Block Diagram

Siemens Healthcare GmbH, Henkestr. 127, 91052 Erlangen
TUV SUDAmerica Inc.
10 Centennial Drive
Peabody, MA 01960
USA
Dear Sir or Madam,
Name
Department
Telephone
Fax
E-mail
Date
SIEMENS ..•
• • ••
Healthlneers ..•
Melanie Martin
5H5 QT QR RA BC52
[phone]
[phone]
[e-mail]
October 27, 2021
We, Siemens Healthcare GmbH, hereby authorize Benjamin Puis, Thomas Ring and Stefan Breu of TUV SUD Product
Service GmbH, Au~ere Fr(jhlingstra~e 45, 94315 Straubing, Germany to act individually as our agent in all matters
relating to applications for the FCCID: S5H-WRC3and the Ie: 267AO-WRC3 equipment authorization in the USAand
CANADAfor the wireless products listed below, including the signing of all documents relating to these matters.
Model Numbers:
Wireless XRay Footswitch Mono,
Wireless XRay Footswitch Mono-MP
Wireless XRay Footswitch Biplane
Receiver, Wireless XRay Footswitch
Radio remote control WRC NRF
WRC NRFreceiver cpl.
4787797
4787813
4787805
4787771
10096785
10096788
This authorization is valid until December 2022 but shall be of no further effect after that date
Sincerely yours,
Siemens Healthcare GmbH
Eva-Maria Reiter
Senior Vice President Quality Management, Regulatory
Affairs and Process Management
Siemens Healthcare GmbH
Management: Bernhard Montag, President and Chief Executive Officer;
Darleen Caron, Jochen Schmitz, Christoph Zindel
Chairman of the Supervisory Board: Ralf P. Thomas
Registered office: Munich, Germany; Commercial Registry: Munich, HRB 213821
WEEE-Reg.-No. DE 64872105
SCF02/2021 V17.04
·6
if! t·£
Volker Glahn
Vice President Regulatory Affairs
Postal address:
Karlheinz-Kaske-Str. 5
91052 Erlangen
Germany
Tel.: [phone]
siemens.com/healthcare
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