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Revision 4.10April 29, 2016
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Company Name (*):
Declaration Scope or Class (*):
Company Unique ID:
Company Unique ID Authority:
Address:
Contact Name (*):Email – Contact (*):Phone – Contact (*):
Authorizer (*):NAME
Title - Authorizer:Quality Manager Email - Authorizer (*):Phone - Authorizer (*):
Effective Date (*):
1) Is the 3TG intentionally added to your product? (*)
Comments
Tantalum (*)
Tin (*)Gold (*)Tungsten (*)
2) Is the 3TG necessary to the production of your company’s products and contained in the finished product that your company manufactures or contracts to manufacture? (*)
Comments
Tantalum (*)
Tin (*)Gold (*)Tungsten (*)
3) Do any of the smelters in your supply chain source the 3TG from the covered countries?(SEC term, see definitions tab) (*)
Comments
Tantalum
Tin (*)Gold (*)Tungsten
4) Does 100 percent of the 3TG (necessary to the functionality or production of your products)originate from recycled or scrap sources? (*)
Comments
Tantalum
Tin (*)Gold (*)Tungsten
5) Have you received data/information for each 3TG from all relevant suppliers? (*)
Comments
Tantalum
Tin (*)Gold (*)Tungsten
6) Have you identified all of the smelters supplying the 3TG to your supply chain? (*)
Comments
Tantalum
Tin (*)Gold (*)Tungsten
Yes, 100%
*** Electronic Co., Ltd.
The purpose of this document is to collect sourcing information on tin, tantalum, tungsten and gold used in products
Mandatory fields are noted with an asterisk (*).
**, Dongguan City, Guangdong, China Click here to check required fields
completion
Link to Terms & Conditions
B. Product (or List of Products)
Company Information No
Go to Product List tab to enter products this declaration applies to
Click here to enter the products this declaration applies to
ludashi
20-May-2016
Answer the following questions 1 - 7 based on the declaration scope indicated above
86-8888-88888888-8888Yes
No Yes
Yes Yes, 100%WWW@https://www.doczj.com/doc/3e694209.html,
www.w@https://www.doczj.com/doc/3e694209.html, Yes Yes 86-8888-88888888-8888
No Yes Answer
Answer Answer Yes Answer No No
No
Answer Answer Yes
Select Language Preference Here:
请选择你的语言:
??? ??? ????? :
表示言語をここから選択してください:Sélectionner la langue préférée ici:Selecione Preferência de idioma Aqui:
W?hlen sie hier die Sprache:
Seleccione el lenguaje de preferencia aqui:
Selezionare la lingua di preferenza qui:
Burada Dil Tercihini Belirleyin:
English
One (1) or more required fields needs to be populated
Revision 4.10April 29, 2016
B
The purpose of this document is to collect sourcing information on tin, tantalum, tungsten and gold used in products
Mandatory fields are noted with an asterisk (*).
Click here to check required fields
completion
Link to Terms & Conditions