2ABSIPG-021Wireless Charge Pad-001

Federal Communication Commission Interference Statement This equipment has been tested and found to comply with the limits for a Class B digital device, pursuant to Part 15 of the FCC Rules. These limits are designed to provide reasonable protection against harmful interference in a residential installation. This equipment generates, uses and can radiate radio frequency energy and, if not installed and used in accordance with the instructions, may cause harmful interference to radio communications. However, there is no guarantee that interference will not occur in a particular installation. If this equipment does cause harmful interference to radio or television reception, which can be determined by turning the equipment off and on, the user is encouraged to try to correct the interference by one or more of the following measures:  Reorient or relocate the receiving antenna.  Increase the separation between the equipment and receiver.  Connect the equipment into an outlet on a circuit different from that to which the receiver is connected.  Consult the dealer or an experienced radio/TV technician for help. FCC Caution: Any changes or modifications not expressly approved by the party responsible for compliance could void the user's authority to operate this equipment. 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. IMPORTANT NOTE: FCC Radiation Exposure Statement: This equipment complies with FCC radiation exposure limits set forth for an uncontrolled environment. This equipment should be installed and operated with minimum distance 10cm between the radiator & your body.

Confidentiality Request Letter Date: 2014/5/20 Federal Communications Commission Authorization and Evaluation Division FCC ID：2ABSIPG-021 Permanent Confidentiality Request Pursuant to Sections 0.457 and 0.459 of the Commission’s Rules, the Applicant Hereby requests confidential treatment of information accompanying this Application As outlined below: 1. Block Diagram 2. Circuit Diagram 3. Operational Description The above materials contain trade secrets and proprietary information not customarily released to the public. The public disclosure of these matters might be harmful to the Applicant and provide unjustified benefits to its competitors. The Applicant understands that pursuant to Rule 0.457, disclosure of this Application and all accompanying documentation will not be made before the date of the Grant for this application Sincerely, Applicant’s company name : POWERGENE TECHNOLOGY CO., LTD. TAIWAN BRANCH Applicant’s company address : 8F-1., No.1, Wuquan 1st Rd., Xinzhuang Dist., New Taipei City 24892, Taiwan Signature : _________________________________ Job Title and Dept. : DAVID HSU / General Manager E-mail : [email protected] Tel. : 886-2-22997006

Date: 2014/5/20 Federal Communications Commission 7435 Oakland Mills Rd Columbia MD 21046-1609 Subject: Product Certification Representative Authorization Letter FCC ID: 2ABSIPG-021 Product name: Wireless Charge Pad-001 To whom it may concern: We the undersigned, hereby authorize following person to act as our agent in the preparation of an application for equipment authorization of model PG-021 to the FCC Rules and Regulations. Sporton International Inc. Address : No. 52, Hwa Ya 1st Road., Kwei-Shan Hsiang, TaoYuan Hsien Taiwan R.O.C. Name : Wayne Hsu Job Title : Vice Manager e-mail : [email protected] We further certifies that neither the applicant nor any party to this application, as defined in 47 CFR Ch. 1.2002(b), is subject to a denial to Federal benefits, that include FCC benefits, pursuant to section 5301 of the Anti-Drug Abuse Act of 1998, 21 U.S.C. 835(a). This appointment also includes the authority to complete FCC Form 731 on our behalf and sign the application as an authorized agent. Applicant : POWERGENE TECHNOLOGY CO., LTD. TAIWAN BRANCH Address : 8F-1., No.1, Wuquan 1st Rd., Xinzhuang Dist., New Taipei City 24892, Taiwan Signature : _________________________________ Name and Job Title. : DAVID HSU / General Manager E-mail : [email protected] Tel. : 886-2-22997006

FCC Test Report Report No. : EP3D2529 SPORTON International Inc. PAGE NUMBER : B1 OF B7 TEL : 886-3-327-3456 ISSUED DATE : Mar. 20, 2014 FAX : 886-3-327-0973 APPENDIX B. Photographs of EUT FCC Test Report Report No. : EP3D2529 SPORTON International Inc. PAGE NUMBER : B2 OF B7 TEL : 886-3-327-3456 ISSUED DATE : Mar. 20, 2014 FAX : 886-3-327-0973 FCC Test Report Report No. : EP3D2529 SPORTON International Inc. PAGE NUMBER : B3 OF B7 TEL : 886-3-327-3456 ISSUED DATE : Mar. 20, 2014 FAX : 886-3-327-0973

PG021 Wireless Pad Print - P.GENE V022014/07/16 1:1 Revise： Artwork PGENE PG-021 PP

FCC Test Report Report No. : EP3D2529 SPORTON International Inc. PAGE NUMBER : B4 OF B7 TEL : 886-3-327-3456 ISSUED DATE : Mar. 20, 2014 FAX : 886-3-327-0973 FCC Test Report Report No. : EP3D2529 SPORTON International Inc. PAGE NUMBER : B5 OF B7 TEL : 886-3-327-3456 ISSUED DATE : Mar. 20, 2014 FAX : 886-3-327-0973 FCC Test Report Report No. : EP3D2529 SPORTON International Inc. PAGE NUMBER : B6 OF B7 TEL : 886-3-327-3456 ISSUED DATE : Mar. 20, 2014 FAX : 886-3-327-0973 FCC Test Report Report No. : EP3D2529 SPORTON International Inc. PAGE NUMBER : B7 OF B7 TEL : 886-3-327-3456 ISSUED DATE : Mar. 20, 2014 FAX : 886-3-327-0973

RF Exposure Report Report No. : FA3D2529 SPORTON INTERNATIONAL INC. Page No. : 1 of 6 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 1 Maximum Permissible Exposure 1.1 Maximum Permissible Exposure 1.1.1 Limit of Maximum Permissible Exposure Limits for Occupational / Controlled Exposure Frequency Range (MHz) Electric Field Strength (E) (V/m) Magnetic Field Strength (H) (A/m) Power Density (S) (mW/ cm²) Averaging Time |E|²,|H|² or S (minutes) 0.3-3.0 614 1.63 (100)* 6 3.0-30 1842 / f 4.89 / f (900 / f)* 6 30-300 61.4 0.163 1.0 6 300-1500 F/300 6 1500-100,000 5 6 Limits for General Population / Uncontrolled Exposure Frequency Range (MHz) Electric Field Strength (E) (V/m) Magnetic Field Strength (H) (A/m) Power Density (S) (mW/ cm²) Averaging Time |E|²,|H|² or S (minutes) 0.3-1.34 614 1.63 (100)* 30 1.34-30 824/f 2.19/f (180/f)* 30 30-300 27.5 0.073 0.2 30 300-1500 F/1500 30 1500-100,000 1.0 30 Note 1: f = frequency in MHz ; *Plane-wave equivalent power density Note 2: For the applicable limit, see FCC 1.1310 RF Exposure Report Report No. : FA3D2529 SPORTON INTERNATIONAL INC. Page No. : 2 of 6 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 RF Field Strength Limits for Controlled Use Devices (Controlled Environment) Frequency Range (MHz) Electric Field (V/m rms) Magnetic Field (A/m rms) Power Density (W/m2) Averaging Time (minutes) 0.003-1 600 4.9 - 6 1-10 600/ƒ 4.9/ƒ - 6 10-30 60 4.9/ƒ - 6 30-300 60 0.163 10* 6 300-1500 3.54 ƒ 0.5 0.0094 ƒ 0.5 ƒ/30 6 1500-15000 137 0.364 50 6 15000-150000 137 0.364 50 616000/ƒ 1.2 150000-300000 0.354 ƒ 0.5 9.4 x 10-4 ƒ 0.5 3.33 x 10-4 ƒ 616000/ƒ 1.2 RF Field Strength Limits for Devices Used by the General Public (Uncontrolled Environment) Frequency Range (MHz) Electric Field (V/m rms) Magnetic Field (A/m rms) Power Density (W/m2) Averaging Time (minutes) 0.003-1 280 2.19 - 6 1-10 280/ƒ 2.19/ƒ - 6 10-30 28 2.19/ƒ - 6 30-300 28 0.073 2* 6 300-1500 1.585 ƒ 0.5 0.0042 ƒ 0.5 ƒ/150 6 1500-15000 61.4 0.163 10 6 15000-150000 61.4 0.163 10 616000/ƒ 1.2 150000-300000 0.158 ƒ 0.5 4.21 x 10 -4 ƒ 0.5 6.67 x 10 -5 ƒ 616000/ƒ 1.2 Note 1: ƒ is frequency in MHz. Note 2: For the applicable limit, see IC RSS-102 RF Exposure Report Report No. : FA3D2529 SPORTON INTERNATIONAL INC. Page No. : 3 of 6 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 1.2 Testing Applied Standards According to the specifications of the manufacturer, the EUT must comply with the requirements of the following standards:  FCC KDB 680106 D01 RF Exposure Wireless Charging Apps v02 - Part 2 Section 2.109 1.3 Ancillary Equipment Ancillary Equipment No. Equipment Brand Name Model Name FCC ID 1 Notebook DELL E5530 DoC 2 Phone Samsung S3 GT-I9300 DoC 1.4 Testing Location Information Testing Location HWA YA ADD : No. 52, Hwa Ya 1st Rd., Kwei-Shan Hsiang, Tao Yuan Hsien, Taiwan, R.O.C. TEL : 886-3-327-3456 FAX : 886-3-327-0973 Test Condition Test Site No. Test Engineer Test Environment RF Conducted TH01-HY Ian 24.8°C / 61% RF Exposure Report Report No. : FA3D2529 SPORTON INTERNATIONAL INC. Page No. : 4 of 6 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 1.5 The Worst Charging Condition Ancillary Equipment Charging Condition Worst Charging Condition Phone < 1% Battery Status < 1% Battery Status Phone 50% Battery Status Note 1: For Wireless Power Consortium Qi specification, a lower operating frequency or high duty cycle result in the transfer of a higher amount of power and charging current. 1.5.1 Test Method Test Method Performed aggregate both leakage E-field and H-field at surrounding the device from all simultaneous transmitting coils. During testing, the EUT was placed on a non-conductive table top and the ancillary equipment (e.g., mobile phone) was placed on the EUT for charging. Maximum E-field and H-field measurements were tested 10cm from each side of the EUT. Along the side of the EUT to center of E-field probe and H-field probe were positioned at the location to search maximum field strength. 1.5.2 Test Setup E-field and H-field Measurement RF Exposure Report Report No. : FA3D2529 SPORTON INTERNATIONAL INC. Page No. : 5 of 6 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 1.5.3 Result of Maximum Permissible Exposure Maximum Permissible Exposure Charging Condition Separation Probe from EUT Side E-field (V/m) H-field Limit (A/m) < 1% Battery Status 10cm Left 1.12 0.318 < 1% Battery Status 10cm Right 1.03 0.317 < 1% Battery Status 10cm Top 0.76 0.323 < 1% Battery Status 10cm Bottom 0.91 0.309 < 1% Battery Status 10cm Z-axis above EUT 2.22 0.383 Limit 614 1.63 Margin Limit (%) 0.36% 23.51% RF Exposure Report Report No. : FA3D2529 SPORTON INTERNATIONAL INC. Page No. : 6 of 6 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 2 Test Equipment and Calibration Data Instrument Manufacturer Model No. Serial No. CharacteristicsCalibration Date Remark B-Field Probe Narda Safety Test Solutions GmbH B-Field Probe 100 cm 2 M-0652 50Hz~400KHz Jun. 17, 2013 Conducted (TH01-HY) Exposure Level Te s t e Narda Safety Test Solutions GmbH ELT-400 N-0210 100KHz~3MHzJun. 26, 2013 Conducted (TH01-HY) Probe EF Narda Safety Test Solutions GmbH 0391 E-FieldD-0667 0.1MHz ~ 3GHzJun. 24, 2013 Conducted (TH01-HY) Broadband Field Meter Narda Safety Test Solutions GmbH NBM-550 E-0847 0.1MHz ~ 3GHzJun. 07, 2013 Conducted (TH01-HY) Note: Calibration Interval of instruments listed above is two year.

FCC Test Report Report No. : FR3D2529 SPORTON INTERNATIONAL INC. Page No. : 1 of 27 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 FCC Test Report Equipment : Wireless Charge Pad-001 Brand Name : P.GENE Model No. : PG-021 FCC ID : 2ABSIPG-021 Standard : 47 CFR FCC Part 15.209 Operating Band : 110-205 kHz FCC Classification : DCD (for 110-205kHz only) Equipment Type : Wireless Power Transfer for Consumer Devices Output power : 5W (from Each Primary Coil) Applicant Manufacturer : POWERGENE Technology Co., LTD. Taiwan Branch 8F.-1, No.1, Wuquan 1st Rd., Xinzhuang Dist., New Taipei City, Taiwan The product sample received on Dec. 25, 2013 and completely tested on Jan. 21, 2014. We, SPORTON, would like to declare that the tested sample has been evaluated in accordance with the procedures given in ANSI C63.10-2009 and shown compliance with the applicable technical standards. The test results in this report apply exclusively to the tested model / sample. Without written approval of SPORTON INTERNATIONAL INC., the test report shall not be reproduced except in full. Reviewed by: Wayne Hsu / Assistant Manager FCC Test Report Report No. : FR3D2529 SPORTON INTERNATIONAL INC. Page No. : 2 of 27 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 Table of Contents 1 GENERAL DESCRIPTION .................................................................................................................... 5 1.1 Information.............................................................................................................................................. 5 1.2 Accessories ............................................................................................................................................ 6 1.3 Support Equipment ................................................................................................................................. 6 1.4 Testing Applied Standards ..................................................................................................................... 6 1.5 Testing Location Information .................................................................................................................. 6 1.6 Measurement Uncertainty ...................................................................................................................... 7 2 TEST CONFIGURATION OF EUT ........................................................................................................ 8 2.1 The Worst Case Configuration ............................................................................................................... 8 2.2 The Worst Charger Frequencies Configuration ..................................................................................... 8 2.3 The Worst Case Measurement Configuration ........................................................................................ 8 2.4 Test Setup Diagram ............................................................................................................................... 9 3 TRANSMITTER TEST RESULT .......................................................................................................... 11 3.1 AC Power-line Conducted Emissions .................................................................................................. 11 3.2 Transmitter Radiated Emissions .......................................................................................................... 15 3.3 Emission Bandwidth ............................................................................................................................. 25 4 TEST EQUIPMENT AND CALIBRATION DATA ................................................................................ 27 APPENDIX A. TEST PHOTOS APPENDIX B. PHOTOGRAPHS OF EUT FCC Test Report Report No. : FR3D2529 SPORTON INTERNATIONAL INC. Page No. : 3 of 27 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 Summary of Test Result Conformance Test Specifications Report Clause Ref. Std. Clause Description Measured Limit Result 1.1.2 15.203 Antenna RequirementAntenna connector mechanism complied FCC 15.203 Complied 3.1 15.207 AC Power-line Conducted Emissions [dBuV]:0.1913990MHz 49.72 (Margin 14.26dB) – QP 40.16 (Margin 13.82dB) – AV FCC 15.207 Complied 3.2 15.209 Transmitter Radiated Emissions [dBuV/m at 3m]:30.000MHz 33.30 (Margin 6.70dB) - PK FCC 15.209 Complied 3.3 15.215(c) Emission Bandwidth 20dB Bandwidth 2.76 [kHz] N/A Complied FCC Test Report Report No. : FR3D2529 SPORTON INTERNATIONAL INC. Page No. : 4 of 27 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 Revision History Report No. Version Description Issued Date FR3D2529 Rev. 01 Initial issue of report Mar. 20, 2014 FCC Test Report Report No. : FR3D2529 SPORTON INTERNATIONAL INC. Page No. : 5 of 27 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 1 General Description 1.1 Information 1.1.1 General Information Wireless Power Transfer General Information Frequency Range Modulation Charging Freq. (kHz) Field Strength (dBuV/m) 110-205 kHz ASK 110-205 79.15 Power Transfer Method Output power from each primary coil Max. coupling surface area Charging Method Magnetic induction and only single primary coil coupling secondary coil 5W 40 cm 2 Client directly contact Note 1: Field strength performed peak level at 3m. 1.1.2 Antenna Information Antenna Category Equipment placed on the market without antennas Integral antenna (antenna permanently attached) External antenna (dedicated antennas) 1.1.3 Type of EUT Identify EUT EUT Serial Number N/A Presentation of Equipment Production ; Pre-Production ; Prototype Type of EUT Stand-alone Combined (EUT where the radio part is fully integrated within another device) Combined Equipment - Brand Name / Model No.: ... Plug-in radio (EUT intended for a variety of host systems) Host System - Brand Name / Model No.: ... Other: 1.1.4 Test Signal Duty Cycle Operated Mode for…

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FCC Test Report Report No. : FR3D2529 SPORTON INTERNATIONAL INC. Page No. : A1 of A5 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 Appendix A. Test Photos FCC Test Report Report No. : FR3D2529 SPORTON INTERNATIONAL INC. Page No. : A2 of A5 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 1 Photographs of Conducted Emissions Test Configuration FRONT VIEW REAR VIEW FCC Test Report Report No. : FR3D2529 SPORTON INTERNATIONAL INC. Page No. : A3 of A5 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 SIDE VIEW FCC Test Report Report No. : FR3D2529 SPORTON INTERNATIONAL INC. Page No. : A4 of A5 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 2 Photographs of Radiated Emissions Test Configuration For radiated emissions 9kHz~30MHz FRONT VIEW REAR VIEW FCC Test Report Report No. : FR3D2529 SPORTON INTERNATIONAL INC. Page No. : A5 of A5 TEL : 886-3-327-3456 Report Version : Rev. 01 FAX : 886-3-327-0973 For radiated emissions 30MHz~1GHz FRONT VIEW REAR VIEW