Test Request Form

This request form is for EMI/EMC testing services. For calibration use the form here
Company Details

Company / Organisation*
Address*
City* :
State* :
Country* :
PIN* :
GST Identification Number (GSTIN)
Contact Person

Name* :
Designation* :
email ID* :
Mobile no:
Alt. Phone :
Equipment Details
Equipment Name*
Model and Manufacturer
Physical Details:
Length* (mm) :
Depth* (mm):
Height* (mm):
Weight* (kg):
Type*:
Electrical Details (Kindly Enter the maximum input values under the test condition):
Input Type* :
I/p Power Freq*. (Hz):
I/p Voltage* (V):
Current* (A):
Incase of multiple power supplies, please provide details in the section below
Test Details
* : (Please be sure to enter the following details for each test)
  • Name of the test and the standard
  • Frequency Range, Level etc. if applicable
  • Is the test ot be repeated ( e.g. for 230V and 110V) and number of repetations
  • Is the test to be conducted on Power Lines, Signal Lines etc. and number of lines

Is the decision rule to be applied for the statement of conformity? No Yes     ⓘ What is this?

Any other remarks?

Service request form

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Contact Details

ccc.chennai@sameer.gov.in

+91 44 2254 4040

+91 9444 83 93 31

https://g.page/SAMEER-CEM

SAMEER-CEM, 2nd Cross Road
CIT Campus, Taramani
Chennai, India. 600 113