3C认证申请书

申请编号 生产厂编号 Application No Factory No CCC认证申请书 Application for the CCC Certification 首次申请 □ 再次申请 □ First Application Second Application 申请日期/Date 产品类别/Product sort 中国质量认证中心 China Quality Certification Centre 1．申请人/Applicant 1.1申请人名称/Name of Applicant 1.2 付款人名称、地址/Name 、Address of Payer 1.3申请人地址、邮编/Address and post code of Applicant 1.4 组织机构代码 1.5联系人/Contact Person 1.6电话/ Telephone 1.7传真/Fax 1.8电子邮件/E-mail 2. 代理机构或中国办事处/Name of Agent or office in China 2.1 代理机构/中国办事处名称/ Name of Agent or office in China 2.2 联系人/Contact Person 2.3电话/ Telephone 2.4传真/Fax 2.5电子邮件/E-mail 2.6 CCC代理申办机构注册证书号/ Register Number Of CCC Agent 3. 制造商/Manufacturer（where the equipment is produced） 3.1制造商名称/Name of Manufacturer 3.2制造商地址/Address of Manufacturer 3.3联系人/Contact Person 3.4 电话/ Telephone 3.5 传真/Fax 3.6 电子邮件/E-mail 4. 生产厂/Factory（where the equipment is produced） 4.1生产厂名称/Name of factory 4.2生产厂地址、邮编/Address and post code of factory 4.3联系人/Contact Person 4.4电子邮件/E-mail4.5电话/ Telephone 4.6传真/Fax 4.7工厂编号/Factory Number 5.产品名称/Name of Production 6.产品类别/Product Sort 7.产品商标/Trade mark 8.型号和规格（中文）/Model and specification 型号和规格（英文）/Model and specification 9. 申请认证产品的GB标准号/ GB standard for the equipment to be certified 9.1平安标准/Standard for Safety 9.2 EMC标准/Standard for EMC如有/If applicable 10. 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 假如有,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