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["經濟部標準檢驗局"]
["太陽眼鏡符合性聲明試驗報告型式分類表"]
["申請者：                                                                申請日期：           \n聯絡人：                           電話：                                 傳真： "]
["一、 型式分類：______________"]
["（一） 品牌：______________"]
["（二） □一般濾鏡 □偏光濾鏡"]
["（三） 主型式"]
[null,"1. 型號（代號）：______________"]
[null,"2. □金屬鏡框 □非金屬鏡框"]
[null,"3. 濾鏡顏色："]
[null,"4. 濾鏡分類：□0 □1 □2 □3 □4"]
[null,"5. 光學等級：□1 □2"]
[null,"6. □適合 □不適合駕駛及道路使用"]
[null,"7. 參考點  □32.0±0.2 mm（成人用太陽眼鏡）"]
[null,null," □27.0±0.2 mm（兒童用太陽眼鏡）"]
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["（四）系列型式："]
["編號","型號（代號）","鏡框材質，請打V",null,"濾鏡顏色","濾鏡分類","光學等級","「駕駛及道路使用」及「參考點」是否與主要型式相同，若否，請註明。","若為送檢之樣品型號，請打V"]
[null,null,"金屬","非金屬"]
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["二、技術文件檢核表（檢具下列文件一式3份）"]
[" （一）□商品之描述："]
["1.商品構造、材料及適用範圍。\n2.商品型錄及4*6吋以上彩色照片。\n3.型號款式一覽表。"]
["註：規格一覽表及照片或型錄應依據型式分類之順序排列，並註明其編號。"]
["（二）□製程概要。"]
["（三）□產製過程品質管制措施或其驗證證明文件。"]
["  (四)□ 產品標示樣張"]

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