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-mail:4.5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: