BABT 758 Issue 5

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Appendix B – Test Report Cover Sheet

A Test Report cover sheet must be included with the application. The following sheet is provided for guidance, other alternatives are acceptable provided the full required information is included.

This sheet should be provided in two formats (one SIGNED copy in PDF, one UNSIGNED copy in Word).

Product Information
PMN / <Note: PMN can be the same as the HVIN, if the HVIN is also used for advertising of product to consumers>
<if no PMN, then list N/A, and provide rationale in exhibit> / ISED Company Number
HMN / <enter N/A if product is not a module or not in a host> / UPN
HVIN / All Used ISED Test Site(s) Reg. #:
FVIN / <enter N/A if there is no firmware version ID for the RF portion of the product> / SAR Test Lab Company Number: / <list N/A, if not applicable, or if SAR lab does not have company number>
RSS # &
Issue # / Frequency Min (MHz) / Frequency Max (MHz) / RF Power (W)
(Conducted/
EIRP/ERP) / Measured BW (kHz)
(99%, 26dB, 6dB etc.) / Calculated BW (kHz)
As per TRC-43
(if none, then list
same as Measured) / Emission Classification / Transmitter Spurious
(dBuV/m@
distance) / Field Strength
(dBuV/m@
distance)
MIN / MAX
e.g.: RSS-210 / 2402 / 2480 / 0.0035 / 0.0035 / 946 / 946 / F1D / -43.0 @ 3m / N/A

* Please provide details below, for each Transmitter and modulation

*Add Additional Rows to above table as necessary.

Agreement Signature
ATTESTATION: The test measurements were made in accordance with the above-mentioned departmental standard(s), and that the radio equipment identified in this application has been subject to all the applicable test conditions specified in the departmental standards and all of the requirements of the standards have been met.
Name:
Signature: / Date: