RCM Declaration

Unrestricted ACMA form – C02 Page 2 of 3 Siemens Ltd – July - 2014
Compliance
The above mentioned product complies with the requirements of the relevant ACMA Standards made under the Radiocommunications Act 1992
and the Telecommunications Act 1997. These Standards are referenced in notices made under section 182 of the Radiocommunications Act
and 407 of the Telecommunications Act.
Evidence of compliance is demonstrated by test reports to the following applicable standards.
Applicable standards
Standard title, number and, if applicable, number of the test report
EN 61800-3
Declaration
I hereby declare that the contents of this form are true and correct, that the product mentioned above complies with the relevant above mentioned standards and all
products supplied under this declaration will be identical to the product identified above.
Note: Under section 137.1 of the Criminal Code Act 1995, it is an offence to knowingly provide false or misleading information to a Commonwealth entity.
Penalty: 12 months imprisonment
SIGNATURE OF SUPPLIER OR AGENT
POSITION IN ORGANISATION: Product Manager
PRINT NAME Paul Sutton DATE 03/02/2015
The Privacy Act 1988 (Cth) (the Privacy Act) imposes obligations on the ACMA in relation to the collection, security, quality, access, use and
disclosure of personal information. These obligations are detailed in the Australian Privacy Principles.
The ACMA may only collect personal information if it is reasonably necessary for, or directly related to, one or more of the ACMA’s functions or
activities.
The purpose of the collection of the personal information in this online form is to ensure the supplier is identified in the ‘Declaration of
conformity’. This information is required under the following notices:
> Radiocommunications Devices (Compliance Labelling) Notice 2003 made under section 182 of the Radiocommunications Act 1992
> Radiocommunications Labelling (Electromagnetic Compatibility) Notice 2008 made under section 182 of the Radiocommunications
Act 1992
> Radiocommunications (Compliance Labelling—Electromagnetic Radiation) Notice 2003 made under section 182 of the
Radiocommunications Act 1992
> Telecommunications Labelling (Customer Equipment and Customer Cabling) Notice 2001 made under section 407 of the
Telecommunications Act 1997.
If you do not provide the information, a compliance label is not able to be applied.
Further information on the Privacy Act and the ACMA’s Privacy Policy is available at www.acma.gov.au/privacypolicy
. The Privacy Policy
contains details about how you may access personal information about you that is held by the ACMA, and seek the correction of such
information. It also explains how you may complain about a breach of the Privacy Act and how we will deal with such a complaint.
Should you have any questions in this regard, please contact the ACMA’s privacy contact officer on telephone on 1800 226 667 or by email at
[e-mail]
.
Digitally signed by Sutton Paul
DN: cn=Sutton Paul, o=Siemens,
email=[e-mail]
m
Date: 2016.03.16 09:20:06
+11'00'
Sutton
Paul