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Application for Equipment Authorization FCC Form 731 TCB Version


Applicant Information
Applicant's complete, legal business name: Samsung Electronics Co Ltd
FCC Registration Number (FRN): 0027908797
Line one: 19 Chapin Rd., Building D
Line two:
P.O. Box:
City: Pine Brook
State: New Jersey
Country: United States
Zip Code: 07058

TCB Information
TCB Application Email Address: tcb@pctest.com
TCB Scope: B1: Commercial mobile radio services equipment in the following 47 CFR Parts 20, 22 (cellular), 24,25 (below 3 GHz) & 27

FCC ID
Grantee Code: A3L Product Code: SMG960U

Person at the applicant's address to receive grant or for contact
First Name: Jenni
Middle Name:
Last Name: Chun
Title: General Manager
Telephone Number: 973-808-6375 Extension:
Fax Number: 973-808-6361
Email: j1.chun@samsung.com
Mail Stop:


Technical Contact
Firm Name: PCTEST Engineering Laboratory, Inc.
First Name: Randy
Middle Name:
Last Name: Ortanez
Line 1: 6660-B Dobbin Road
Line 2:
P.O. Box:
City: Columbia
State:
Country: United States
Zip Code: 21045
Telephone Number: 410-290-6652 Extension:
Fax Number: 410-290-6654
E-Mail: tcb@pctest.com

Non Technical Contact
Firm Name:
First Name:
Middle Name:
Last Name:
Line 1:
Line 2:
P.O. Box:
City:
State:
Country:
Zip Code:
Telephone Number: Extension:
Fax Number:
E-Mail:

Long-Term Confidentiality
Does this application include a request for confidentiality for any portion(s) of the data contained in this application pursuant to 47 CFR § 0.459 of the Commission Rules?:   Yes

Short-Term Confidentiality
Does short-term confidentiality apply to this application?:   Yes
If so, specify the short-term confidentiality release date (MM/DD/YYYY format):   04/27/2018
Note: If no date is supplied, the release date will be set to 45 calendar days past the date of grant.

Software Defined/Cognitive Radio
Is this application for software defined/cognitive radio authorization?   No

Equipment Class
Equipment Class:   PCE - PCS Licensed Transmitter held to ear
Description of product as it is marketed: (NOTE: This text will appear below the equipment class on the grant): Multi-band GSM/EDGE/UMTS/CDMA/LTE Phone with Bluetooth, WLAN, ANT+ and RFID

Related OET KnowledgeDataBase Inquiry
Is there a KDB inquiry associated with this application?  Yes

Modular Equipment
Modular Type:  Does not apply

Application Purpose
Application is for:   Original Equipment

Composite/Related Equipment
Is the equipment in this application a composite device subject to an additional equipment authorization?   Yes
Is the equipment in this application part of a system that operates with, or is marketed with, another device that requires an equipment authorization?   No

The related application is in the process of being filed under the FCC ID(s) A3LSMG960U

Equipment Specifications
Line
Entry		 Lower
Frequency		 Upper
Frequency		 Power
Output		 Tolerance Emission
Designator		 Microprocessor
Number		 Rule
Parts		 Grant
Notes
1 817.9 823.1 0.308 2.5 ppm 1M27F9W 9 HC
2 824.2 848.8 0.794 2.5 ppm 246KGXW 22H HC
3 824.2 848.8 0.166 2.5 ppm 247KG7W 22H HC
4 824.7 848.31 0.124 2.5 ppm 1M28F9W 22H HC
5 826.4 846.6 0.11 2.5 ppm 4M14F9W 22H HC
6 1712.4 1752.6 0.159 2.5 ppm 4M14F9W 27 HC
7 1850.2 1909.8 1.191 2.5 ppm 241KGXW 24E HC
8 1850.2 1909.8 0.302 2.5 ppm 245KG7W 24E HC
9 1851.25 1908.75 0.21 2.5 ppm 1M28F9W 24E HC
1 1852.4 1907.6 0.223 2.5 ppm 4M15F9W 24E HC
11 663 698 0.117 2.5 ppm 9M03G7D 27 HC
12 663 698 0.098 2.5 ppm 9M06W7D 27 HC
13 663 698 0.113 2.5 ppm 18M0G7D 27 HC
14 663 698 0.093 2.5 ppm 18M0W7D 27 HC
15 699 716 0.071 2.5 ppm 9M03G7D 27 HC
16 699 716 0.058 2.5 ppm 9M01W7D 27 HC
17 777 787 0.087 2.5 ppm 4M55G7D 27 HC
18 777 787 0.079 2.5 ppm 4M51W7D 27 HC
19 777 787 0.073 2.5 ppm 9M00G7D 27 HC
2 777 787 0.061 2.5 ppm 9M01W7D 27 HC
21 788 798 0.1 2.5 ppm 4M52G7D 9 HC,PF
22 788 798 0.089 2.5 ppm 4M53W7D 9 HC,PF
23 788 798 0.093 2.5 ppm 9M03G7D 9 HC,PF
24 788 798 0.078 2.5 ppm 9M03W7D 9 HC,PF
25 814 824 0.245 2.5 ppm 9M00G7D 9 HC
26 814 824 0.212 2.5 ppm 8M95W7D 9 HC
27 821.5 821.5 0.109 2.5 ppm 13M5G7D 22H,9 HC
28 821.5 821.5 0.096 2.5 ppm 13M5W7D 22H,9 HC
29 824 849 0.144 2.5 ppm 13M5G7D 22H HC
3 824 849 0.122 2.5 ppm 13M5W7D 22H HC
31 1710 1780 0.304 2.5 ppm 18M0G7D 27 HC
32 1710 1780 0.266 2.5 ppm 18M0W7D 27 HC
33 1850 1915 0.249 2.5 ppm 18M0G7D 24E HC
34 1850 1915 0.224 2.5 ppm 18M0W7D 24E HC
35 2305 2315 0.181 2.5 ppm 4M56G7D 27 HC
36 2305 2315 0.169 2.5 ppm 4M52W7D 27 HC
37 2305 2315 0.174 2.5 ppm 9M01G7D 27 HC
38 2305 2315 0.156 2.5 ppm 9M02W7D 27 HC
39 2500 2570 0.282 2.5 ppm 18M0G7D 27 HC
4 2500 2570 0.248 2.5 ppm 18M0W7D 27 HC
41 2496 2690 0.547 2.5 ppm 9M01G7D 27 HC
42 2496 2690 0.294 2.5 ppm 9M01W7D 27 HC
43 2496 2690 0.494 2.5 ppm 18M0G7D 27 HC
44 2496 2690 0.318 2.5 ppm 18M0W7D 27 HC

Test Firm Information
Name of test firm and contact person on file with the FCC:
Firm Name:   Element Materials Technology Washington DC LLC
First Name:   Zach
Last Name:   Keyser
Telephone Number: 1111111111 Extension:
Fax Number: 
E-mail:  zach.keyser@element.com

Grant Comments
Enter any text that you would like to appear at the bottom of the Grant of Equipment Authorization:
Output power listed is ERP for Part 22, 27, 22H/90S, and 90R for frequencies below 1 GHz, EIRP for Part 24 and 27 for frequencies above 1 GHz, and conducted for Part 90S. The maximum Part 90.635(b) conducted power for LTE B26 operations at 15 MHz Bandwidth is 0.252 W. SAR compliance for body-worn operating configurations is limited to the specific configurations tested for this filing. Body-worn operations are restricted to belt-clips, holsters or similar accessories that have no metallic component in the assembly and must provide at least 1.5 cm separation between the device and the user's body. End-users must be informed of the body-worn operating requirements for satisfying RF exposure compliance. This device supports bandwidths of 1.4/3/5/10 MHz for LTE Band 12 and 5, bandwidths of 5/10 MHz for LTE Band 17, 13, 14, and 30, bandwidths of 1.4/3/5/10/15 MHz for LTE Band 26, bandwidths of 1.4/3/5/10/15/20 MHz for LTE Bands 2/25 and 4/66, and bandwidths of 5/10/15/20 MHz for LTE Bands 71, 7, 38, and 41. The highest reported SAR for head, body-worn accessory, product specific (wireless router), and simultaneous transmission use conditions is 0.35 W/kg, 0.96 W/kg, 0.95 W/kg, and 1.59 W/kg, respectively. HAC Rating: M4 T3 - 2011 This device also contains functions that are not operational in U.S. Territories. This filing is only applicable for US operations.

Equipment Authorization Waiver
Is there an equipment authorization waiver associated with this application?  No
If there is an equipment authorization waiver associated with this application, has the associated waiver been approved and all information uploaded?:  No

WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1)), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503).

SECTION 5301 (ANTI-DRUG ABUSE) CERTIFICATION:
The applicant must certify that neither the applicant nor any party to the application is subject to a denial of Federal benefits, that include FCC benefits, pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. § 862 because of a conviction for possession or distribution of a controlled substance. See 47 CFR 1.2002(b) for the definition of a "party" for these purposes.

Does the applicant or authorized agent so certify?  Yes

Applicant/Agent Certification:

I certify that I am authorized to sign this application. All of the statements herein and the exhibits attached hereto, are true and correct to the best of my knowledge and belief. In accepting a Grant of Equipment Authorization as a result of the representations made in this application, the applicant is responsible for (1) labeling the equipment with the exact FCC ID specified in this application, (2) compliance statement labeling pursuant to the applicable rules, and (3) compliance of the equipment with the applicable technical rules. If the applicant is not the actual manufacturer of the equipment, appropriate arrangements have been made with the manufacturer to ensure that production units of this equipment will continue to comply with the FCC's technical requirements.

Authorizing an agent to sign this application, is done solely at the applicant's discretion; however, the applicant remains responsible for all statements in this application.

If an agent has signed this application on behalf of the applicant, a written letter of authorization which includes information to enable the agent to respond to the above section 5301 (Anti-Drug Abuse) Certification statement has been provided by the applicant. It is understood that the letter of authorization must be submitted to the FCC upon request, and that the FCC reserves the right to contact the applicant directly at any time.

Signature of Authorized Person Filing:  Chan Ho Youn
Title of authorized signature: 

Complete items below if agent signs the application:

Firm Name: 
First Name: 
Middle Name: 
Last Name: 
Line 1: 
Line 2: 
P.O. Box: 
City: 
State: 
Country: 
Zip Code: 
Telephone Number:  Extension: 
Fax Number: 
E-mail: