Covered list attestation FCC application letter Kiwa RF_755_02 Page 1 of 2 15-02-2023
[PLACE COMPANY LOGO HERE OR PUT ON COMPANY LETTERHEAD]
Certification Application Attestation Statements Instant Care, Inc. 2080 Wineridge PL. Suite A Escondido, CA 92029 United States Subject: FCC ID: <XO8-900ZTX>
To Whom It May Concern:
Statement for 47 CFR section 2.911(d)(5)(i)
[Instant Care, Inc.] certifies that as of the date of the application the equipment for which authorization is sought is not covered equipment1 prohibited from receiving an equipment authorization pursuant to section 2.903 of the FCC rules. If the equipment for which the applicant seeks authorization is produced by any of the entities identified on the current Covered List, including affiliates or subsidiaries of the named companies, the applicant must include an explanation on why the equipment is not covered equipment. Additional Explanation: <N/A>
Statement for 47 CFR section 2.911(d)(5)(ii)
[Instant Care, Inc.] (the applicant) certifies that, as of the date of the filing of this application, the applicant
- is /
- is not (3) identified on the Covered List as an entity producing covered equipment. Date:
City:
Name(2) :
Function:
Telephone number:
Email address:
3/2/2023 Escondido Richard Darling CEO
(877) 424-4050 rich@myinstantcare.com Signature:
Revision Record Sheet:
1 - The Commissions Covered List is published by the Public Safety and Homeland Security Bureau and posted on the Commissions website. This Covered List, which is periodically updated, identifies particular equipment, produced by particular entities, that constitutes covered equipment. https://www.fcc.gov/supplychain/coveredlist .
(2): For FCC it must be the Grantee Code owner or the authorized agent.
(3): double click on the appropriate box and select checked then OK Covered list attestation FCC application letter Kiwa RF_755_02 Page 2 of 2 15-02-2023
[PLACE COMPANY LOGO HERE OR PUT ON COMPANY LETTERHEAD]
Revision Section Page Date Remark(s) number number 07-02-2023 1st version issued by RvM 01 02 1 15-02-2023 Changed Applicant to Company RvdM and added Subject: FCC ID:
Issued/modified by Function Revision Date
: Richard van de Meer
: Certification assessor
: 02
: 15-02-2023 Verified by Function Date
: Willem Jan Jong
: Team Lead
: 16-02-2023 Released by Function Date of release:
: Axel Gase
: Manager Quality Assurance
: __-02-2023