Mahmoud Abu-Alaydeh

Agent TI5000 assinado

Intelbras Industria de Telecomunicacao Eletronica Brasileira TI5000 TI5000 2A76R-TI5000 2A76RTI5000 ti5000

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File Info : application/pdf, 1 Pages, 137.71KB

Document DEVICE REPORTGetApplicationAttachment.html?id=6088882
TCB Authority to Act as Agent

Number:

MS-0045317

Revision:

0

Effective date: Oct 8, 2021

The following is a sample Agency Request letter, which needs to be completed on company letterhead, signed by an authorized Applicant/Agent, and submitted to TÜV Rheinland.
Authority to Act as Agent Date: __2022-08-10____________

TUV Rheinland of North America, Inc. 1279 Quarry Lane., Suite. A Pleasanton, CA 94566

To Whom It May Concern:

I appoint TUV Rheinland (Shenzhen) Co., Ltd. to act as our agent in the preparation of this application for equipment certification. I certify that submitted documents properly describe the device or system for which equipment certification is sought. I also certify that each unit manufactured, imported or marketed, as defined in the FCC or Industry Canada's regulations will have affixed to it a label identical to that submitted for approval with this application.

For instances where our authorized agent signs the application for certification on our behalf, I acknowledge that all responsibility for complying with the terms and conditions for Certification, as specified by TUV Rheinland Group, still resides with Intelbras Industria de Telecomunicacao Eletronica Brasileira, Rodovia BR 101 KM 210 Area Industrial Sao Jose Brazil.

For TCB applications, We certify that we are not subject to denial of federal benefits, that includes FCC benefits, pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. 862. Further, no party, as defined in 47 CFR 1.2002 (b), to the application is subject to denial of federal benefits, that includes FCC benefits.

Thank you,

Agency Agreement Date: _2022-08-10_

Agreement is valid for 12 months from the above date.

By:

__________________________ (Signature)

_____Jucelio Valdir Svaldi (Print name)

_________Gerente__________________

_____+554832819927 _

(Title)

(Telephone)

On behalf of:

Intelbras Industria de Telecomunicacao Eletronica Brasileira __ (Company Name)

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