Application for Equipment Authorization FCC Form 731 TCB Version
Applicant Information
Applicant's complete, legal business name:
Qualcomm Atheros, Inc.
FCC Registration Number (FRN):
0003716743
Line one:
1700 Technology Dr
Line two:
P.O. Box:
City:
San Jose
State:
California
Country:
United States
Zip Code:
95110
TCB Information
TCB Application Email Address:
LST.FRE.CertNotice@ul.com
TCB Scope:
A4: UNII devices & low power transmitters using spread spectrum techniques
FCC ID
Grantee Code:
PPD
Product Code:
-QCNFA344AH
Person at the applicant's address to receive grant or for contact
First Name:
Paul
Middle Name:
Last Name:
Guckian
Title:
Vice President, Regulatory Engineering
Telephone Number:
858-651-1547
Extension:
Fax Number:
858-651-1547
Email:
pguckian@qti.qualcomm.com
Mail Stop:
Technical Contact
Firm Name:
SGS Taiwan Ltd.
First Name:
Violetta
Middle Name:
Last Name:
Tang
Line 1:
No.134, Wu Kung Road, New Taipei Industrial Park,
Line 2:
P.O. Box:
City:
New Taipei City
State:
Country:
Taiwan
Zip Code:
16675
Telephone Number:
886-2-22993279
Extension:
24803
Fax Number:
886-2-22982698
E-Mail:
violetta.tang@sgs.com
Non Technical Contact
Firm Name:
SGS Taiwan Ltd.
First Name:
Violetta
Middle Name:
Last Name:
Tang
Line 1:
No.134, Wu Kung Road, New Taipei Industrial Park,
Line 2:
P.O. Box:
City:
New Taipei City
State:
Country:
Taiwan
Zip Code:
24803
Telephone Number:
886-2-22993279
Extension:
Fax Number:
886-2-22982698
E-Mail:
violetta.tang@sgs.com
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):
08/19/2016 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:
DSS - Part 15 Spread Spectrum Transmitter
Description of product as it is marketed:
(NOTE: This text will appear below the equipment class on the grant):
802.11a/b/g/n/ac + BT4.1 M.2 2230 Type Card
Related OET KnowledgeDataBase Inquiry
Is there a KDB inquiry associated with this application?
No
Modular Equipment
Modular Type:
Single Modular Approval
Application Purpose
Application is for:
Class II permissive change or modification of presently authorized 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 has been granted under the FCC ID(s) PPD-QCNFA344AH
Equipment Specifications
Line
Lower
Upper
Power
Tolerance
Emission
Microprocessor
Rule
Grant
1
2402.00000000
2480.00000000
0.0200000
15C
CC
Test Firm Information
Name of test firm and contact person on file with the FCC:
Firm Name:
SGS Taiwan Ltd.
First Name:
Ryan
Last Name:
Wang
Telephone Number:
+886-2-2299-3279
Extension:
1708
Fax Number:
+886-2-2298-2248
E-mail:
Ryan-ec.wang@sgs.com
Grant Comments
Enter any text that you would like to appear at the bottom of the Grant of Equipment Authorization:
Class II Permissive Change to allow portable configuration in the specific tablet host (Acer N15W9). Modular Approval. Output power listed is maximum combined conducted. This module may be installed only by the OEM or an OEM integrator. Installation in portable devices is limited to a laptop or notebook PC where the antennas used during SAR testing (or equivalent antennas) are installed to provide at least 1cm distance from the base of the device and with an antenna-to-antenna separation distance of at least 3cm. The antennas used for this transmitter must not be collocated or operating in conjunction with any other antenna or transmitter within a host device, except in accordance with FCC multi-transmitter product procedures. Grantee must provide installation and operating instructions for complying with FCC multi-transmitter product procedures. Grantee must coordinate with OEM integrators to determine applicable host configurations to ensure RF exposure compliance, including simultaneous transmission. The highest reported SAR values for body and simultaneous exposure conditions across all filings under this equipment code and FCC ID are 0.12 W/kg and 1.45 W/kg respectively.
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:
Willis Chen
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:
Search|RSS |Updates |E-Filing |Initiatives |
