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RCM Registration Form

This form is your registration of intention to use the RCM. Please complete all applicable details on the form and then submit it. Your specified Contact Name will be contacted within 5 working days to finalise the details and arrange payment for your registration ($110.00 including GST). (The registration is not effective until payment is made).

If you require more information please telephone 02 9237 6031.

New Registration
Change an existing Registration
SUPPLIER DETAILS
Supplier Name:

SUPPLIER IDENTIFICATION ON PRODUCT
We advise our intention to mark products with Regulatory Compliance Mark under the conditions set out in AS/NZS 4417, and to use one or more means of supplier identification as provided below.

General Business name:
(Australia)
General Business name:
(New Zealand)
Registered Business name:
(Australia)
Registered Business name:
(New Zealand)

ACN: (Australia only)
ARBN: (Australian Registered Body Number, Australia only)
Trademark number: (Australia)
Trademark number: (New Zealand)
Trademark Logo: Yes
No
ACA Supplier code: (Issued by the Australian Communications Authority)
Issue supplier code: Yes (Do you want the RCM Registrar to
No issue you with a Supplier Code?)

FIELDS OF APPLICATION
Electrical Safety, Part 2
EMC, Part 3
Radiocommunications Regulations, Part 4

AUSTRALIAN CONTACT DETAILS
Contact Name:
Contact Title:
Address:
Suburb:
State:
Post Code:
Country: Australia
Telephone:
FAX:
Email Address:
Web Site:
NEW ZEALAND CONTACT DETAILS
Contact Name:
Contact Title:
Address:
Suburb:
Post Code:
Country: New Zealand
Telephone:
FAX:
Email Address:
Web Site:

We understand that the products may only be marked with the RCM where the supplier maintains a compliance folder on the product, containing the supplier's declaration of compliance and all documents required by applicable parts of AS/NZS 4417.