A3LBTM2015BLUE TOOTH MODULE

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RF_160, Issue 02 Declaration of Authorization We Name: Samsung Electronics Co Ltd Address: 19 Chapin Rd., Building D City: Pine Brook State: New Jersey Country: United States Declare that: Name Representative of agent: Ms. Cathy Wang Agent Company name: BTL Inc. Address: No.3 Jinshagang 1st Road, Shixia, Dalang Town City: Dong Guan Country: China is authorized to apply for Certification and signing related documents of the following product(s), including 731 form(s): Product description: BLUE TOOTH MODULE Type designation: BTM2015 Trademark: SAMSUNG on our behalf. Date: 2015-07-30 City: Pine Brook Name: Chan Ho Youn, Function: General Manager Signature:  . Notes: (1): Required for FCC application (2): For FCC it must be the Grantee Code “owner” or the authorized agent.

FCC, Request for non-disclosure Date: 10-Aug-09 RF_501, Issue 5 Page 1 of 1 Company Name: Samsung Electronics Co Ltd Address : 19 Chapin Rd., Building D City: Pine Brook Country: United States To: Telefication B.V., Dept. FCC TCB Edisonstraat 12A 6902 PK ZEVENAAR The Netherlands Subject: Request for confidentiality FCC ID: A3LBTM2015 Reference number: ###### Dear FCC TCB, 1. Long-Term Confidentiality Pursuant to 47 CFR Section 0.459(a) & (b), we hereby requests non-disclosure and confidential treatment of the following materials submitted in support of FCC certification application: Bill(s) of Material Block Diagrams Operational Description Schematic Diagrams Tune-up Procedure Above materials contain secrets, proprietary and technical information, which would customarily be guarded from competitors under 47 CFR, section 0.457(d)(2). Disclosure or publication or any portion of this company confidential material to other parties could cause substantial competitive harm and provide unjustified benefits for competitors. 2. Short-Term Confidentiality (STC) Pursuant to Public Notice DA 04-1705 of the Commission’s policy, in order to comply with the marketing regulations in 47 CFR §2.803 and the importation rules in 47 CFR §2.1204, a pplicant hereby requests Short-Term Confidential treatment of the following materials (note 1): Internal Photos User’s Manual Test Set-up Photos External Photos Justification: Planned Release Date STC: (notes 2, 3, 4, 5) Date: 2015-07-30 Name and signature of applicant: Chan Ho Youn Notes: 1) A document or type of document can only have ONE type of confidentiality! 2) Short-Term confidentiality is in principle for 45 days from date of grant; it can be extended max 3 times (total time 180 days max.)! 3) FCC must be informed when marketing begins earlier. 4) Release takes place automatically thus extension must be requested in time. Telefication does not remind you of this! 5) Request for extension or for release must be received by Telefication at least 7 days before date of actual marketing or before expiration of the STC period

Modular Approval Request FCC (per DA 00-1407) Company name: Samsung Electronics Co Ltd Address: 19 Chapin Rd., Building D, Pine Brook, New Jersey, United States 07058 FCC ID：A3LBTM2015 Items to be covered Answer from applicant 1. The modular transmitter must have its own RF shielding. YES, Please refer to External Photos. 2. The modular transmitter must have buffered modulation/data inputs (if such inputs are provided) to ensure that the module will comply with Part 15 requirements under conditions of excessive data rates or over-modulation. NO, this device has no buffered modulation/data inputs. 3. The modular transmitter must have its own power supply regulation. NO, this device has no power supply regulation. 4. The modular transmitter must comply with the antenna requirements of Section 15.203 and 15.204(c). The antenna must either be permanently attached or employ a “unique” antenna coupler (at all connections between the module and the antenna, including the cable).. YES, it is printed antenna. 5. The modular transmitter must be tested in a stand-alone configuration, i.e., the module must not be inside another device during testing. This is intended to demonstrate that the module is capable of complying with Part 15 emission limits regardless of the device into which it is eventually installed. NO, The EUT is tested while installed within a typical host. Refer to test setup photo. 6. The modular transmitter must be labeled with its own FCC ID number, and, if the FCC ID is not visible when the module is installed inside another device, then the outside of the device into which the module is installed must also display a label referring to the enclosed module. This exterior label can use wording such as the following: “Contains Transmitter Module FCC ID: 2AEMI-PHOTON” or “Contains FCC ID: 2AEMI-PHOTON.” Any similar wording that expresses the same meaning may be used. The Grantee may either provide such a label, an example of which must be included in the application for equipment authorization, or, must provide adequate instructions along with the module which explain this requirement. In the latter case, a copy of these instructions must be included in the application for equipment authorization. YES, please refer to the exhibition label sample for this module. 7. The modular transmitter must comply with any specific rule or operating requirements applicable to the transmitter and the manufacturer must provide adequate instructions along with the module to explain any such requirements. A copy of these instructions must be included in the application for equipment authorization. For example, there are very strict operational and timing requirements that must be met before a transmitter is authorized for operation under Section 15.231. For instance, data transmission is prohibited, except for operation under Section 15.231(e), in which case there are separate field strength level and timing requirements. Compliance with these requirements must be assured. YES, please refer to the user manual. 8. The modular transmitter must comply with any applicable RF exposure requirements. For example, FCC Rules in Sections 2.1091, 2.1093 and specific Sections of Part 15, including 15.319(i), 15.407(f), 15.253(f) and 15.255(g), require that Unlicensed PCS, UNII and millimeter wave devices perform routine environmental evaluation for RF Exposure to demonstrate compliance. In addition, spread spectrum transmitters operating under Section 15.247 are required to address RF Exposure compliance in accordance with Section 15.247(b)(4). Modular transmitters approved under other Sections of Part 15, when necessary, may also need to address certain RF Exposure concerns, typically by providing specific installation and operating instructions for users, installers and other interested parties to ensure compliance. YES, RF exposure statement is attached in the user manual. Note: If compliance with one or more of the numbered requirements, listed above, cannot be demonstrated, it may be possible to obtain a “Limited Modular Approval” (LMA). Name and surname of applicant (or authorized representative): Chan Ho Youn Date: 2015-07-30 Signature:

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FCC RF EXPOSURE REPORT FCC ID: A3LBTM2015 Project No. : 1507C021 Equipment : BLUE TOOTH MODULE Model : BTM2015 Applicant : Samsung Electronics Co Ltd Address : 19 Chapin Rd., Building D, Pine Brook, New Jersey, United States According: : FCC Guidelines for Human Exposure IEEE C95.1 BTL INC. No.3, Jinshagang 1st Road, Shixia, Dalang Town, Dongguan, China. TEL: +86-769-8318-3000 FAX: +86-769-8319-6000 MPE CALCULATION METHOD: Calculation Method of RF Safety Distance: where: S = power density P = power input to the antenna G = power gain of the antenna in the direction of interest relative to an isotropic radiator R = distance to the center of radiation of the antenna Table for Filed Antenna Ant. Brand Model Name Antenna Type Connector Gain(dBi) Note 1 N/A N/A printed N/A 0.76 TEST RESULTS EUT： BLUE TOOTH MODULE Model Name : BTM2015 Temperature： 25 °C Relative Humidity: 55 % Test Voltage : AC 120V/60Hz Test Mode ： TX Mode _1Mbps Antenna Gain (dBi) Antenna Gain (numeric) Peak Output Power (dBm) Peak Output Power (mW) Power Density (S) (mW/cm 2 ) Limit of Power Density (S) (mW/cm 2 ) Te s t Result 0.76 1.1912 5.41 3.4754 0.000824041 Complies 0.76 1.1912 6.12 4.0926 0.000970401 Complies 0.76 1.1912 4.64 2.9107 0.000690161 Complies EUT： BLUE TOOTH MODULE Model Name : BTM2015 Temperature： 25 °C Relative Humidity: 55 % Test Voltage : AC 120V/60Hz Test Mode ： TX Mode _3Mbps Antenna Gain (dBi) Antenna Gain (numeric) Peak Output Power (dBm) Peak Output Power (mW) Power Density (S) (mW/cm 2 ) Limit of Power Density (S) (mW/cm 2 ) Te s t Result 0.76 1.1912 3.61 2.2961 0.000544441 Complies 0.76 1.1912 5.07 3.2137 0.000761991 Complies 0.76 1.1912 2.91 1.9543 0.000463391 Complies Note: the calculated distance is 20 cm.

Report No.: BTL-FICP-1-1507C021 Page 1 of 109 FCC&IC Radio Test Report FCC ID: A3LBTM2015 IC: 649E-BTM2015 This report concerns (check one): Original Grant Class II Change Project No. : 1507C021 Equipment : BLUE TOOTH MODULE Model Name : BTM2015 Applicant : Samsung Electronics Huizhou Co., Ltd Address : NO. 256, ZHONGKAI 6TH ROAD, CHENJIANG STREET, ZHONGKAI HIGH-TECH DEVELOPMENT ZONE, HUIZHOU CITY, GUANGDONG PROVINCE, P.R.CHINA Date of Receipt : Jul. 01, 2015 Date of Test : Jul. 01, 2015 ~ Jul. 15, 2015 Issued Date : Jul. 16, 2015 Tested by : BTL Inc. Testing Engineer : (David Mao) Technical Manager : (Leo Hung) Authorized Signatory : (Steven Lu) BTL INC. No.3, Jinshagang 1st Road, Shixia, Dalang Town, Dongguan, Guangdong, China. TEL: +86-769-8318-3000 FAX: +86-769-8319-6000 Report No.: BTL-FICP-1-1507C021 Page 2 of 109 Declaration BTL represents to the client that testing is done in accordance with standard procedures as applicable and that test instruments used has been calibrated with the standards traceable to National Measurement Laboratory (NML) of CHINA, or National Institute of Standards and Technology (NIST) of U.S.A. BTL's reports apply only to the specific samples tested under conditions. It is manufacture’s responsibility to ensure that additional production units of this model are manufactured with the identical electrical and mechanical components. BTL shall have no liability for any declarations, inferences or generalizations drawn by the client or others from BTL issued reports. BTL’s report must not be used by the client to claim product certification, approval, or endorsement b y NVLAP, NIST, or any agency of the Federal Government. This report is the confidential property of the client. As a mutual protection to the clients, the public and BTL-self, extracts from the test report shall not be reproduced except in full with BTL’s authorized written approval. BTL’s laboratory quality assurance procedures are in compliance with the ISO Guide 17025 requirements, and accredited by the conformity assessment authorities listed in this test report. Limitation For the use of the authority's logo is limited unless the Test Standard(s)/Scope(s)/Item(s) mentioned in this test report is (are) included in the conformity assessment authorities acceptance respective. Report No.: BTL-FICP-1-1507C021 Page 3 of 109 Table of Contents Page 1 . CERTIFICATION 7 2 . SUMMARY OF TEST RESULTS 8 2.1 TEST FACILITY 9 2.2 MEASUREMENT UNCERTAINTY 9 3 . GENERAL INFORMATION 10 3.1 GENERAL DESCRIPTION OF EUT 10 3.2 DESCRIPTION OF TEST MODES 12 3.3 TABLE OF PARAMETERS OF TEXT SOFTWARE SETTING 12 3.4 BLOCK DIAGRAM SHOWING THE CONFIGURATION OF SYSTEM TESTED 13 3.5 DESCRIPTION OF SUPPORT UNITS 13 4 . EMC EMISSION TEST 14 4.1 CONDUCTED EMISSION MEASUREMENT 14 4.1.1 POWER LINE CONDUCTED EMISSION LIMITS 14 4.1.2 TEST PROCEDURE 14 4.1.3 DEVIATION FROM TEST STANDARD 14 4.1.4 TEST SETUP 15 4.1.5 EUT OPERATING CONDITIONS 15 4.1.6 EUT TEST CONDITIONS 15 4.1.7 TEST RESULTS 15 4.2 RADIATED EMISSION MEASUREMENT 16 4.2.1 RADIATED EMISSION LIMITS 16 4.2.2 TEST PROCEDURE 17 4.2.3 DEVIATION FROM TEST STANDARD 17 4.2.4 TEST SETUP 18 4.2.5 EUT OPERATING CONDITIONS 19 4.2.6 EUT TEST CONDITIONS 19 4.2.7 TEST RESULTS (9KHZ TO 30MHZ) 19 4.2.8 TEST RESULTS (30MHZ TO 1000 MHZ) 20 4.2.9 TEST RESULTS (ABOVE 1000 MHZ) 20 5 . NUMBER OF HOPPING CHANNEL 21 5.1 APPLIED PROCEDURES 21 5.1.1 TEST PROCEDURE 21 5.1.2 DEVIATION FROM STANDARD 21 5.1.3 TEST SETUP 21 5.1.4 EUT OPERATION CONDITIONS 21 5.1.5 EUT TEST CONDITIONS 21 5.1.6 TEST RESULTS 21 Report No.: BTL-FICP-1-1507C021 Page 4 of 109 Table of Contents Page 6 . AVERAGE TIME OF OCCUPANCY 22 6.1 APPLIED PROCEDURES / LIMIT 22 6.1.1 TEST PROCEDURE 22 6.1.2 DEVIATION FROM STANDARD 22 6.1.3 TEST SETUP 22 6.1.4 EUT OPERATION CONDITIONS 23 6.1.5 EUT TEST CONDITIONS 23 6.1.6 TEST RESULTS 23 7 . HOPPING CHANNEL SEPARATION MEASUREMENT 24 7.1 APPLIED PROCEDURES / LIMIT 24 7.1.1 TEST PROCEDURE 24 7.1.2 DEVIATION FROM STANDARD 24 7.1.3 TEST SETUP 24 7.1.4 EUT TEST CONDITIONS 24 7.1.5 TEST RESULTS 24 8 . BANDWIDTH TEST 25 8.1 APPLIED PROCEDURES 25 8.1.1 TEST PROCEDURE 25 8.1.2 DEVIATION FROM STANDARD 25 8.1.3 TEST SETUP 25 8.1.4 EUT OPERATION CONDITIONS 25 8.1.5 EUT TEST CONDITIONS 25 8.1.6 TEST RESULTS 25 9 . PEAK OUTPUT POWER TEST 26 9.1 APPLIED PROCEDURES / LIMIT 26 9.1.1 TEST PROCEDURE 26 9.1.2 DEVIATION FROM STANDARD 26 9.1.3 TEST SETUP 26 9.1.4 EUT OPERATION CONDITIONS 26 9.1.5 EUT TEST CONDITIONS 26 9.1.6 TEST RESULTS 26 10 . ANTENNA CONDUCTED SPURIOUS EMISSION 27 10.1 APPLIED PROCEDURES / LIMIT 27 10.1.1 TEST PROCEDURE 27 10.1.2 DEVIATION FROM STANDARD 27 10.1.3 TEST SETUP 27 10.1.4 EUT OPERATION CONDITIONS 27 10.1.5 EUT TEST CONDITIONS 27 10.1.6 TEST RESULTS 27 11 . MEASUREMENT INSTRUMENTS LIST 28 Report No.: BTL-FICP-1-1507C021 Page 5 of 109 Table of Contents Page 12 . EUT TEST PHOTO 30 ATTACHMENT A - CONDUCTED EMISSION 34 ATTACHMENT B - RADIATED EMISSION (9KHZ-30MHZ) 37 ATTACHMENT C - RADIATED EMISSION (30MHZ TO 1000MHZ) 39 ATTACHMENT D - RADIATED EMISSION (ABOVE 1000MHZ) 46 ATTACHMENT E - NUMBER OF HOPPING CHANNEL 71 ATTACHMENT F - AVERAGE TIME OF OCCUPANCY 73 ATTACHMENT G - HOPPING CHANNEL SEPARATION MEASUREMENT 86 ATTACHMENT H - BANDWIDTH 91 ATTACHMENT I - PEAK OUTPUT POWER 96 ATTACHMENT J - ANTENNA CONDUCTED SPURIOUS EMISSION 101 Report No.: BTL-FICP-1-1507C021 Page 6 of 109 REPORT ISSUED HISTORY Issued No. Description Issued Date BTL-FICP-1-1507C021 Original Issue. Jul. 16, 2015 Report No.: BTL-FICP-1-1507C021 Page 7 of 109 1. CERTIFICATION Equipment : BLUE TOOTH MODULE Brand Name : SAMSUNG Model Name : BTM2015 Applicant : Samsung Electronics Huizhou Co., Ltd Manufacturer : Samsung Electronics Co., Ltd Address : 129, SAMSUNG‐RO, YEONGTONG‐GU, SUWON‐SI, GYEONGGI‐DO, 443‐742 REPUBLIC OF KOREA Factory : Samsung Electronics Huizhou Co., Ltd Address : NO. 256, ZHONGKAI 6TH ROAD, CHENJIANG STREE T, ZHONGKAI HIGH-TECH DEVELOPMENT ZONE, HUIZHOU CITY, GUANGDONG PROVINCE, P.R.CHINA Date of Test…

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