Application Form of Inspectiontesting for the Safety Type Approval of Motor Vehicles-980224

Application Form of Testing for the Safety Type Approval of Whole Vehicles(1/2) Application Index： Applicant Address of Applicant Contact Person E-mail Telephone No. Fax No. Brand VIN No. Model No. Engine No.

※Testing Items:(Refer to the Testing Items Index of next page)

Vehicle Safety Testing Directions: □020 □032 □033 □034 □040 □050 □060 □070 □080(□35˚ curb weight condition. □28 ˚ loading condition.) □091 □100 □110 □120 □130 □140 □220 (□Proving Ground □Chassis Dynamometer) □230 □240□241 □422 □423 □431 □432 □441 □451 □452 □460 □461 □462 □470 □541□542 Test Items for □ 550(□Complete vehicle □Body sections □Quasi-static calculation □Computer simulation of Application complete vehicle) □ EMI EMS EMI EMS Total Items 561(□ □ )□562(□ □ ) □630 □631 □640 □650 □670 □680 □710 □750 □ 760 □770 □Electromagnetic Compatibility (Applicable to motor-assisted bicycle and electric bicycle) □Other FMVSS (U.S.):□Installation of lighting and light-signaling devices □Installation of devices for indirect Vision □Tyre pressure monitoring system □The inspection requirement of fuel system for LPG vehicle □Other Return the Fixtures □Receive by oneself □Postal service to return（The expenses is paid by the customer） □ARTC on behalf handles □Don't need the test report, only need to provide an test data.； Testing Report □Duplicate copy of Chinese version ； □English version；Duplicate copy of English version Offer of Test Report □Express delivery (□Additional digital copy) □Others(□Additional digital copy) Report Delivery □The same as applicant's address Address □Mail to： 1. In addition to application form, each page of submitted documents shall be stamped or signed by manufacturer and the president (or authorized person). 2. It is self-provided to test samples by the client, the test result is only responsible for the event that examined the products, the testing result and recorded items (including reports, photos and film) can't be used for the Remark purpose of the business promotes and legal lawsuit to the outside. 3. ARTC shall not be liable for any consequential losses arising from the failure of the test service or part of the test service, such as (but not limited to) loss of profit, loss of production time, or loss of market opportunity. 4. This agreement shall be construed and enforced in accordance with the laws of Taiwan. The parties hereby consent to and submit to jurisdiction of Taiwan Changhua District Court.

Authorized Signature：______Date of Application

Expected Testing Expected Report Testing Director Undertaker Date Issuing Date Total Expenses NTD$ Other Related Premium Index

Testing Items Index(2/2):

表單生效日期：106/10/15 QM.AC-89-0002.20_2 020. The requirement of specification for motor vehicle. 431, 432. Anti-lock braking system (ABS). (VSCC conducts witness test , no test report from 441. Steering control system –The protection of the driver ARTC) against the steering mechanism in the event of impact. 032, 033,034. The installation of lighting and light-signaling 451, 452. The protection of the occupants in the event of a devices. lateral collision. 040. Static Braking. 461, 462. The protection of the occupants in the event of a 050. The inspection requirement of fuel systemfor LPG frontal collision. vehicle. 470. Steering equipment. 060. The inspection requirement of fuel system for CNG 541, 542. Prevention of fire risks for the large passenger vehicle vehicle. 070. The lateral protection device and the Rear Underrun 550. Strength of super structure for large passenger vehicle. Vehicle Protection Device (RUPD)(or bumper). 561, 562. Electromagnetic Compatibility. Safety 080. The requirement of vehicle tilt stability. 630, 631. The requirement of specification for Low Floor Bus. Testing 091. Installation of audible warning devices. 640. Electric safety requirements for battery electric vehicles Directions 100. Installation requirements of pay load meter. 650. The prevention requirements for high temperature, 110. The installation requirement of turning and reversing compression and electrical shock of electric motorcycle audible warning device. 670. Wheelchair accessible vehicle. 120. The thermal-insulation protection device of exhaust 680. Tyre pressure monitoring system. system for motorcycle. 710. Driving vision assistant system. 130. The requirement of stability and durability regarding 750. Speed limitation devices. motorcycle stands. 760. The location and identification of hand control, tell-tales 140 .The requirement regarding the passenger hand-holds and indicators. of motorcycle. 770. Speed limitation devices. 220. Speedometer. Electromagnetic Compatibility. 230, 231. Installation of devices for indirect vision. 240,241. Driver operated controls. (Applicable to motor-assisted bicycle and electric bicycle】 422, 423. Dynamic braking. FMVSS 108. Installation of lighting and light-signaling devices 303, 304. The inspection requirement of fuel system for LPG Testing 111. Installation of devices for indirect vision vehicle Items 138. Tyre pressure monitoring system

表單生效日期：106/10/15 QM.AC-89-0002.20_2