Test Report r4

FCC ID: I88IPC2605N

Test Report

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FCCID_1747475

the wireless lab APPLICATION FOR FCC EQUIPMENT AUTHORIZATION (Form 731) Section: One Applicant’s complete, legal ZyXEL Communications Corporation business name Applicant’s FCC Registration 0021059092 Number (FRN) Need FRN? (y/n) Request for Grantee Code * FCC ID: (Grantee I88IPC2605N 17 characters maximum + Applicant Code) Address line 1 No. 6, Innovation Rd. II, Science Based Industrial Park Address line 2 City Hsin-Chu Zip/ Postal Code 231 State P.O. Box Country Taiwan Phone +886-3-578-3942 First Name Thomas Fax +886-3-578-2439 Middle Name Email sales@zyxel.com Last Name Wei Mail Stop Title Senior Manager * Request for Grantee Code requires completion of Section One. If Applicant does not have FCC Grantee Code, additional costs may apply. Section: Two Instead of Applicant, the original Grant is authorized to be mailed to (All questions regarding the application will be directed to this contact. The original grant and invoice will be sent to this contact.) Technical Contact Company Name Teleconformity Address Rietven 31 City Enschede Zip/ Postal Code 7534NH State Overyssel P.O. Box Country The Netherlands Phone +31 84 8395876 Contact Person Mark Koop Fax +31 84 8362566 mark.koop@ Title Manager Email teleconformity.com Non - Technical Contact Company Name the same as Technical Contact Address City Zip/ Postal Code State P.O. Box Country Phone Contact Person Fax Title Email Section: Three Does this application include a request for confidentiality for any portion(s) of the data Yes No contained in this application pursuant to 47 CFR § 0.459 of the Commission Rules? Does this application include a request for Short Term Confidentiality (STC)? Yes No Is this application for Software Defined Radio (SDR) authorization? Yes No Is there a PBA associated with this Application? Please specify KDB number: Yes No Does the applicant request a defered Grant Date? If so, specify date when Grant should be issued (MM/DD/YYYY): Yes No MiCOM Labs, 440 Boulder Court, Suite 200, Pleasanton, CA 94566 Tel: +1 (925) 462-0304, Fax: +1 (925) 462-0306, Web: www.micomlabs.com Page 1 of 2 Doc#: MC_F_731 (Rev 3.3)

the wireless lab Is this a Modular or Limited Modular Certification? Yes No Modular Type: (please complete if you answered “Yes“ above) Single Modular Approval Limited Single Modular Approval Split Modular Approval Split Limited Modular Approval Description of product as it is marketed IP Camera (note: this text will appear below the equipment class on the grant) Application for Original equipment Change in identification of presently authorized equipment: Original FCC ID: Original Grant Date (MM/DD/YYYY): Class II permissive change or modification of presently authorized equipment Class III permissive change to software defined radio Note: this may only be filed for applications pertaining to Software Defined Radio Equipment Specifications The equipment will be operated under FCC Rule Part(s) 15.247 Frequency range in MHz Rated RF Frequency tolerance Emission Designator FCC Equipment Code power output (%, Hz, ppm) (NOT applicable to any (example: DTS, DSS, PCE, IN WATTS Part 15 devices) JBP, etc) 2412 2462 0.0117 DTS 2422 2452 0.0071 DTS NOTE: If additional Equipment Specifications required, please use separate page Is the equipment in this application? (a) a composite device subject to an additional equipment authorization? Yes No (b) part of a system that operates with, or is marketed with, another device that requires Yes No an equipment authorization? If either of the above questions is answered “Yes” please complete the following statement (c) The related application checked above is (Check one box only) has been granted under the FCC ID listed to the right FCC ID: is in the process of being filed under the FCC ID listed to the right is pending with the FCC under the FCC ID listed to the right MiCOM Labs, 440 Boulder Court, Suite 200, Pleasanton, CA 94566 Tel: +1 (925) 462-0304, Fax: +1 (925) 462-0306, Web: www.micomlabs.com Page 2 of 2 Doc#: MC_F_731 (Rev 3.3)

the wireless lab Section: Four Name of Test Firm and contact person on file with the FCC, if different from applicant or contact person Company name Cerpass Technology Corporation Address No.3, 2F-11, YuanQu St. City Taipei City Zip Postal Code 115 State P.O. Box Country Taiwan Phone +886 226558100 5205 Contact Person Sophia Lin Fax +886 226558200 Email sophial@cerpass.com.tw FCC Registered Test Site Number (required for part 15 and 18 applications) 488071 Read each certification carefully before answering and signing this application WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1)), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503). SECTION 5301 (ANTI-DRUG ABUSE) CERTIFICATION: The applicant must certify that neither the applicant nor any party to the application is subject to a denial of Federal benefits, that include 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 47 CFR 1.2002(b) for the definition of a “party” for these purposes Does the applicant or authorized agent so certify? Yes No APPLICANT/AGENT CERTIFICATION: I certify that I am authorized to sign this application. 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 MiCOM Labs Certification as a result of the representations made in this application, the applicant is responsible for (1) labeling the equipment with the exact FCC ID specified in this application, (2) compliance statement labeling pursuant to the applicable rules, and (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 FCC’s technical requirements. Authorizing an agent to sign this application is done solely at the applicant’s discretion; however, the applicant remains responsible for all statements in this application. If an agent has signed this application on behalf of the applicant, a written letter of authorization which includes information to enable the agent to respond to the above Section 5301 (Anti-Drug Abuse) Certification statement has been provided by the applicant. It is understood that the letter of authorization must be submitted to MiCOM Labs Certification or the FCC upon request, and that MiCOM Labs Certification or FCC reserves the right to contact the applicant directly at any time. Original written signature of Date 2012-07-06 authorized signer (Month, Day, Year) Typed/printed name of Mark Koop Title of Manager authorized signer authorized signer Complete items below if an agent signs the application Firm name Teleconformity Address Rietven 31 City Enschede Zip/ Postal Code 7534NH State Overyssel P.O. Box Country The Netherlands Phone +31 84 8395876 Contact Person Mark Koop Fax +31 84 8362566 mark.koop@ Title Manager Email teleconformity.com MiCOM Labs, 440 Boulder Court, Suite 200, Pleasanton, CA 94566 Tel: +1 (925) 462-0304, Fax: +1 (925) 462-0306, Web: www.micomlabs.com Page 3 of 2 Doc#: MC_F_731 (Rev 3.3)


Document Created: 2012-07-19 11:49:36
Document Modified: 2012-07-19 11:49:36
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