Product Licence Application form

Product or device registration for testing and licensing

Name of the products: *

Purpose of the product:

Describe how the product is used:

Images of the products:

Click or drag a file to this area to upload.

Internet address where is the product:

The documentation you have about the product (enter in the original language and translated into English or Croatian what you already have, and it refers to results and registration in other countries):

Click or drag files to this area to upload. You can upload up to 10 files.

The product is already on the market for sale / enter how long and in which countries and under which name:

I am registering the product as (choose one or both options):

MANUFACTURER
DEALER

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MANUFACTURER'S NAME:

MANUFACTURER'S adress (street, city, country):

MANUFACTURER'S e-mail:

MANUFACTURER'S website / URL:

MANUFACTURER'S Phone:

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DISTRIBUTOR'S NAME (if you are a distributor):

DISTRIBUTOR'S adress (street, city, country):

DISTRIBUTOR'S e-mail:

DISTRIBUTOR'S website / URL:

DISTRIBUTOR'S Phone:

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If you register the product as a product manufacturer and you have an already developed network of your distributors (representatives), then list them here:

Name of distributors and their countries (areas) where representatives are:

NOTES:

Two copies of the product must be sent to our address of the institute for testing:

IPED, Kosirnikova 80, 10000 Zagreb, Croatia

If the product has already been tested at other research institutes, then only the License for the product is issued and it is not necessary to send 2 copies of the product to our address. A decision on this will be made upon receipt of this form with all the documentation you have entered.

After receipt of the application, we will contact you with further instructions and send you information for payment of the costs of testing and/or issuing a license.