FCC ID: A3LEPP4300 WIRELESS CHARGER

Label Information C2 3-R1.0 WIRELESS CHARGER MODEL : EP-P4300 INPUT : 9.0 V 1.67 A FCC ID : A3LEPP4300 IC : 649E-EPP4300 S/N :

This device complies with part 15 of the FCC Rules. Operation is subject to the following two conditions:(1) This device may not cause harmful interference, and

(2) this device must accept any interference received, including interference that may cause undesired operation. 0

. 4 2 MADE IN VIETNAM / FABRIQU AU VIETNAM 36.0

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S/N: 14 3

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19 Chapin Rd., Building D Pine Brook, New Jersey, 07058, United States 11 December 2020 FederalCommunicationsCommission AuthorizationandEvaluationDivision 7435OaklandMillsRoad, Columbia,MD21046 LETTERFORAUTHORIZATION FCC ID: A3LEPP4300 Towhomitmayconcern:

I,theundersigned,herebyauthorizeLabManagerHyunchae, You andofSGSKoreaCo.,Ltd.and hereafterreferredtoasSGSKorea,toactonourbehalfinallmannersrelatingtoapplicationfor equipmentauthorization,includingsigningofalldocumentsrelating tothesematters.AnyandallactscarriedoutbyLabManagerHyunchae, Youof SGSKoreaCo., Ltd.onourbehalfshallhavethesameeffectasactsofourown. I, the undersigned, hereby certify that we are not subject to a denial of federal benefits, that includesFCCbenefits,pursuanttoSection5301oftheAntiDrugAbuseActof1988,21U.S.C. 853(a). InauthorizingSGSKoreaasouragent,westillrecognizethatweareresponsibleto:

a) complywiththerelevantprovisionsofthecertificationprogram;

b) makeallnecessaryarrangementsfortheconductoftheevaluation,includingprovision forexaminingdocumentationandaccesstoallareas,records(includinginternalaudit reports) and personnel for the purposes of evaluation (e.g. testing, inspection, assessment,surveillance,reassessment)andresolutionofcomplaints;

c) makeclaimsregardingcertificationonlyinrespectofthescopeforwhichcertification hasbeengranted;

d) do not use our product certification in such a manner as to bring the Certification Divisionintodisreputeandnotmakeanystatementregardingourproductcertification whichtheCertificationDivisionmayconsidermisleadingorunauthorized;

e) upon suspension or cancellation of certification, discontinue use of all advertising matter that contains any referencethereto and returnanycertification documents as requiredbytheCertificationDivision;

f) usecertificationonlytoindicatetheproductsarecertifiedasbeinginconformitywith specifiedstandards;

g) endeavor to ensure that no certificate or report nor any part thereof is used in a misleadingmanner;

h) ensurethatanyreferencetoourproductcertificationincommunicationmediasuchas documents, brochures or advertising, complies with the requirements of the CertificationDivision;

19 Chapin Rd., Building D Pine Brook, New Jersey, 07058, United States i) j) keep a record of all complaints made known to the us relating to the products compliance with requirements of the relevant standard and to make these records availabletotheCertificationDivisionwhenrequested;

takeappropriateactionwithrespecttosuchcomplaintsandanydeficienciesfoundin productsorservicesthataffectcompliancewiththerequirementsforcertification;

k) documenttheactionstaken. Thisauthorizationisvaliduntilfurtherwrittennoticefromtheapplicant. SincerelyYours Jenni Chun /GeneralManager Samsung ElectronicsNorth America INC. TEL: +1-973-808-6362 E-mail: j1.chun@samsung.com

SGS North America Inc. 620 Old Peachtree Road SUITE 100 Suwanee, Georgia 30024 United States Applicant Declaration Applicant Legal Business Name Samsung Electronics Co., Ltd. 19 Chapin Rd., Building D, Pine Brook, New Jersey, 07058 Address Grantee Code FCC ID Contact Email Contact Phone Authorized Contact Name A3L A3LEPP4300 Jenni Chun j1.chun@samsung.com 973-808-6375 I, the undersigned, certify that I am an authorized signatory for the Applicant and therefore declare;

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. 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:

labeling the equipment with the exact FCC ID as specified in this application,

(1)

(2) compliance statement labeling pursuant to the applicable rules,

(3) compliance of the equipment with the applicable technical rules, if the Applicant is not the actual manufacturer of the equipment, appropriate arrangements have been made with the manufacturer to ensure that production units of this equipment will continue to comply with the FCCs technical requirements. in accordance with 47 CFR 2.909 and KDB394321, the Applicant has read, understood and agrees to accept that they are the responsible party and agree to abide by their responsibilities as specified under 47 CFR 2.909 and KDB394321. in accordance with ISO17065, 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)

(2)

(3) the Applicant understands, accepts and agrees that a sample may be requested for surveillance testing. the Applicant shall make provisions to always have a production sample available upon request by SGS, FCC and/or ISED. the Applicant shall, upon request by SGS, at the Applicants expense, provide a production sample of the requested product to SGS, FCC and/or ISED as instructed. The sample shall include all support devices, cables, software, accessories or other hardware or software required for evaluation, review, certification and audit surveillance of products certified by SGS. neither the Applicant nor any party to the application is subject to a denial of Federal benefits, that includes FCC benefits, pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. 862 because of a conviction for possession or distribution of a controlled substance. See 47CFR 1.2002(b) for the definition of a party for these purposes. the Applicant has read, understood, accepts and agrees to abide by the SGS North America, Inc.(TCB) terms and conditions. Link to CFRs: https://www.fcc.gov/wireless/bureau-divisions/technologies-systems-and-innovation-division/rules-regulations-title-47 Link to KDBs: https://apps.fcc.gov/oetcf/kdb/index.cfm Link to RSP-100: https://www.ic.gc.ca/eic/site/smt-gst.nsf/eng/sf01130.html Applicant Signature:

Date: December 11, 2020 Print Name:

Title:

*NOTE: This declaration cannot be signed by an Agent, it shall be signed by an authorized person listed in the FCC database Jenni Chun General Manager a) b) c) d) e) f) g) Applicant Declaration Rev:0.0

19 Chapin Rd., Building D Pine Brook, New Jersey, 07058, United States 11 December 2020 FederalCommunicationsCommission AuthorizationandEvaluationDivision 7435OaklandMillsRoad, Columbia,MD21046 REQUEST FORCONFIDENTIALITY FCC ID: A3LEPP4300 ToWhomItMayConcern:

PursuanttoSections0.457and0.459oftheCommissionsRules(CFR47),andSection552(b)(4) of the Freedom of Information Act, Samsung Electronics Co., Ltd. hereby requests confidentiality and treatment of certain information accompanying this application. The materials contain trade secrets and proprietary information not customarily released to the public.ThepublicdisclosureofthesemattersmightbeharmfultotheApplicantand provideunjustifiedbenefitstoitscompetitors. WearealsoherebyrequestShortTermConfidentialityfor180daysafterthegrantasoutlined in Public Notice DA 041705. This provision will give Samsung Electronics Co., Ltd temporary confidentiality of commercially sensitive information prior to product release. The requested PermanentandTemporaryConfidentialexhibitsarelistedasfollows:

CONFIDENTIALLIST 1 BlockDiagram Permanent 2 OperationalDescriptions ShortTerm 3 4 5 6 Schematics ExternalPhotos InternalPhotos TestSetupPhotos 7 UserManual TheApplicantunderstandsthatpursuanttoRule0.457,disclosureofthisapplicationandall accompanyingdocumentations,whereapplicable,willnotbemadepublicbeforethedateof theGrantforthisapplication. SincerelyYours, Jenni Chun /GeneralManager Samsung ElectronicsNorth America INC. TEL: +1-973-808-6362 E-mail: j1.chun@samsung.com

(Signature1) sbtilen Technical Manager On behalf of: SGS Korea Co. Ltd. (Company Name) Telephone: +82-31-428-0903 FCC ID: A3LEPP4300 Gentlemen:

Theres a EP-P4300 that would like to have your authorization as an Inductive wireless power transfer applications approval. The specific product as below, EP-P4300, with its designed features and specified description, considers special requirements for KDB 680106 DO1 v03 section 5, b) requirements. Company:

WIRELESS CHARGER Shae LO) A3LEPP4300 Product Name:

Model Number:

FCC ID:

KDB 680106 D01 v03 Section 5, b) Requirements:

(1) Power transfer frequency is less that 1 MHz

(2) Output power from each primary coil is less than or equal 15 watts.

(3) The transfer system includes only single primary and secondary coils. This includes charging systems that may have multiple primary coils and clients that are able to detect and allow coupling only between individual pairs of coils

(4) Client device is placed directly in contact with the transmitter

(5) Mobile exposure conditions only (portable exposure conditions are not covered by this exclusion).

(6) The aggregate H-field strengths at 15 cm surrounding the device and 20 cm above the top surface from all simultaneous transmitting coils are demonstrated to be less than 50% of the MPE limit. e Silat NA she Samsung Electronics Co., Ltd. Date: 09 Dec, 2020 Product Technical Specification:

0.126 2 ~ 0.129 2 MHz 0.144.5 ~ 0.147.5 MHz 2 W, 4.5 W, 7.5 W,9 W. The transfer system including a charging system with multiple primary coils are to detect and allow only between individual pairs of coils. Client device is placed directly in orem ALM NI Cm NECTeRSONUUEKS Mobile conditions only H-Field: 0.222 A/m (at 15 cm)

< 0.815 A/m (50% of the limit) Hyunchae You

(Print name) Result:

Complied Complied Complied Complied Complied Complied Cover Letter-Wireless Charger Approval