为申请书附件（一式二份）
授权人签章 Authorized signatory
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