承认不使用证明.doc

填寫日期Application Date: 2015/11/25 承認不使用證明 Certificate of Non-Use of The Controlled Substances(For Parts Approval) Company Name: LITEON CORPORATION 公司名稱Company Name: (Seal). 負責人 Person in Charge: (Signature) 負責人電子郵件 Email of Person: We hereby certify that ANY material, where usage has been prohibited (Listed as Level 1) according to latest version of SS-00259 and LITEON Controlled Substances Spec (9713100001), are not contained in any parts, semi-finished units (unit parts) or packaging materials sold to LITEON . 本公司銷售的零件及組裝件上使用的材料和零件中，未使用最新版SS-00259及管控物質標準9713100001中，所禁止的1級管理對象（物質及其用途），特此證明。 Any usage of Level R or Level JIG substances listed in 9713100001 shall be disclosed in MCD. 任何R級或JIG級物質的使用，須揭露於物質組成宣告(MCD)中。 Regarding materials used in the manufacture of the parts, unit parts or packaging materials, we notify that they are made up of the following ingredients; 零件及組裝件上使用的材料和零件等，由以下材料構成： (1) Part and sub-material/unit part: 光寶料號LITEON Part No.: 零件重量Part Weight (g): 零件品名Part and Sub-material Name: 生產工廠Production Plant: Table (1) Materials used 編號No. 部位名稱Portion/ Region Name 原材製造商Raw Material Manufacturer 材名稱 / 型號Material / Type Name 指定原材?*DRM? (Y/N) 指定原材供應商的ID號碼DRM Vender’s ID No. MSDS的檔名或頁碼MSDS/ MIL sheet etc. No. ICP報告編號ICP Report No. 備註Remarks * Please add rows as needed. 欄位不足，請自行增加。 * DRM = Designated Raw Material 指定原材 (2) If metal or alloys including zinc are listed, please answer the following questions. 如果在零件中採用了含鋅的金屬合金，請回答以下問題 2.1 Is brass used是否使用黃銅?.2 If Yes, 是的話 Free-machining brass rod is used. 是快削黃銅 Free-machining brass rod is NOT used. 不是快削黃銅 2.3 If free-machining brass rod is used, 如果使用了快削黃銅棒 Please list the manufacturer name and the product name, as well as the maximum content of Cadmium (Cd). 請記載快削黃銅棒的“材料廠家名稱和材料名稱”，以及“鎘含量最大值”。 Name of manufacturer and product 材料廠家名稱/材料廠家型號： Maximum level (PPM) of Cd 含鎘量保證值： (Cd 100 ppm) (3) Zinc used in hot dip g