RF_160, Issue 04 Rex Kao (1) Worldwide Testing Services (Taiwan) Co., Ltd. 6F., No. 58, Lane 188, Ruey Kuang Road, Neihu District, Taipei 114, Taiwan CLIMAX TECHNOLOGY CO., LTD. No. 258, Sinhu 2nd Rd., Neihu District, Taipei City 114, Taiwan ( R.O.C.) CLIMAX TECHNOLOGY CO., LTD. Declaration of Authorization We Name:
Address:
City:
Country:
Declare that:
Name Representative of agent:
Agent Company name:
Address:
City:
Country is authorized to apply for Certification of the following product(s):
Product description: Panic Button Type designation: PBx-xxxxx-xxxxx Series (x=0~9, A~Z or blank) Trademark:
Validity/ expiry date on our behalf. Date:
City:
Name:
Function:
Signature:
Notes:
(1): Required for FCC application
(2): For FCC it must be the Grantee Code owner or the authorized agent. Hardware Engineer George Lin (2) 2019-12-30 Taipei NA