Camera Link HS Advanced Registration Declaration – Page 2

Company Name:
Address:
City: / State/Province: / Zip/Postal Code: / Country:
Website:
Contact Name:
Title:
Phone: / Fax:
e-mail:
Address (if different from company above):

There may be occasions where a company wishes to register Camera Link HS products and obtain licensing rights prior to being able to complete the required matrix and certification forms. An example would be preparing product literature prior to an up-coming show where a new product will be introduced. You are responsible for ensuring the product(s) will be compliant with the Camera Link HS standard.

Products that are registered prior to their formal certificationwill be allowed temporary usage of the distinctive registered trademark logo on their product, product literature, and packaging under the following terms and conditions:

  • The company certifies in the block below that their product complies with the standard to the extent that it can be determined at this time.
  • The company agrees to complete the applicable Compliancy Matrix for each product being registered, and submit them to the AIA within 90 days of the matrix becoming available.
  • The company agrees to complete and submit results of compliancy test tools within 90 days after they are made available for each product registered.
  • The company agrees to ensure their product is compliant and remedy any identified compliancy deficiencies within 120 days of their being identified or cease using the intellectual property of the standard, trademarked name and logo.
  • The company pays the applicable annual license fee of $1000 USD for AIA Members and $1750 USD for non-AIA Members.

Certification Statement
I hereby certify that the products listed on page 2 of this form are or will be compliant with the Camera Link HS specification and we agree under penalty of law to the aforementioned terms and conditions for use of the licensed registered trademarked name and logo. Authorized Electronic Signature of Company Officer is the printed name enclosed between forward slashes, i.e. (/John W. Smith/)
Name: / Authorized Electronic Signature:
Title: / Date:

Registration is requested for the following products:

Product (Brand/model identification): / Transmitting Device
Frame Grabber
Other:
URL LINK:
Product (Brand/model identification): / Transmitting Device
Frame Grabber
Other:
URL LINK:
Product (Brand/model identification): / Transmitting Device
Frame Grabber
Other:
URL LINK:
Product (Brand/model identification): / Transmitting Device
Frame Grabber
Other:
URL LINK:
Product (Brand/model identification): / Transmitting Device
Frame Grabber
Other:
URL LINK:
Product (Brand/model identification): / Transmitting Device
Frame Grabber
Other:
URL LINK:
Product (Brand/model identification): / Transmitting Device
Frame Grabber
Other:
URL LINK:
Product (Brand/model identification): / Transmitting Device
Frame Grabber
Other:
URL LINK:
Product (Brand/model identification): / Transmitting Device
Frame Grabber
Other:
URL LINK:
AIA Action
Reviewed: / Checklist Complete:
Yes No
Registration fee: / Conforming product:
Yes No Not applicable
Certification complete:
Yes No / Compliancy tools submitted:
Yes No
Complete: / Product list updated:

Camera Link HS is a registered trade mark of the AIA.

The AIA will use all legal means necessary to protect this trade mark.