申请表格下载.docx

申请编号：OIMLCN20000X OIML Issuing Authority, China Application No.：OIMLCN20000X OIML 证书申请表 Application Form of OIML Certificate 1、申请单位信息 Applicant’s information 申请单位名称 Applicant 国家/经济体 邮箱 Economy Email 地址 Address 电话 邮政编码 Tel. Postcode 联系人 负责人 Contact person Responsible person 制造商与申请单位是否相同？/Is applicant the same as manufacturer? ☐是/Yes ☐ 否/No 如不同，请填写 2 中信息./If no, please fill in the blanks in section 2. 2、制造商信息 Manufacturer’s information 制造商 Manufacturer 国家/经济体 联系人 电话 Economy Contact Tel. person 地址 Address 3、产品信息 Information of instrument 仪器类型 Instrument category 仪器名称 Instrument name NIM-OIML-YW-01-A2 申请编号：OIMLCN20000X OIML Issuing Authority, China Application No.：OIMLCN20000X 型号/技术规格 Type/Specification s 4、技术文件 Technical documentation ☐产品说明书 Operating/Instruction manual, including a description of the adjustment (calibration) procedure ☐产品照片 Photographs of the instrument ☐生产标准 Production standard ☐检测标准 Testing standards/procedures ☐ 机 械 图 （ 包 括 爆 炸 图 ， 如 适 用 ） Mechanical diagrams (exploded views of all types, if applicable) ☐主要零部件清单 List of main components ☐铅封位置图片及铅封形式 Sealing/securing information, including a drawing with the locations where and description how the instrument can be secured against dismantling and adjustment by the user ☐铭牌图片 Diagrams showing the markings on the individual instruments ☐相关试验报告 Relevant test reports ☐软件流程图 Block diagram of the software ☐电路原理图 Drawings of electric circuit ☐PCB 电路布线图 PCB drawings 5、其他信息 Other information 相关模块是否获得其他 OIML 证书及报 ☐ 有/Yes ☐ 无/No 告 Any OIML Certificate, Type Evaluation Report or Test Report 如有，请提供详细资料 obtained for the relevant module(s) If yes, please provide details 6、填表说明 Instruction for the application form NIM-OIML-YW-01-A2 申请编号：OIMLCN20000X OIML Issuing Authority, China Application No.：OIMLCN20000X 1. 请用英文填写此表。Please complete this form in English; 2. 请为每个器具或模块单独填写申请表; Please use a single application form for each instrument or module category. 3. 若申请人与制造商不同，需提交相关授权文件，以证明申请人已获得制造商授权； Documents, e.g. power of attorney or authorization letter, must be provided to indicate that the applicant has been authorized by the manufacturer when the applicant is different from the manufacturer. 4. 申请表和技术文件及其他信息应一式两份分别提交给发证机构和 OIML 指定实验室。 Application Form, relevant technical documents and other information shall be submitted, in duplicate, to both the Issuing Authority and designated Test Laboratory; 5. 请将此申请发送至中国 OIML 证书发证机构/中国计量科学研究院，邮箱: oimlia@nim.ac.cn; Please submit the electronic application documents to OIML Issuing Authority, China, i.e., National Institute of Metrology by email: oimlia@nim.ac.cn 6. 您可以通过纸质或 Email 的方式寄送该申请表格。如果您使用 Email 的方式寄送，则应将 此包含手写签字的表格以扫描电子版的形式发送给发证机构。 Application Form can be submitted in paper or electronically. If submitting by email, a scan version of this form with original signature must be included. 作为申请人，我（们）在此同意发证机构的相关条款和后附认证协议。 As the applicant, I (we) hereby agree to the relevant terms and conditions of Issuing Authority, China and the Certification Agreement attached. 申请人签字/单位盖章： Signature/Stamp(on behalf of the applicant): NIM-OIML-YW-01-A2