Electrical Product Safety Certification Scheme (EPSCS)

Section 376 Section Technical standards & 407 Section Labelling Requirements of Telecommunication Act 1997

Please complete and confirm details below to appear in the ACMA CB Statement and the CBA Telecom Certificate of Compliance

• 1. Submission of an application and payment does not require the certification body to issue a certificate that the customer equipment or customer cabling complies with the standards where it does not in the opinion of the certification body.
• 2. The maximum processing time for a complete application is 20 working days subject to carrier clearance (if applicable).
• 3. The applicant may request a stop of work on the application at any time. In this case, the application will be returned but the payment will be retained.

I hereby declare that:

• (a) The contents of this application and any enclosures are true and correct; and
• (b) I have the authority to sign this application on behalf of the applicant.
• (c) That I did not apply this device for approval with other ACMA Certification Body

Each article described above complies with the standards nominated.

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.

Any modification to components, construction or design of the article will be notified to Certification Body Australia.

I agree and comply with the obligations set out in the CBA Terms and Condition for certification services.