PROJECT NO.
7
Certelecom Debbie Bedard
Attestation statement
Modular Medical, Inc. 23MODD1-1 Insulin pump patch 2BDWN23MODD1-1 2BDWN23MODD11 23modd1 1
Not Your Device? Search For Manuals or Datasheets below:
File Info : application/pdf, 2 Pages, 278.79KB
Document DEVICE REPORTGetApplicationAttachment.html?id=7119697December 4, 2023
U.S. Agent Designation for Service of Process Certification Attestation Letter
Nemko North America, Inc. 303 River Road Ottawa K1V 1H2 Canada
ATTN.: Reviewing Engineer
FCC ID: 2BDWN23MODD1-1 Applicant FRN: 0034519496
Per section §2.911(d)(7) of the FCC rules, Modular Medical, Inc. ("the applicant") certifies that the equipment for which authorization is sought is designated to the following U.S. Designated agent* for service of process:
Company Name: Physical U.S. Company Address: Agent Name: Agent Email Address: Agent FRN**:
Modular Medical, Inc. 10740 Thornmint Road, San Diego, CA 92127 Paul DiPerna [email protected] 0034519496
The above contact person accepts the obligation for service of process.
The applicant accepts its obligation to maintain an agent for service of process in the United States for no less than one year after either the grantee has permanently terminated all marketing and importation of the applicable equipment within the U.S., or the conclusion of any Commission-related administrative or judicial proceeding involving the equipment, whichever is later.
Applicant Signed:
Designated Agent Signed:
(Required, if different to Applicant):
Signed: Paul DiPerna (Dec 4, 2023 17:48 PST)
Printed name:
Paul DiPerna
Title:
President
Company Name: Modular Medical, Inc.
Date:
December 4, 2023
Signed: Printed name: Title: Company Name: Date:
Click here to enter text. Click here to enter text. Click here to enter text. Click here to enter a date.
* the applicant must designate a contact located in the United States for purposes of acting as the applicant's agent for service of process, regardless of whether the applicant is a domestic or foreign entity. An applicant located in the United States may designate itself as the agent for service of process.
** the agent does not have an FRN because they do no other business with the FCC except for acting as a US agent for service of process, and therefore are not required to have their own FRN.
10740 Thornmint Road, San Diego, CA 92127 - modular-medical.com
FCC U.S. Agent Designation Attestation MODD
Final Audit Report
2023-12-05
Created: By: Status: Transaction ID:
2023-12-04 Tracey Manson ([email protected]) Signed CBJCHBCAABAA89FbjLjctR3Qs_muMQKdxiKv5vjhUiYQ
"FCC U.S. Agent Designation Attestation MODD" History
Document created by Tracey Manson ([email protected])
2023-12-04 - 11:48:59 PM GMT- IP address: 76.199.110.25
Document emailed to Paul DiPerna ([email protected]) for signature
2023-12-04 - 11:50:13 PM GMT
Email viewed by Paul DiPerna ([email protected])
2023-12-05 - 1:48:01 AM GMT- IP address: 76.199.110.25
Document e-signed by Paul DiPerna ([email protected])
Signature Date: 2023-12-05 - 1:48:10 AM GMT - Time Source: server- IP address: 76.199.110.25
Agreement completed.
2023-12-05 - 1:48:10 AM GMT
Related FCC IDs:
- 2BDWN23MODD1-1 - Modular Medical, Inc. Insulin pump patch [23MODD1-1] Debbie Bedard Acrobat Sign