Declaration of Conformity

SUPPLIER'S DECLARATION OF CONFORMITY
According to Sec. 2.1077, 47 CFR of the FCC Rules.
This device complies with Part 15 of the FCC Rules. Operation is subject to the following two
conditions: (1) This device may not cause harmful interference, and (2) This device must
accept any interference received, including interference that may cause undesired operation.
Equipment EUT Type
TV Broadcast Receiver
Kind of product
Wi-Fi Kit 2.0
Trade Name
Samsung
Model
MIM-H04UN
Variant Model
MIM-H04U
Applied Rules
47 CFR Part 15, Subpart B / ANSI C63.4-2014
ICES-003 Issue 6
Manufacturer
Samsung Electronics Co., Ltd.
(Maetan dong) 129, Samsung-ro, Yeongtong-Gu, Suwon-Si,
Gyeonggi-Do 16677 Korea
We hereby declare that the equipment bearing the trade name and model number specified
above was tested conforming to the applicable FCC Rules under the most accurate
measurement standards possible, and that all the necessary steps have been taken and are
in force to assure that production units of the same equipment will continue to comply with the
Commission’s requirements.
U.S. RESPONSIBLE PARTY
Samsung Electronics America, Inc.
QA Lab America
19 Chapin Rd. Building D, Pine Brook, NJ 07058
CONTACT PERSON
Ms. Jenni Chun, General Manager
Regulatory & Environmental Affairs
E-Mail : [e-mail]
Tel : [phone] Fax : [phone]