Approval And/Or Modificationof a Certificate

S-0001A - Application Check Sheet

Approval and/or Modificationof a Certificate

for an Electrical Product

This form is to be completed in accordance with guidelines inForm S-0021 available at

To Edit – Yellow boxes – Click to Check; Grey shaded areas -Click once to edit.

Application Check Sheet - For use with Form S-0001

This form is to be used for checking that you have provided all necessary information for the application for a new approval and/or modification.
Click yellow boxes. Check off items to ensure all information and documentation is included with your application. / Has information been provided?
1. Application Details / Yes / N/A
Type of application / New approval and or modification
Current or allocated approval number
Optional approval mark or RCM / Is an alternative approval mark used?
2. Applicants Details
Business name / The registered business who will hold the approval - Required
Street address / The registered business street address - Required
Postal address / The registered business postal address - Required
ABN or ACN or ARBN / Required if applicable
Contact name / The owner or employee with delegated responsibility - Required
Telephone/Mobile/Fax
Email
3. Consultant Details / Authorisation letter from applicant included?
Business name
Postal address
ABN or ACN or ARBN
Contact name
Telephone/Mobile/Fax
Email
4. Product Details
Regulatory description (if applicable) / As per SAA Declaring Definitions on our web site
General description / More specific description
Trade or brand name
Main model number/name
Electrical rating / Such as 230V 50Hz 10A 2400W
Manufacturer’s name and address
5. General Modifications
Information included / If applicable
6. Additional Models
Additional models included / If applicable
Differences included / If additional models
7. Test Report Details
Date of report
Name of laboratory
Test report number
Test standard
CurrentRelevantAS/NZS Standard: / This is the AS/NZS that the product must comply with
8.a Applicant Declaration
Signed and dated (if applicable)
8.b Consultant Declaration
Signed and dated (if applicable)
9. Payment Details
Payment included
Additional Information / For details of below requirements see Form Guide S-0021
Colour photos / Required and must be included
Sample
Instructions
Circuit diagrams
All Amendments covered?
Australian Deviations covered?

NEED MORE INFORMATION?

Website:

Or write to:The General ManagerPh:+61 7 3393 9455

SAA Approvals Pty Ltd Fax:+61 7 3393 9499

PO Box 189

Cannon Hill QLD 4170

Australia

SAA Approvals Pty LtdRegistered Office – 10 Barrack Street //Sydney // NSW // 2000

ABN: 91 125 451 327Z:\Policy & Ops\Master Docs\Application Form & Guides\S-0001A