Application Forms


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.

List of Required Forms
All Download

Separate Download

* Please use this column when the format(s) is/are separately needed.

New Modifi-
Application Forms (01-06) (PDF: 1.1MB)
  • * 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
Requisite Requisite
  • * 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
Requisite Requisite
Requisite Requisite
Requisite For additions, amendments
  • * 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

* 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


  • 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 :
  • 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 :
  • 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 :
  • 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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