Application Forms

IECEE CB Scheme

Please send the application documents either by e-mail, fax or post to the testing center/laboratory at which you wish to make the application. (In case of post, test sample(s) can be enclosed with the documents.)
Please read the "Terms of Agreement for Applications regarding Testing and Certification Services" before proceeding with your application.

Terms of Agreement

List of Required Forms
All Download	Separate Download * Please use this column when the format(s) is/are separately needed.	New	Modification
Application Forms (01-06) (PDF: 1.6MB)	01 [Application Form 1/2] JQA Application for Testing/Certification Services (PDF: 489KB) * In case of more than one service at the same time (such as the simultaneous application for CB Certification and Application agency service), please provide us with only one sheet (1st page) of the application form. * Please include the signature or the seal of Applicant's responsible person.	Requisite	Requisite
	02 [Application Form 2/2] IECEE CB Scheme (PDF: 373KB)	Requisite	Requisite
	03 Shipping Address List (PDF: 270KB) * If this list is not provided or is kept blank, this item will be sent for the attention of the contact person noted in the application form.	When necessary	When necessary
	04 Manufacturing Factory List (PDF: 199KB)	Requisite	Requisite
	05 Application for CB Test Certificate (PDF: 773KB)	Requisite	Requisite
	06 List of Critical Components (PDF: 275KB)	Requisite	For additions, amendments
07 Power of Attorney (PDF: 777KB) * If the applicant and the contact person belong to different entities each other, please provide us this document.		When necessary	When necessary
Documentation to be prepared by the Applicant
Declaration (Word: 14KB) * According to the stipulation of para.4.2.5 IECEE02, which is a guideline of CB Scheme, it is necessary to specify all the names and addresses of all the manufacturing factories in the CB Certificate. In addition, it is necessary for the applicant to submit the declaration assuring that the products at all the manufacturing factories are identical/equivalent to each other. The client relevant to this matter are required to send us this declaration. (If there is any difference in aspect of safety and/or complying with applicable standard(s), please describe the details, such as the differences between the models, destinations of the product.)		For additions, amendments	For additions, amendments
User manual		Requisite	When necessary
Circuit diagram(s)		Requisite	For additions, amendments

Note on Electronic Application Registration

By registering under the Electronic Application system, you can omit the signature/seal from the next application.

If you wish the registration, please fill out the "Electronic Application Registration Form" and send it to any JQA's Center or Laboratory where you apply, by PDF e-mail. (Original paper form is not required)

Electronic Application Registration

Contact

Safety & EMC Center (Tokyo)
4-4-4, Minamiosawa, Hachioji-shi, Tokyo 192-0364, Japan
TEL : +81 (0)42-679-0246 / FAX : +81 (0)42-679-0170
E-mail : jtp-safety-cstm@jqa.jp
TSURU EMC Branch
2096, Ohata, Tsuru-shi, Yamanashi 402-0045, Japan
TEL : +81 (0)554-43-5517/ FAX : +81 (0)554-43-6316
SHIKATSU Branch (Aichi)
53-1, Yamaura, Yakushiji, Kitanagoya-shi, Aichi 481-0005, Japan
TEL : +81 (0)568-23-0023 / FAX : +81 (0)568-23-0116
E-mail : shikatsu-emc-cstm@jqa.jp
KITA-KANSAI Testing Center (Osaka)
1-7-7, Ishimaru, Minoh-shi, Osaka 562-0027, Japan
TEL : +81 (0)72-729-2244 / FAX : +81 (0)72-728-6848
E-mail : kita-customers@jqa.jp
SAITO EMC Branch
7-3-10, Saito-asagi, Ibaraki-shi, Osaka 567-0085, Japan
TEL : +81 (0)72-640-5270 / FAX : +81 (0)72-640-5271

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