Agent Details (if applicable) - please submit Agent’s Authorisation:

I hereby declare: - that each article described above complies with the standards nominated, - that each article of the description specified above for which approval is hereby sought, is identical to the electrical article being the subject of the test reports attached, - that any modification to components, construction or design of the article will be notified to Certification Body Australia, and - that I agree and comply with the obligations set out in the CBA Terms and Condition for certification services. - that Iauthorise Certification Body Australia to use the information provided in this application for registration or updating of the National Electrical Equipment Certification and Registration Database in Electrical Equipment Safety System (EESS), as according to the EESS Scheme Rules or as per the Regulatory Authority requested.