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Please provide the required information below and submit electronically to [email protected]
Name of Applicant
Address of Applicant
Copy of FCC Grant of Industry Canada Certificate
Check this box if the FCC Grant is attached.
Description of Device
Brand Name
Model Number
Mailing Address (If different from above)
Payment
A fee of USD $200 is required for each application.Check the appropriate box for payment type.
Wire Transfer USD Check Credit Card*
*Attach completed credit card form.
Application Form CTYPE‐1A TYPE APPROVAL
Check this box if FCC Grant is attached: OffWire Transfer: OffUSD Check: OffCredit Card: OffText1: Text2: Text3: Text4: Text5: Text6: