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申請編號:                        申請人編號:
(Application No.):                    Applicant No. :
                                            生產廠編號:    
                                       Factory No:



CCC認證申請書

Application for the CCC Certification




                
申請人/ Applicant:                      
                                        
生產廠/Factory:                        
                                        
             申請日期/Date:                          
             產品類別/Product sort:                      









中國質量認證中心
China Quality Certification Centre

1．申請人/Applicant
1.1申請人名稱/Name of Applicant:                                            
                                                                    
1.2 付款人名稱及地址/Invoice Address:                                    
                                                                    
1.3申請人地址、郵編/Address and post code of Applicant:
                                                                    
                                                                                
1.4 聯系人/Person to be contacted:    
1.5 電話/Applicant’s Telephone:
1.6 傳真/Fax:
1.7 電子郵件/E-mail:
2. 代理機構或中國辦事處名稱, 聯系人姓名, 地址, 郵編, 電子郵件、電話及傳真/Name of Agent or office in China, its contact person, Address, Post Code, E-mail, Tel. No. & Fax No.:                                            
                                                                      
3. 制造商/Manufacturer where the equipment is produced:
3.1制造商名稱/Name of Manufacturer:                                                    
                                                                            
3.2制造商地址/Address of Manufacturer:                                      
                                                                    
3.3 聯系人/Person to be contacted:
3.4 電話/ Manufacturer’s Telephone:
3.5 傳真/Fax:
3.6 電子郵件/E-mail:
4. 制造廠/factory where the equipment is produced:
4.1制造廠名稱/Name of factory:                                            
                                                                                
4.2制造廠地址、郵編/Address and post code of factory:                                            
                                                                    
4.3 聯系人/Person to be contacted:    
4.4 電話/factory’s Telephone:                  4.5 傳真/Fax:                    
4.6 電子郵件/E-mail:
5.產品名稱/Name of the equipment:                                      
6.產品商標/Trade mark of the equipment:                                  

7.型號和規格/Model and specification:                                  
                                                                  
                                                                  
                                                                  
8. 申請認證產品的GB標準號/Number of the GB standard for the equipment to be certified:
8.1 安全標準/Standard for Safety:                                                   
8.2 EMC標準/Standard for EMC(如有/If applicable):                                    
9. 申請認證的產品是否有CB測試證書/Has the applying equipment been awarded the CB Test Certificate:
是/Yes 否/No
如果有,給出CB測試證書的編號和獲證日期/If  “Yes”, give the number and date of the CB Test Certificate:
a. CB證書號/No. Of CB Certificate:                                              
b. 獲證日期/Issued Date:                                                
c. 頒發CB測試證書的中國質量認證中心/Name of the NCB issuing the CB Test Certificate:                                                    
我們聲明我們將遵守中國質量認證中心的認證規則和程序,支付認證所需的申請,試驗, 工廠審查及其它有關的費用;中國質量認證中心將不承擔獲得產品合格認證的制造廠或銷售商應承擔的任何法律責任.
We declare that we will follow the rules and procedures of the CQC and make payment for the fees arising from the application, testing, inspection and other services.


授權人簽章/Authorized signatory


注/Notice:
1. 申請人應將申請書一式二份寄CQC產品(一、二、三、四)處, 第三份自己存檔.
郵寄地址/Address: 中國 北京朝陽區芳草地西街15號                                                            
請用中、英二種文字填寫申請人, 制造廠和認證產品的名稱.
Two copies of this Application Form is to be sent by the Applicant to the CQC Product Certification Department., and a third copy should be filed by the Applicant.
CQC Mail Address: No.15 Fangcaodixijie Chaoyang District Beijing 100020,China
Please fill in the names of the applicant, factories and products to be certified in both Chinese and English.
2. 有關CQC產品認證的公開文件可通過上網獲取, 網址是http://WWW.CQC.COM.CN      

申 請 人 承 諾

1) 始終遵守認證計劃的安排的有關規定;
2) 為進行評價作出必要的安排,包括審查文件、進入所有的區域、查閱所有的記錄(包括內部審核報告)和評價所需人員(例如檢驗、檢查、評定、監督、復評)和解決投訴的有關規定;
3) 僅在獲準認證的范圍內作出有關認證的聲明;
4) 在使用產品認證結果時,不得損害CQC的聲譽、不得做使(中國質量認證中心)認為可能誤導或未經授權的聲明;
5) 當證書被暫停或撤銷時,應立即停止涉及認證內容的廣告,并按CQC要求交回所有認證文件;
6) 認證僅用于表明獲準認證的產品符合特定標準;
7) 確保不采用誤導的方式使用或部分使用認證證書和報告;
8) 在傳播媒體中對產品認證內容的引用,應符合CQC的要求.

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申請人授權簽字: