SG SGS North America Inc. 620 Old Peachtree Road SUITE 100 Suwanee, United States Georgia 30024 Applicant Declaration Applicant Legal Business Name PAI TECHNOLOGY LIMITED Address Room H, 18/F, Ning Jin Centre. 7 Cheng Yip Street, Kwun Tong, Kowloon, Hong Kong Grantee Code 2APRA FCCID 2APRA83004 Authorized Contact Name Haixin.Zhu Contact Email zhuhaixin@putao.com Contact Phone
+86 021-54679188 I, the undersigned, certify that I am an authorized signatory for the Applicant and therefore declare;
a) in accordance with 47CFR2.911
(d), all of the statements herein and the exhibits attached hereto are true and correct to the best of my knowledge and belief. b) in accepting a Grant of Equipment Authorization issued by a TCB, under the authority of the FCC, as a result of the representations made in this application, the Applicant is responsible for:
(1) labeling
(2) compliance
(3) compliance the equipment statement of the equipment with the exact FCC ID as specified in this application, to the applicable rules, labeling rules, with the applicable technical pursuant c) if the Applicant that production is not the actual units of this equipment manufacturer of the equipment, appropriate arrangements have been made with the manufacturer to ensure will continue to comply with the FCC's technical requirements d) in accordance with 47 CFR 2.909 and KDB394321, the party and agree to abide by their responsibilities as specified under 47 CFR 2.909 and KDB394321. Applicant has read, understood and agrees to accept that they are the responsible e) in accordance with 1S017065, FCC KDB641163, FCC KDB610077, KDB394321 and RSP-100, the Applicant has read, understood, accepts and agrees to abide by the post market surveillance requirements.
(1) the Applicant
(2)the Applicant
(3)the Applicant understands, shall make provisions shall, upon request accepts and agrees that a sample may be requested to always have a production sample available testing. for surveillance by SGS, FCC and/or sample of theequested upon request a production cables, ISED. product to SGS, or other hardware provide devices, or by SGS, at the Applicant's expense, FCC and/or software required ISED as instructed. for evaluation, The sample shall include review, certification and audit surveillance all support software, accessories by SGS. certified of products f) neither the Applicant 5301 of the Anti-Drug 47CFR 1.2002(b) nor any party to the application Abuse Act of 1988, 21 U .S.C. 862 because is subject for the definition of a "pa'forthese purposes to a denial of Federal benefits, that includes of a conviction for possession or distribution FCC benefits, pursuant of a controlled to Section substance. See g) the Applicant has read, understood, accepts and agrees to abide by the SGS North America, lnc.(TCB) terms and condions Link to CF Rs: htt s://www.fcc. Link to KDBs: https://apps.fcc.qov/
Link to RSP-100:
https://www.ic. oetcf/kdb/index.cfm qc.ca/eic/site/smt-
qst.nsf/enq/sf01130.html ov wireless/bureau-divisions/techn I ies-s tems-and-innovation-division/rules-r lations-title-4 7 Applicant Signature:
-,/ , Print Name:
HaiXin Zhu Title:
Certification Manager Date: _.:, j(, f. I
*NOTE: This declaration cannot be signed by an Agent, it shall be signed by an authorized person listed in the FCC database Applicant Declaration Rev:0.0