Payment

FCC ID: TX2RTU7305BG13HMC

Cover Letter(s)

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FCCID_1117841

FCC:Success:Form 159 - PRINTABLE VERSION 第 1 頁，共 1 頁 Remittance ID:1600205 Authorization Number:094046 Successful Authorization -- Date Paid: 6/1/09 FILE COPY ONLY!! READ INSTRUCTIONS FEDERAL COMMUNICATIONS COMMISSION APPROVED BY OMB CAREFULLY BEFORE REMITTANCE ADVICE 3060-059 PROCEEDING FORM 159 PAGE NO 1 OF 1 SPECIAL USE (1) LOCKBOX #979095 FCC USE ONLY SECTION A - Payer Information (2) PAYER NAME (if paying by credit card, enter name exactly as it appears on your card) (3) TOTAL AMOUNT PAID (dollars and cents) $235.00 Bureau Veritas Consumer Products Services (Hong Kong) L (4) STREET ADDRESS LINE NO. 1 No.19, Haw Ya 2nd Road (5) STREET ADDRESS LINE NO. 2 Kueishan, Taoyuan (6) CITY (7) STATE (8) ZIP CODE 333 (9) DAYTIME TELEPHONE NUMBER (INCLUDING AREA CODE) (10) COUNTRY CODE (IF NOT IN U.S.A.) 88633183232 TW FCC REGISTRATION NUMBER (FRN) AND TAX IDENTIFICATION NUMBER (TIN) REQUIRED (11) PAYER (FRN) (12) FCC USE ONLY 0017827122 IF PAYER NAME AND THE APPLICANT NAME ARE DIFFERENT, COMPLETE SECTION B IF MORE THAN ONE APPLICANT, USE CONTINUATION SHEETS (FORM 159-C) (13) APPLICANT NAME Realtek Semiconductor Corp. (14) STREET ADDRESS LINE NO. 1 No. 2, Innovation Road II, Hsinchu Science Park, (15) STREET ADDRESS LINE NO. 2 (16) CITY (17) STATE (18) ZIP CODE Hsinchu 300 (19) DAYTIME TELEPHONE NUMBER (INCLUDING AREA CODE) (20) COUNTRY CODE (IF NOT IN U.S.A.) 886-3-5780211 TW FCC REGISTRATION NUMBER (FRN) AND TAX IDENTIFICATION NUMBER (TIN) REQUIRED (21) APPLICANT (FRN) (22) FCC USE ONLY 0014512230 COMPLETE SECTION C FOR EACH SERVICE, IF MORE BOXES ARE NEEDED, USE CONTINUATION SHEET (23A) FCC Call Sign/Other ID (24A) Payment Type Code(PTC) (25A) Quantity EAC 1 (26A) Fee Due for (PTC) (27A) Total Fee FCC Use Only $60.00 $60.00 (28A) FCC CODE 1 (29A) FCC CODE 2 TX2RTU7305BG13H 13EA447640 (23B) FCC Call Sign/Other ID (24B) Payment Type Code(PTC) (25B) Quantity EBC 1 (26B) Fee Due for (PTC) (27B) Total Fee FCC Use Only $175.00 $175.00 (28B) FCC CODE 1 (29B) FCC CODE 2 TX2RTU7305BG13H 13EA447640 https://fjallfoss.fcc.gov/ElectronicForm159/success_159_html/printed159_success.cfm 2009/6/1

Electronic Form 159 第 1 頁，共 1 頁 Electronic Form 159 Payment Confirmation Your transaction has been approved. For your records, please note the following: REMITTANCE ID NUMBER : 1600205 AUTHORIZATION NUMBER : 094046 AMOUNT PAID : $235.00 Customer Service FCC Fees Web Policies / Privacy Policy FCC Home Page If you have any questions or concerns please contact your licensing system help desk. https://fjallfoss.fcc.gov/ElectronicForm159/E159/success.cfm?RemittanceID=1600205&matchremit=23DED01... 2009/6/1

paygovadmin@mail.doc.twa 收件人 "rennie@adt.com.tw" <rennie@adt.com.tw> i.gov 副本抄送 2009/06/01 下午 04:30 副本密送 主旨 Pay.Gov Payment Confirmation THIS IS AN AUTOMATED MESSAGE. PLEASE DO NOT REPLY. Your transaction has been successfully completed. Payment Summary Application Name: Remittance Advice Form 159 Pay.gov Tracking ID: 24VGNCE8 Agency Tracking ID: 1600205 Account Holder Name: Bureau Veritas Consumer Products Services (Hong Kong) L Transaction Type: Sale Billing Address: No.19, Haw Ya 2nd Road City: 333 Country: USA Card Type: Visa Card Number: ************0638 Payment Amount: $235.00 Transaction Date: Jun 1, 2009 4:30:45 AM


Document Created: 2009-06-01 16:37:00
Document Modified: 2009-06-01 16:37:00
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