GC标志认证变更申请书.doc

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1、 威凯认证检测有限公司 Vkan Certification & Testing Co., Ltd. (CVC) 总部地址:中国广州市科学城开泰大道天泰一路3号(510663) No.3, Tiantaiyi Road, Kaitai Avenue, Science City, Guangzhou, 510663, P. R. China 电话(TEL): +86-20-32293693 申请编号 (Application No.):传真(FAX): +86-20-32293700 GC标志认证变更申请书GC-Mark Type Approval Modification Applicatio

2、n Form（请用中英文填写 Please provide information in both English and Chinese if available）基本信息 BASIC INFORMATION原申请/证书编号 Number of Original Application/Certificate: 申请人名称 APPLICANT: 地址 Address: 联系人Contact: 电话号码 Tel.: 传真号Fax: 邮箱Email: 代理机构/中国办事处 Agent or Office in China: 地址: Address: 联系人Contact: 电话号码 Tel.:

3、传真号Fax: 邮箱Email: 制造商名称 Manufacturer: 地址Address : 联系人Contact: 电话号码 Tel.: 传真号Fax: 邮箱Email: 生产厂名称 Factory: 地址Address : 联系人Contact: 电话号码 Tel.: 传真号Fax: 邮箱Email: 付款人名称 INVOICE TO: 地址Address : 联系人Contact: 电话号码 Tel.: 传真号Fax: 邮箱Email: 证书收件人名称Certificate(s) sent to: 地址Address : 联系人Contact: 电话号码 Tel.: 传真号Fax:

4、邮箱Email: 申请变更事项 Items to Be Modified变更项 Modification Item变更前 Before Modification变更后 After Modification申请人承诺 APPLICANTS UNDERTAKINGS申请人承诺 The Applicant undertakes that:1、申请人提供的所有文件信息均真实可信；出口货物的制造厂与本申请中声明的制造厂一致；All the documents and materials provided by the Applicant are authentic and accurate; the p

5、roducts to be exported hereunder are produced by the same Manufacturer as stated herein.2、如以上承诺与事实不符造成任何不良后果，或对威凯/第三方造成损害或经济损失，由申请人承担全部责任并负责赔偿。The Applicant shall assume full liabilities and indemnities for any consequences or damages or economic losses to CVC or any third parties incurred by any breach of the above undertakings made by the Applicant.3、申请人未向除威凯以外的其他认证机构申请类似的认证。The same application has not been lodged with any other notified body.申请人签字盖章 Signature and Seal of Applicant(申请书其它页面请加盖骑缝章)日期 Date:- 2 -CB1-QP-0028-0-0002A0