i LEMBAGA SERTIFIKASI PRODUK RODUCT CERTIFICATION BODY SERTIFIKASI PRODUK PENGGUNAAN TANDA SNI ‘SNI MARKING PRODUCT CERTIFICATION ~ FORMULIR PERMOHONAN SERTIFIKASI PRODUK SPPT SN "APPLICATION FORM OFSNI PRODUCT CERTIFICATION Seluuh ital ana Soran Ee The ifomaton wl be ested as conten DATA KLEEN UNTUK Five DDATA OF APPLICANT (FOR MANUFACTURER) 17 PERANGGONG JAVA PERSON IN CHARGE Nana Kuo Name dant No singhu Roa, Xahus Seo, Husdu Rg, ‘ross Guangzhou PRChina 2: Teleon/ Fax NA PreneFax tome NA Mobile phone runber © Alanna Iakugggec.comen Enal Ades ‘Ware nnara Chinese ‘izenehp 9. atten Geral Manage of Operation Poon "12, Wik Manalomen ‘Management epresentatvOMs coordinator a Name Tery Tang Name > Anat No8 Jinghu Roa, Xinhua Street, Huadu Reg, ‘Adsoss Guangzhou PRChina © TeepenFax ssseosese Prone 4 Note sscosesoe0 Mobie ptone Halaman 1 dari9LEMBAGA SERTIFIKASI PRODUK VKAN |____ PRODUCT CERTIFICATION BODY on Wi (SERTIFIKASI PRODUK PENGGUNAAN TANDA SNI [PES* | _“*" sy MARKING PRODUCT CERTIFICATION | ~FORHULIR PERNOHONAN SERTIFKASI PRODUK SPPT SN "APPLIGATION FORM OFSM PRODUCT CERTIFICATION ,— Alamat emai Ea Aes ter ang@agee.comen 73 Ha ‘Contact Person arent wih clause | 14) tema ane samo % anat ass Nod Ingha Ree, Xue Sree Hund Reg, ‘Guangziou PRChina Tena Prone 4 Not Noble pene samsee@ggeccomen Amat enat al Adee soe satan Peston Mo uses Unt ¢ : ‘_NFORI DDATAOF COMPANY (WANUFACTURER) 2.4 Nama Perusahaan Company Name (Nana vam san trade (Witbe wten in ere) oguang Sete Company Lined ‘22 Kantor Pusat Ofiaeed es 2 Aina Nong Rou, Xn Stee, usd Re, aes Guangahou PRChina Teena Eas Phone ax canzecosea e Ammatenat saecggecomen ral Adess 4. Weta tpn gee coment Fioa Halaman 2 uiLEMBAGA SERTIFIKASI PRODUK PRODUCT CERTIFICATION BODY. d ‘SERTIFIKASI PRODUK PENGGUNAAN TANDA SNI 'SNI MARKING PRODUCT CERTIFICATION ~FORIULIR PERMOHONAN SERTIFIKASI PRODUK SPPT SMI ‘APPLICATION FORM OFSNI PRODUCT CERTIFICATION "ian sean Netra Act (sto evar i hese denesityewom Tara No. NWP ‘Taxpayer nunber (tol be ranted in hess Indonesia sxom “Transat .wuoersve Indust bushes sence (choul eran in hess fone ewom Trarlaty NA tavntotereessesan 8 oence pit 2 Paik FactoryPtant Alana aoe No Jingh Road, Xinhua Steet, Huadu Re, Guangzhou PRChina cn oon gee@agee.comen itv gee omen! ANTORPERWAKILAN DINDONESIA UNTUK PRODUX POR] [REPRESENTATIVE IN NDONESIA (FOR MPORTED PRODUCT ONLY) Wana Pansat ‘Company Kame .Alanat ‘dios Teesonax Phoneax Fide NA Vislaman 3 daiLEMBAGA SERTIFIKASI PRODUK ‘KAN Q PRODUCT CERTIFICATION BODY KAN aan ‘SERTIFIKASI PRODUK PENGGUNAAN TANDA SN ‘SNI MARKING PRODUCT CERTIFICATION FORMULIR PERMGHONAN SERTIFIKASI PRODUK SPPT SN "APPLICATION FORM OFSNI PRODUCT CERTIFICATION © Benabubung ‘Contact person | ar son n company ‘Not, Mie Number 9-Almatemal mal Ages ska Penn pesatean Notary Act 1 Npwe Taxpayer number 4. WwuTDerswe Indust business sence ke NABI Number ofmpate sence (AP) (rs mem ing No. HS ut peu yg (shoul be deta wth HS Nabe ofimpred [produ po TZNFORWASI PRODUK PRODUCT INFORMATION i Faodle Proust ALLURE 42.No.sut SNIND, SSN 04-6253-2003, 43 The Tye | Wireless Speaker | seek oanane rnd (Hrs ses dengan dokunen HA) Harman Kardon Fida Halaman 4 dari9| LEMBAGA SERTIFIKASI PRODUK KAN PRODUCT CERTIFICATION BODY Tarrio ‘SERTIFIKASI PRODUK PENGGUNAAN TANDA SNI 'SNI MARKING PRODUCT CERTIFICATION FORHULIR PERMOHONAN SERTIFICAS PRODUK SPPT SHI a "APPLICATION FORM OFSNI PRODUCT CERTIFICATION (God te aati wih rede brand ene or brand regis eter fo Drie Genera of Intec Proper Minty ew of Repub of inne) i *T5 Sur pepsin mera erage eT mihi Delgaton ter fom brand ome to anata ite bard estan nt _applantpopeies) pig, “6 Sat Peniian ingot Later of inpoter apponiment (forinpoted product) BAHASADAN LOKASI PADRE Languange and Location 51 Bahasa yang gunkan i ngtungan sabe | Chinese Language usodin fat caton 52, Metrzadaa pstromah Yes, eval in English Aalaity of elo (thor in Inconsin or ngs) '58.Jarak (kn) dan okt tempuh (am) da bands | the Guangzhou North Rly Station, 6, 2h stata erdokat the Guangchou Bayun Intemational Arpot, lata on mada anspor’ ving ‘thm. slavnaan Distae (nin) andere hour om sare ithe port or ston (sas deste resportsion used) Vi PROSES PRODUCTION 8 ‘Hans dlameikansiktur omarisaspensahean) | orgnisacionel statue of Ma (tou be tated wih orgeizatin stucre) ‘62, PRODUKSI DAN PENGENDALAN KUALITAS ‘PRODUCTION AND QUALITY CONTROL | Flow Halaman 5 dariLEMBAGA SERTIFIKASI PRODUK ___ PRODUCT CERTIFICATION BODY Teotnen BIE SERTIFIKASI PRODUK PENGGUNAAN TANDA SNI ‘SNI MARKING PRODUCT CERTIFICATION FORMULIR PERMOHONAN SERTIFICASI PRODUK SPPT SWI "APPLICATION FORM OFSNI PRODUCT CERTIFICATION ‘rp rots mesure engendain kala (np mayan penn, i dar ban ingge round en ental eogan ercana engendalan mi dan sas dts) ez Prouctn Process Fowcnantincutng sage of | THOR Reese reste uy ceteris sg, cat | fom rawneterto fetes got ard tell b> | sinister eotuee tact wit cay ian and precincts) _| tet ces 3 DAFTAR PERALATAN INSPEKSI_DAN UI =) LIST OF NSPECTIONTESTING Pe EQUIPMENT isonet bs ‘A PROSES SUBKONTRAR SUBCONTRACT PROCCESS dune proses yng dubtonaltan dam 4) “tl scone preoesfnpocertage) . Namaden alt sutkotaktar Name ard ates funcoace Bases an suo Puss be subronrated (iungitandenan dam roses) (stouldbe acted wih dtl proces aren) = ‘65. LIST OF SUPPLIER kee (Stou be atached wih spproved super) Wohave approved supple is but for confidently requirements, we can ony brovide dng onsteaut VISUNBERDAYA WANUSIA HUMAN RESOURCES. 77. Jani ana | Tota Number of Employees 00 72 Jal aryawan dl basian posi Tota man powerin production os 75S aryavan dbasian pengendalin may “otal man powerin quay contol a 7A Salah aryan selin produ dan etal man power ouside producton an ual contd 0 Fide alaman 6 dari9LEMBAGA SERTIFIKASI PRODUK PRODUCT CERTIFICATION BODY KSI PRODUK PENGGU SH ‘SNI MARKING PRODUCT CERTIFICATION “ORMULIR PEF APPLICATION FORM OFSW PRODUCT CERTIFICATION ‘SELURUH IN THE ABOVE INFORNATION I BEING TRUTHFULLY SUBMITTED GUIDANCE IFKASI PRODUK SPPT SN yBERIAN ADALAH BENAR Part | Penanagung Tawa Responsible person Wakil Manajenen Managemen epresentativelQMS coordinator | Orang yang beranggung jawab untuk sistem — ‘Orang yang bortangging javab di penashaan rodsen (dengan jabatantetings yg perushaan Person who will e responsible in product, ‘manufacturer shouldbe the highest positon in sompany) ‘mangjemen muta Person who responsible fr quality management system 5 Pengabang ‘Orang yang db tanggung jab uu tberkoesponden dengan BAT LSpr Person who wil be getting contact with Contact person cerieation body “FNansa Persahaan dan Lakai Paik Company name and plant location Teas Name of product manufacturer andthe plant location 3. Walil di ladoasis Representative in Indonesia Five Tela The name of company tat wil be responsible for product quality in Indonesia dese with ontaet person Hislaman 7 dari9KAN PRODUCT CERTIFICATION BODY arotsamt = ‘SERTIFIKASI PRODUK PENGGUNAAN TANDA SN] ‘SNI MARKING PRODUCT CERTIFICATION FORMULIR PERM IKASI PRODUK SPT SHI APPLICATION FORM OFSNI PRODUCT CERTIFICATION. Q LEMBAGA SERTIFIKASI PRODUK agian Part 1. Prodi - ‘Nama Produk | Product Name of product NOS Sead acuan da prod SNINo Relating to SNL reference Tipe “elas 4 Type ‘Type of product. 7 Meek ‘ask dean ang el Songs Sc sna [Name of brand product relating with registration ‘Svat pendlogsian mers ‘Mou or any leer regarding agroement Delegation leer etweum band owner with manufctre if the ‘rand not manuficturer properties Sart polar iponie “el Later of impor deepaton Delegation rom manufrs npr agian Pare Tafa yang Tiga Tlan pabie Ta 7 Languange wed in fctory Languangs het wd fr daly communication Avail of tensor Available waite 3. Jarak dan waktu tempuh dari bandara atau Telas | aio terdkat| Distance and time fom nearest either airport or station Five Halaman 8 dari9LEMBAGA SERTIFIKAS! PRODUK PRODUCT CERTIFICATION BODY ptf ‘SERTIFIKASI PRODUK PENGGUNAAN TANDA SNI 'SNI MARKING PRODUCT CERTIFICATION FOR RMOHONAN SERTIFI SH "APPLICATION FORM OFSNI PRODUCT CERTIFICATION agian PareV Organi “eae Organization Complete organization and shouldbe atached [2 Poses produlal dan pengendaian muta Production and quay contol ‘ith complete organization structure 1 Dilengkap dengan aur proses] Production proces rom raw materi o product and tached with quality plan for each proccess ‘nd production facilites (3 stants) “Data pertain seksTpenauian List inspetontesting equipment Tear List of equipment for tetng and inspection for ual contra Prose yang disboalan Tear ‘Subcontracted proccess Process that subsontcted 5, Dafar supplier yang discar Tee List of approved supple Approved supplier Bagian V PartV T Tanah eayawan Teas ‘otal number employees Total of employees [2 Tami awn bgian produit “Total man power in production Total employees ia production line Tania Tayawan a pangendalian mate Total man power in quality coal Total employees in quality contr 7 Tania Karyawan sli produ dan pengeedalian muta “otal manpower outside production and quay contra Teas ‘ota employes excluding production and quality contol Fiva Hilaman 9 dari9FACTORY VISIT ft onan QUESTIONNAIRE, wotcine yssoe 14 12 ‘QUESTIONNAIRE (tobe completed by spptcant) Objective “Tobin stale formation about manufacturer which will use a8 reference factory vst General Information (Pease atch your cman rote as wel a ochre) scab none e200 bubes Berge Gk SS te ears ‘Season Ning Ros nj Set aD comwaronoy AnSog nreposetve Tory Tang “evotone_ +86 19560380000, Tesphre +06 19500388000, ‘Company Structure Loge Frm Limited Company mt Gust 6800 ‘rae Comte USA exe) Asis ‘8 epstet_SNI 04-6253-2003 Mon Rast an puata Pa ad pron “ALLURE: install MAIN pate and lock scrows-Intallthe cover and lock serows-Intal the woofer and fullrange speaker-Pure tone test “= Function test-SPL test ~Version of retest~Fiished product est~ tulsa Appearance checking Packing Tn Oreut Teste, PCM (Personal Comput Measurement, IncetonPatorad:_AVMT(Audo Video Wut Teste) acon Part ncoming ingpecton by 1QCtineoming Quality Cont ‘Recalve pan——» IGC Inepocton —— StoragetG) —> in rome Preparation Fal wipcion Outgoing Qual inspection by Quay Assurance empee ninco? _6800 peopleA FACTORY VisiT Garage ‘TOvRheinand QUESTIONNAIRE meas for. o60t Fatman at ra zo + uatty system + Has he manufacturers aul 2am and check regi that ll ocumerted Prosadres ae rqured{ stra eureatontoay) yes Cno + acter aunty Sam ate or steed ye ced By roi ca of ONS ‘rats noe eon ores en a the autor team allowed to enlr allocation inthe factory as wall as has an acceso ee tho all precossoe reciving, process and ct going 233), Byes ano Wino the responsbel pereon? *+ Hf any change has been made tothe cotfod product and documentation within this year, has this change been made wih he authorsaton ofthe icerce holder yes Bro tyes leas provide nore information| + Remarks (it appcabe)GGEC — ‘CONFORMITY DECLARATION Number: ‘The undersigned Name Mr Sam Xiao TierPostion (GM of Business Unit + Deciare herewith under own responsibilty that our product, which were produce in the plant location mentioned below has been follow our company’s quality product and ‘management system, a6 well a5 ful the requirements of the ually standard for the production of Commodity / Product ALLURE Type Wireless Speaker Trade Brand Harman Kardon Plant Location Guoguang Electic Co.Ltd|No 8 Jinghu RéXinhua Street, Huadu Repion,Guangzhou P.R,,China 510800 ‘Applicable SNI Re ‘SRI Nomar Su THe 1 SRT 06-5255-2005 “aio, deo od other SBaTON Haves = Safely requirements Required document to be submitted as part of declaration of conformity ‘Application documents contrac agreement legal entity (copy) business permit (copy) registration of trade mert/brand name (copy) ‘This Conformity Declaration is being trutfuly submited