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SUCOFINDO INTERNATIONAL CERTIFICATION SERVICES

SUCOFINDO

SUCOFINDO INTERNATIONALCERTIFICATION SERVICESa Strategic Business Unit of PT. SUCOFINDO (PERSERO

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SUCOFINDO INTERNATIONAL CERTIFICATION SERVICES

Application forProduct Certication

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SUCOFINDO INTERNATIONAL CERTIFICATION SERVICES

APPLICATION FOR PRODUCT CERTIFICATION

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APPLICANT INFORMATION

Na0e of Organi6ation 1

A//ress 1

P*one 7 Fa8 No. 1 e0ai- 1

Status (I0,orter9 Re,resentati&e9 Agent9 etc 1

C*ief E8ecuti&e1

!anage0ent Re,resentati&e 1

FACTORY :

Na0e of Organi6ation 1

A//ress 1

P*one 7 Fa8 No. 1 e0ai- 1

C*ief E8ecuti&e1

!anage0ent Re,resentati&e 1

Nu0:er of E0,-oees1

Esti0ate/ 0ont*- out,ut of ,ro/uct to :e certifie/ (;uantit1

No. of s*ifts ,er /a1

Co0,an Docu0ents (A,,-icant an/ Factor 1P-ease attac* t*e fo--o+ing /ocu0ents 1

i. Co0,an Lega- Registration (A

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SUCOFINDO INTERNATIONAL CERTIFICATION SERVICES

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QUALITY CONTROL / QUALITY SYSTEM INFORMATION

Certifications (;ua-it9 en&iron0ent9 ,ro/uct9 @SE etc current- *e-/ 1P-ease attac* co, of certificateNo Certificate Certificate No. Cert. Bo/ Va-i/ Date%.

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Infor0ation on t*e ua-it Contro-?ua-it Sste0 Detai-s9Please briefly describe the quality control (quality system) applied

Su:contracte/ Process 1

P-ease attac* 1i. Co0,an organi6ation c*artii. List of Co0,onents an/ 0ateria-siii. Process F-o+c*arti&. ua-it Contro- C*ec

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SUCOFINDO INTERNATIONAL CERTIFICATION SERVICES

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.Pro/uct Test Re,ort Detai-s (if a&ai-a:-e(Please attach copy of test report)

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SUCOFINDO INTERNATIONAL CERTIFICATION SERVICES

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SUCOFINDO INTERNATIONAL CERTIFICATION SERVICES

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SUCOFINDO INTERNATIONAL CERTIFICATION SERVICES

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SUCOFINDO INTERNATIONAL CERTIFICATION SERVICES

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