FCC/TCB Approvals
Industry Canada Approvals
Notified Body for Europe
APPLICATION FORM – NB OPINION
PRODUCT DESCRIPTION
Manufacturer(1) Name
Manufacturer Address
:
:
Brand/Trade Name
Model/Type Designation
Product Description(2)
Product Specifications
:
:
:
:
Please fill out ANNEX 1
TECHNICAL CONSTRUCTION FILE - APPLICANT INFORMATION
Applicant Name (3)
Applicant Address
:
:
Signed by (Name & Title) :
Date
TCF Identification(4)
:
:
CUSTOMER INFORMATION
Company Name(5)
Company Address
:
:
Phone number
Contact person(5)
Email address
:
:
:
(1) The manufacturer is the person responsible for designing and manufacturing a product, and whose intention is to place it
on the European Union market. A manufacturer may contract out the design or production. Notes: Companies that have
been contracted out by manufacturer shall not be listed. In all cases, the manufacturer is ultimately responsible for the
product and its compliance with the law. The manufacturer is also responsible for designing and manufacturing the product
in accordance with the essential requirements of all relevant directives, and for following the conformity assessment
procedures from the appropriate directives, such as compiling a Technical File, affixing the CE marking, and drawing up
the Declaration of Conformity. A manufacturer may be located inside or outside the EU. A manufacturer can appoint an
Authorized Representative to act on his/her behalf, but he/she must be located in the EU.
(2) Please, describe in no more than 8 words (e.g. 40MHz Remote control for toy, Handheld transceiver, Mobile phone,
Portable wireless radio microphones, PDA with GSM and Bluetooth, RFID Reader, etc.).
(3) Applicant: Name, address etc of the party seeking the opinion.
(4) TCF Identification: Unique identification of the documentation.
(5) Company submitting this application to TIMCO. Invoice and Opinion will be sent to contact person.
849 NW State Road 45 • P.O. Box 370 • Newberry, Florida 32669 USA
Telephone (352) 472-5500 • (888) 472-2424 • FAX (352) 472-2030 • email: tei@timcoengr.com
Page 1 of 3
FCC/TCB Approvals
Industry Canada Approvals
Notified Body for Europe
ANNEX 1
PRODUCT SPECIFICATIONS
Intended Use / Category(6)
RF output power
Frequency band (MHz)
Modulation
Antenna type
Duty cycle (%)
:
:
:
:
:
:
Non-Specific Short Range Device
xx dBm or W indicate whether EIRP/ERP/Conducted
xxx
AM
Integral /or indicate type and gain for detachable antenna
xx
Intended Use/Category(6)
RF output power
Frequency band (MHz)
Modulation
Antenna type
Duty cycle (%)
:
:
:
:
:
:
SRD – Wideband data transmission system (Bluetooth)
xx dBm or W indicate whether EIRP/ERP/Conducted
2402-2480
FHSS (GFSK)
Integral /or indicate type and gain for detachable antenna
xx
Intended Use/Category(6)
RF output power
Frequency band (MHz)
Modulation
Antenna type
Duty cycle (%)
:
:
:
:
:
:
SRD – Wideband data transmission system
11b: xxmW and 11g: xxmW indicate whether Conducted/or EIRP
2412-2472
DSSS (BPSK/QPSK/CCK) and OFDM (BPSK/QPSK/16QAM/64QAM)
Integral /or indicate type and gain for detachable antenna
11b: xx and 11g: xx
Intended Use/Category(6)
RF output power
Frequency band (MHz)
Modulation
Antenna type
Duty cycle (%)
:
:
:
:
:
:
EGSM900
xx dBm or W indicate whether EIRP/ERP/Conducted
880-915
GMSK
Integral /or indicate type and gain for detachable antenna
-
Intended Use/Category(6)
RF output power
Frequency band (MHz)
Modulation
Antenna type
Duty cycle (%)
:
:
:
:
:
:
DCS1800
xx dBm or W indicate whether EIRP/ERP/Conducted
1710-1785
GMSK
Integral /or indicate type and gain for detachable antenna
-
Intended Use/Category(6)
RF output power
Frequency band (MHz)
Modulation
Antenna type
Duty cycle (%)
:
:
:
:
:
:
WCDMA (UMTS)
xx dBm or W indicate whether EIRP/ERP/Conducted
1920-1980
QPSK
Integral /or indicate type and gain for detachable antenna
-
(6) Please refer to ERC RECOMMENDATION 70-03 or actual standard title for relevant category or intended use.
849 NW State Road 45 • P.O. Box 370 • Newberry, Florida 32669 USA
Telephone (352) 472-5500 • (888) 472-2424 • FAX (352) 472-2030 • email: tei@timcoengr.com
Page 2 of 3
FCC/TCB Approvals
Industry Canada Approvals
Notified Body for Europe
ANNEX 2
Technical File in accordance with R&TTE Directive Annex IV
Under the provisions of Annex IV of the Directive 1999/5/EC of the European Parliament and of the
Council of 9 March 1999 on Radio Equipment and Telecommunications Terminal Equipment (R&TTE
directive) and the mutual recognition of their conformity, We, the undersigned, have established a
Technical Construction File as referenced in this application to be presented to the Notified Body to
enable assessment of the product conformity with the essential requirements of the R&TTE Directive
and to be kept available to the relevant national authorities of any Member State for inspection purposes
for a period ending at least 10 years after the last product has been manufactured.
ITEM #
01
02
TECHNICAL DOCUMENT DESCRIPTION
Technical File in accordance with R&TTE directive Annex II point 4
Declaration of Conformity in accordance with R&TTE Directive Annex II point 1
and to specific test suites described in R&TTEdirective Annex III
We, the undersigned, have established a Technical file comprising of the following exhibits:
1.
2.
3.
4.
5.
6.
7.
(list of exhibits)
…
…
…
…
…
Drawn up in (type in location)
Date (mm/dd/yyyy)
Signature
Family/Last Name and First/Given Name
Position/Title
Company Name(7) (Applicant)
(7) Applicant or authorized agent. If the agent signed here (for example test labs), please provide an authorization letter from
the applicant.
849 NW State Road 45 • P.O. Box 370 • Newberry, Florida 32669 USA
Telephone (352) 472-5500 • (888) 472-2424 • FAX (352) 472-2030 • email: tei@timcoengr.com
Page 3 of 3