2BDWN23MODD1-1Insulin pump patch

User Guide Toll-free at 866-710-1200 10740 Thornmint Road San Diego, CA 92127 United States For updates, questions, or assistance with your MODD1 System, please contact Modular Medical Customer Care anytime. We are here for you. Visit www.Modular-Medical.com 1 This User Guide will help you navigate your Modular Medical MODD1 Insulin Delivery System (referred to as the “MODD1 System”). It provides warnings, helpful notes, and step-by-step instructions for the safe use of the System. Federal law restricts this device to sale by or on the order of a physician. The System should only be used by people who have been prescribed this device and only for the stated intended use. This User Guide uses symbols and highlighted text to indicate important information. Important safety information is highlighted, as seen below. This provides helpful information to assist with the use of your MODD1 System. This informs you of any problems associated with the the use or misuse of the MODD1 System, including malfunctions, failures, damage to the device or other property. This informs you of important safety information associated with the use or misuse of the MODD1 System, including injury or death. About This User Guide WARNING: Before using your MODD1 System, ensure that you have been appropriately trained on its use by a certified Modular Medical Insulin Delivery System trainer. CAUTION: NOTE: WARNING: 2 1.0 Overview ........................................................................ 1.1 Indications for Use ....................................................... 1.2 Insulin Compatibility Information ................................ 1.3 Contraindications for Use ............................................ 1.4 MODD1 System ............................................................. 1.5 System Components .................................................... 2.0 Setting Up Your System ................................................... Step 1: Preparing the Infusion Site ................................. Step 2: Inserting the Infusion Set .................................... Step 3: Power on the Pump ............................................. Step 4: Program your Basal Schedule in the App ........... Step 5: Filling the Syringe with Insulin ............................. Step 6: Filling the Insulin Cartridge .................................. Step 7: Priming the Infusion Tube .................................... Step 8: Attaching the Adhesive Pad and Placing the System to Your Body ......................... 3.0 Using the System .............................................. 3.1 Checking the System Status ............................ 3.2 Delivering a Bolus ............................................. 3.3 Cancelling a Bolus Delivery .............................. 3.4 Suspending Basal Delivery ............................... 3.5 Detaching Your Pump ....................................... 3.6 Replacing Your Infusion Set & Cartridge .......... 3.7 Replacing Your Pump ..................................... TABLE OF CONTENTS 4.0 MMI Phone Application ..................................... 4.1 Connecting the App to the Pump ...................... 4.2 Setting Basal Schedule ...................................... 4.3 General App Interface......................................... 4.4 Pump Status ....................................................... 4.5 Activity Log ......................................................... 4.6 App Notifications ............................................... 4 5 5 6 8 10 32 33 35 37 38 39 41 43 44 47 48 49 51 52 53 12 13 14 16 18 20 23 26 29 3 5.0 Critical Alarms......................................................... 6.0 Emergency Kit ......................................................... 7.0 Care and Maintenance ............................................. 7.1 Usage Conditions .................................................... 7.2 Storage Conditions ................................................. 7.3 Possible Risks .......................................................... 7.4 Non-serviceable Equipment Statement.............. 7.5 Trouble Shooting ...................................................... 7.6 Traveling by Air ......................................................... 7.7 MRI Safety Information ............................................ 7.8 Customer Care .......................................................... 7.9 Warranty .................................................................. 7.10 Return & Exchange Policy ................................... ...... 8.0 Technical Information ......................................... 8.1 System Specifications .......................................... 8.2 Performance Characteristics ........................... 8.3 Time to Occlusion Alarm ...................................... 8.4 Electromagnetic Compatability ........................... 8.5 Federal Communictions Commission ................. 8.6 External Influences Information ........................... 9.0 Label Symbols ....................................................... 9.1 Glossary ................................................................. 9.2 Index ....................................................................... 54 56 58 59 61 63 64 65 67 67 68 69 70 72 72 81 82 87 89 91 94 96 4 INTENDED USE: The Modular Medical MODD1 Insulin Delivery System is intended for the treatment of diabetes mellitus in persons requiring insulin. Your MODD1 System consists of a Pump, Insulin Cartridge, Infusion Set, Adhesive Pad, and a MMI App. The App operates on your smartphone device and connects to the Pump via Bluetooth® connection to support basal rate programming and activity information. The MODD1 System can be filled with up to 3.0mL (300 units) of Humalog® U-100 rapid-acting insulin and can be worn continuously for three days. Your Healthcare Professional will help you to manage your insulin dosing regimen and prescribe insulin. The MODD1 System can b…

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10740 Thornmint Road, San Diego, CA 92127 - modular-medical.com Covered Equipment Certification Attestation Letter December 4, 2023 Nemko North America, Inc. 303 River Road Ottawa K1V 1H2 Canada ATTN.: Reviewing Engineer FCC ID: 2BDWN23MODD1-1 Modular Medical, Inc. (“the applicant”) certifies that the equipment for which authorization is sought is not “covered” equipment prohibited from receiving an equipment authorization pursuant to section §2.903 of the FCC rules. Note: If the equipment for which the applicant seeks authorization is produced by any of the entities identified on the current Covered List, the applicant should include an explanation on why the equipment is not “covered” equipment. Modular Medical, Inc. (“the applicant”) certifies that, as of the date of the filing of the application, the applicant is not identified on the Covered List as an entity producing “covered” equipment. Signed: Printed name: Paul DiPerna Title: President Company Name: Modular Medical, Inc. Date: 12/4/2023 Paul DiPerna (Dec 4, 2023 17:47 PST) FCC Covered Equipment Certification Attestation Letter MODD Final Audit Report2023-12-05 Created:2023-12-04 By:Tracey Manson ([email protected]) Status:Signed Transaction ID:CBJCHBCAABAAFnUeJldAPxNMB3XnYGwbM57a8uZJwJ1f "FCC Covered Equipment Certification Attestation Letter MODD" History Document created by Tracey Manson ([email protected]) 2023-12-04 - 11:48:19 PM GMT- IP address: 76.199.110.25 Document emailed to Paul DiPerna ([email protected]) for signature 2023-12-04 - 11:48:35 PM GMT Email viewed by Paul DiPerna ([email protected]) 2023-12-05 - 1:46:54 AM GMT- IP address: 76.199.110.25 Document e-signed by Paul DiPerna ([email protected]) Signature Date: 2023-12-05 - 1:47:54 AM GMT - Time Source: server- IP address: 76.199.110.25 Agreement completed. 2023-12-05 - 1:47:54 AM GMT

* the applicant must designate a contact located in the United States for purposes of acting as the applicant’s agent for service of process, regardless of whether the applicant is a domestic or foreign entity. An applicant located in the United States may designate itself as the agent for service of process. ** the agent does not have an FRN because they do no other business with the FCC except for acting as a US agent for service of process, and therefore are not required to have their own FRN. 10740 Thornmint Road, San Diego, CA 92127 - modular-medical.com U.S. Agent Designation for Service of Process - Certification Attestation Letter December 4, 2023 Nemko North America, Inc. 303 River Road Ottawa K1V 1H2 Canada ATTN.: Reviewing Engineer FCC ID: 2BDWN23MODD1-1 Applicant FRN: 0034519496 Per section §2.911(d)(7) of the FCC rules, Modular Medical, Inc. (“the applicant”) certifies that the equipment for which authorization is sought is designated to the following U.S. Designated agent* for service of process: Company Name: Modular Medical, Inc. Physical U.S. Company Address: 10740 Thornmint Road, San Diego, CA 92127 Agent Name: Paul DiPerna Agent Email Address: [email protected] Agent FRN**: 0034519496 The above contact person accepts the obligation for service of process. The applicant accepts its obligation to maintain an agent for service of process in the United States for no less than one year after either the grantee has permanently terminated all marketing and importation of the applicable equipment within the U.S., or the conclusion of any Commission-related administrative or judicial proceeding involving the equipment, whichever is later. Applicant Signed: Designated Agent Signed: (Required, if different to Applicant): Signed: Signed: Printed name: Paul DiPerna Printed name: Click here to enter text. Title: President Title: Click here to enter text. Company Name: Modular Medical, Inc. Company Name: Click here to enter text. Date: December 4, 2023 Date: Click here to enter a date. Paul DiPerna (Dec 4, 2023 17:48 PST) FCC U.S. Agent Designation Attestation MODD Final Audit Report2023-12-05 Created:2023-12-04 By:Tracey Manson ([email protected]) Status:Signed Transaction ID:CBJCHBCAABAA89FbjLjctR3Qs_muMQKdxiKv5vjhUiYQ "FCC U.S. Agent Designation Attestation MODD" History Document created by Tracey Manson ([email protected]) 2023-12-04 - 11:48:59 PM GMT- IP address: 76.199.110.25 Document emailed to Paul DiPerna ([email protected]) for signature 2023-12-04 - 11:50:13 PM GMT Email viewed by Paul DiPerna ([email protected]) 2023-12-05 - 1:48:01 AM GMT- IP address: 76.199.110.25 Document e-signed by Paul DiPerna ([email protected]) Signature Date: 2023-12-05 - 1:48:10 AM GMT - Time Source: server- IP address: 76.199.110.25 Agreement completed. 2023-12-05 - 1:48:10 AM GMT

10740 Thornmint Road, San Diego, CA 92127 - modular-medical.com Nemko North America, Inc. 303 River Road, Ottawa, Ontario, Canada K1V 1H2 Attn: Director of Certification Authority to Act as Agent for FCC Application On our behalf, I appoint Spencer Zhong of Nemko Canada, Inc. at 303 River Road, Ottawa, Ontario, Canada K1V 1H2, to act as our agent in the preparation of this application for equipment certification. I certify that submitted documents properly describe the device or system for which equipment certification is sought. I also certify that each unit manufactured, imported or marketed, as defined in FCC regulations will have affixed to it a label identical to that submitted for approval with this application. In signing this letter, Applicant certifies that neither the applicant nor any party to the application is not subject to a denial of Federal benefits, that include FCC benefits, pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. § 862 because of a conviction for possession or distribution of a controlled substance. Further, no party, as defined in 47 CFR 1.2002 (b), to the application is subject to denial of federal benefits, that includes FCC benefits. We also declare that the information provided to the FCC is true and correct to the best of our knowledge (47 CFR 2.911(d)) and we have been informed of the grantee responsibilities (47 CFR 2.909) with regard to certified equipment. For instances where our authorized agent signs the application for certification on our behalf, I acknowledge that all responsibility for complying with the terms and conditions for certification, as specified by Nemko Canada Inc, still resides with Modular Medical, Inc. Dated: December 4, 2023 Agency agreement expiration date: 2024-11-30 *Up to 12 months Signed by: Paul DiPerna Signature Print name President Title 949.370.9062 Phone On behalf of: Modular Medical, Inc. Company name Paul DiPerna (Dec 4, 2023 17:46 PST) Authority to Act as Agent - FCC MODD Final Audit Report2023-12-05 Created:2023-12-04 By:Tracey Manson ([email protected]) Status:Signed Transaction ID:CBJCHBCAABAAgkvTuUWNV5Zy-ZKZbZB2zXRiEPV9lCC1 "Authority to Act as Agent - FCC MODD" History Document created by Tracey Manson ([email protected]) 2023-12-04 - 11:47:35 PM GMT- IP address: 76.199.110.25 Document emailed to Paul DiPerna ([email protected]) for signature 2023-12-04 - 11:47:58 PM GMT Email viewed by Paul DiPerna ([email protected]) 2023-12-05 - 1:45:41 AM GMT- IP address: 76.199.110.25 Document e-signed by Paul DiPerna ([email protected]) Signature Date: 2023-12-05 - 1:46:12 AM GMT - Time Source: server- IP address: 76.199.110.25 Agreement completed. 2023-12-05 - 1:46:12 AM GMT

10740 Thornmint Road, San Diego, CA 92127 - modular-medical.com December 6, 2023 Nemko North America, Inc. 303 River Road, Ottawa, Ontario, Canada K1V 1H2 Attn: Director of Certification Request for Confidentiality – FCC FCC ID: 2BDWN23MODD1-1 Pursuant to FCC 47 CFR 0.457(d)(1)(ii) and 0.459 and FCC guidance published in KDB 726920, we hereby request confidential treatment of information accompanying this application as outlined below. We request the exhibits selected below as long term confidential (LTC) be withheld from public view permanently: Selection of exhibits for LTC - general Exhibit name ☒ Permanent (Long Term) Block Diagrams ☒ Permanent (Long Term) Operation Description / Theory of Operation ☒ Permanent (Long Term) Parts List & Placement / BOM ☒ Permanent (Long Term) Schematics Selection of exhibits for LTC - specific 1 Exhibit name ☐ Permanent (Long Term) Tune-Up Procedure ☐ Permanent (Long Term) SDR 2 Software / Security Info Selection of exhibits for LTC (with NDA) 3 Exhibit name ☐ Permanent (Long Term) User’s Manual ☐ Permanent (Long Term) Internal Photos We also request the exhibits selected below as short term confidential (STC) be withheld from public view for a period of 180 days 4 from the date of the Grant of Equipment Authorization and prior to marketing. This is to avoid premature release of sensitive information prior to marketing or release of the product to the public: Selection of exhibits for STC 5 Exhibit name ☐ Short Term Block Diagrams ☐ Short Term Operation Description / Theory of Operation ☐ Short Term Parts List & Placement / BOM ☐ Short Term Schematics ☐ Short Term User’s Manual ☐ Short Term Internal Photos ☒ Short Term External Photos ☒ Short Term Test Setup Photos ☐ Short Term Tune-Up Procedure (for Licensed equipment only) Our company has spent a substantial effort in developing this product and it is one of the first of its kind in the industry. Having the subject information easily available to "competition" would negate the advantage they have achieved by developing this product. Not protecting the details of the design will result in financial hardship. When the device is marketed before the requested number of days listed above, the grantee will inform the TCB to release the Short- Term Confidentiality information withheld on the FCC equipment authorization website . 1 - Tune up procedure is applicable only for licensed equipment. 2 - The FCC rules require that any radio, in which the software is designed or expected to be modified by a party other than the manufacturer that would affect the operating parameters of frequency range, modulation type, maximum output power or other radio frequency parameters outside the range under which the transmitter has been approved in accordance with the FCC rules, must be certified as a software-defined radio (SDR). 3 - These items require further information to be provided to TCB before permanent confidentiality will be extended to these exhibits. Please refer to FCC KDB 726920 and review section II, 3) regarding specific information (NDA) that must accompany these requests. 4 - Number of days can be listed up to 180 but should not go past the date of beginning of product marketing/sale. 5 - Any exhibits that may have already been requested to have “Permanent” confidentiality need not be repeated under Short-Term confidentiality request. 10740 Thornmint Road, San Diego, CA 92127 - modular-medical.com The above information contains trade secrets and proprietary information not customarily released to the public. The public disclosure of this information might be harmful to the applicant and provide unjustified benefits to its competitors. The Applicant understands that pursuant to Rule 0.457(d)(1)(ii), disclosure of this Application and all accompanying materials will not be made before the date of the Grant for this Application. Sincerely, Signed by: Paul DiPerna Signature Print name President Title 949.370.9062 Phone Modular Medical, Inc. Company 10740 Thornmint Road, San Diego, CA 92127 Address Paul DiPerna (Dec 6, 2023 11:45 PST) Request for Confidentiality - FCC - MODD V2 Final Audit Report2023-12-06 Created:2023-12-06 By:Tracey Manson ([email protected]) Status:Signed Transaction ID:CBJCHBCAABAAozd-8EJ34_v2yTsPIa7kHXscpEpew6Nd "Request for Confidentiality - FCC - MODD V2" History Document created by Tracey Manson ([email protected]) 2023-12-06 - 7:32:43 PM GMT- IP address: 76.199.110.25 Document emailed to Paul DiPerna ([email protected]) for signature 2023-12-06 - 7:33:02 PM GMT Email viewed by Paul DiPerna ([email protected]) 2023-12-06 - 7:45:41 PM GMT- IP address: 76.199.110.25 Document e-signed by Paul DiPerna ([email protected]) Signature Date: 2023-12-06 - 7:45:53 PM GMT - Time Source: server- IP address: 76.199.110.25 Agreement completed. 2023-12-06 - 7:45:53 PM GMT

External Photos of EUT External view 1 External view 2 External view 3 External view 4 External view 5 External view 6

Label

LBL-4 v.6.0 Made in Mexico MTL-54 MR (01)XXXXXXXXXXXXX (10) PYYAAAL (21) MM-YYAAALXX Modular Medical Inc. San Diego, CA 92127, USA 866-710-1200 modular-medical.com 90% 15% 140° F 60° C -4° F -20° C PUMP (x1) IP24 FCC ID : 2BDWN23MODD1-1 PYYAAALL YYYY-MM-DD

Internal Photos of EUT Fig 1 PCBA view 1 Fig 2 PCBA view 2 Fig 3 PCBA placement in host

www.nemko.com ARFWL (FCC & ISED MPE Exemption)).docx; Date: May, 2021 Assessment report REP0182701-3R1ARWL Date of issue: January 16, 2024 Applicant: Modular Medical, Inc. Product: Insulin Pump Path Model MODD1 FCC ID: 2BDWN23MODD1-1 Type of assessment: SAR Exemption Report Specifications:  FCC 47 CFR Part 2 Subpart J, §2.1093  KDB 447498 D01 General RF Exposure Guidance v06 Choose Scandinavian trust Report reference ID: REP00182701-3R1ARWL Page 2 of 7 Lab and test locations Company name Nemko USA, Inc. Address 1110 Faraday Ave, Suite 150 City Carlsbad State California Postal code 92008 Country USA Telephone +1 760 444 3500 Website www.nemko.com Prepared by James Cunningham, EMC/WL Manager Date January 16, 2024 Reviewer signature Limits of responsibility Note that the results contained in this report relate only to the items tested and were obtained in the period between the date of initial receipt of samples and the date of issue of the report. This test report has been completed in accordance with the requirements of ISO/IEC 17025. All results contain in this report are within Nemko USA’s ISO/IEC 17025 accreditation. Copyright notification Nemko USA Inc. authorizes the applicant to reproduce this report provided it is reproduced in its entirety and for use by the company’s employees only. Any use which a third party makes of this report, or any reliance on or decisions to be made based on it, are the responsibility of such third parties. Nemko USA Inc. accepts no responsibility for damages, if any, suffered by any third party because of decisions made or actions based on this report. © Nemko USA Inc. Report reference ID: REP00182701-3R1ARWL Page 3 of 7 Table of Contents Table of Contents ......................................................................................................................................................................................................... 3 Evaluation summary ........................................................................................................................................................................... 4 1.1 SAR exemption for stand-alone transmission ........................................................................................................................................................... 4 Section 1.1 SAR exemption for stand-alone transmission Report reference ID: REP00182701-3R1ARWL Page 4 of 7 Evaluation summary 1.1 SAR exemption for stand-alone transmission 1.1.1 References, definition, and limits FCC §2.1093 (2) The SAR limits for general population/uncontrolled exposure are 0.08 W/kg, as averaged over the whole body, and a peak spatial-average SAR of 1.6 W/kg, averaged over any 1 gram of tissue (defined as a tissue volume in the shape of a cube). Exceptions are the parts of the human body treated as extremities, such as hands, wrists, feet, ankles, and pinnae, where the peak spatial-average SAR limit is 4 W/kg, averaged over any 10 grams of tissue (defined as a tissue volume in the shape of a cube). Exposure may be averaged over a time period not to exceed 30 minutes to determine compliance with general population/uncontrolled SAR limits. FCC KDB 447498 D01 4.3.1 Standalone SAR test exclusion considerations a) For 100 MHz to 6 GHz and test separation distances ≤ 50 mm, the 1-g and 10-g SAR test exclusion thresholds are determined by the following: [(max. power of channel, including tune-up tolerance, mW) / (min. test separation distance, mm)] [√f (GHz) ] ≤ 3.0 for 1-g SAR, and ≤ 7.5 for 10-g extremity SAR, where: • f (GHz) is the RF channel transmit frequency in GHz • Power and distance are rounded to the nearest mW and mm before calculation • The result is rounded to one decimal place for comparison • The values 3.0 and 7.5 are referred to as numeric thresholds in step b) below. The test exclusions are only applicable when the minimum test separation distance is ≤ 50 mm, and for transmission frequencies between 100 MHz and 6 GHz. When the minimum test separation distance is < 5 mm, a distance of 5 mm is applied to determine SAR test exclusion. b) For 100 MHz to 6 GHz and test separation distances > 50 mm, the 1-g and 10-g SAR test exclusion thresholds are determined by the following: 1) {[Power allowed at numeric threshold for 50 mm in step a)] + [(test separation distance – 50 mm) (f (MHz) /150)]} mw, for 100 MHz to 1500 MHz 2) {[Power allowed at numeric threshold for 50 mm in step a] + [(test separation distance – 50 mm) x 10]} mW, for > 1500 MHz and ≤ 6 GHz c) For frequencies below 100 MHz, the following may be considered for SAR test exclusion. 1) For test separation distances > 50 mm and < 200 mm, the power threshold at the corresponding test separation distance at 100 MHz in step b) is multiplied by [1 + log(100/f (MHz) )] 2) For test separation distances ≤ 50 mm, the power threshold determined by the equation above for 50 mm and 100 MHZ is multiplied by ½. 3) SAR measurement procedures are not established below 100 MHz. Table 1.1-1: SAR Test Exclusion Thresholds for 100 MHz – 6 GHz and ≤ 50 mm Separation: 5 mm 10 mm 15 mm 20 mm 25 mm 30 mm 35 mm 40 mm 45 mm 50 mm 150 MHz 39 77 116 155 194 232 271 310 349 387 300 MHz 27 55 82 110 137 164 192 219 246 274 450 MHz 22 45 67 89 112 134 157 179 201 224 835 MHz 16 33 49 66 82 98 115 131 148 164 900 MHz 16 32 47 63 79 95 111 126 142 158 1500 MHz 12 24 37 49 61 73 86 98 110 122 1900 MHz 11 22 33 44 54 65 76 87 98 109 2450 MHz 10 19 29 38 48 57 67 77 86 96 3600 MHz 8 16 24 32 40 47 55 63 71 79 5200 MHz 7 13 20 26 33 39 46 53 59 66 5400 MHz 6 13 19 26 32 39 45 52 58 65 5800 MHz 6 12 19 25 31 37 44 50 56 62 Notes: Values in the table are in mW 10-g Extremity SAR Test Exclusion Power Thresholds are 2.5 times higher than the 1-g SAR Test Exclusion Thresholds indicated above. These thresholds do not apply, by extrapolation or other means, to occupational exposure limits. Section 1.1 SAR exemption for stand-alone transmission Report reference ID: RE…

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www.nemko.com FCC 15.247 & RSS-247 (BLE), Version V1.1 Nemko USA Inc., a testing laboratory, is accredited by ANAB. The tests included in this report are within the scope of this accreditation. REP0038337-1R1TRFWL Date of issue: January 16, 2024 Applicant: Modular Medical, Inc. Product description: Insulin pump patch Model: Product marketing name(s): MODD1 N/A FCC ID: 2BDWN23MODD1-1 Specifications:  FCC 47 CFR Part 15, Subpart C – §15.247 Operation within the bands 902 – 928 MHz, 2400 – 2483.5 MHz, 5727 – 5850 MHz Test report Report reference ID: REP0038337-1R1TRFEMC Page 2 of 57 Lab and test locations Company name Nemko USA Inc. Address 2210 Faraday Ave, Suite 150 City Carlsbad State California Postal code 92008 Country USA Telephone +1 760 444 3500 Website www.nemko.com FCC Site Number Test Firm Registration Number: 392943; Designation Number: US5058 ISED Test Site 2040B-3 Tested by Martha Espinoza, Wireless Test Engineer Reviewed by James Cunningham, EMC/WL Manager Review date January 16, 2024 Reviewer signature Limits of responsibility Note that the results contained in this report relate only to the items tested and were obtained in the period between the date of initial receipt of samples and the date of issue of the report. This test report has been completed in accordance with the requirements of ISO/IEC 17025. All results contain in this report are within Nemko USA’s ISO/IEC 17025 accreditation. This report must not be used by the client to claim product certification, approval, or endorsement by ANAB, NIST, or any agency of the U.S. Government. Copyright notification Nemko USA Inc. authorizes the applicant to reproduce this report provided it is reproduced in its entirety and for use by the company’s employees only. Any use which a third party makes of this report, or any reliance on or decisions to be made based on it, are the responsibility of such third parties. Nemko USA Inc. accepts no responsibility for damages, if any, suffered by any third party as a result of decisions made or actions based on this report. © Nemko USA Inc. Report reference ID: REP0038337-1R1TRFEMC Page 3 of 57 Table of Contents Table of Contents ......................................................................................................................................................................................................... 3 Report summary ................................................................................................................................................................................. 4 1.1 Test specifications .................................................................................................................................................................................................... 4 1.2 Exclusions ................................................................................................................................................................................................................. 4 1.3 Statement of compliance .......................................................................................................................................................................................... 4 1.4 Test report revision history ....................................................................................................................................................................................... 4 Summary of test results ...................................................................................................................................................................... 5 2.1 Sample information .................................................................................................................................................................................................. 5 2.2 Testing period ........................................................................................................................................................................................................... 5 2.3 Test results ............................................................................................................................................................................................................... 5 Equipment under test (EUT) details ..................................................................................................................................................... 6 3.1 Disclaimer ................................................................................................................................................................................................................. 6 3.2 Applicant................................................................................................................................................................................................................... 6 3.3 Manufacturer..............................................................................................................................................................…

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