APPLICATION FOR FINAL TYPE APPROVAL/ACCEPTANCE
1.
PARTICULARS OF VENDOR
i)
(ii)
2.
Full names of Company/Business
....................................................................................................
P.O. Box.......................Tel No.: ..................Fax No...................
Email ………………….
Physical Address:
Town....................Estate.....................Street/Road.....................
Name of Building....................Floor................Room...................
DESCRIPTION OF EQUIPMENT
ITEM NO
TYPE
MANUFACTURER
MAKE AND
MODEL
SERIAL
NUMBER/IMEI
COUNTRY
OF ORIGIN
3. DETAILS OF INSTALLATIONS
ITEM
NO
MAKE,
MODEL,
TYPE OF
EQUIPMENT
DATE
PROVISIONALLY
APPROVED BY CCK &
REFERENCE NUMBER
DATE OF
INSTALLATION
POSTAL,
TELEPHONE
, FAX, EMAIL &
PHYSICAL
ADDRESS OF
REFERENCE
CONTACT
PERSON &
RANK IN
ESTABLISHME
NT
Please continue on a separate sheet. Also attach details of employees and their qualifications
and details of workshop.
4. DECLARATION
I hereby apply for Final Type Approval/Acceptance / authority to market the
equipment(s) specified above in Kenya on behalf of my company I certify that all
information I have given in this form is correct to the best of my knowledge.
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