A3LEPP4300WIRELESS CHARGER

19 Chapin Rd., Building D Pine Brook, New Jersey, 07058, United States 11 December 2020 Federal Communications Commission Authorization and Evaluation Division 7435 Oakland Mills Road, Columbia, MD 21046 REQUEST FOR CONFIDENTIALITY FCC ID: A3LEPP4300 To Whom It May Concern: Pursuant to Sections 0.457 and 0.459 of the Commission’s Rules (CFR 47), and Section 552 (b) (4) of the Freedom of Information Act, Samsung Electronics Co., Ltd. hereby requests confidentiality and treatment of certain information accompanying this application. The 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. We are also hereby request Short‐Term Confidentiality for 180 days after the grant as outlined in Public Notice DA 04‐1705. This provision will give Samsung Electronics Co., Ltd temporary confidentiality of commercially sensitive information prior to product release. The requested Permanent and Temporary Confidential exhibits are listed as follows: CONFIDENTIAL LIST Permanent 1 Block Diagram 2 Operational Descriptions 3 Schematics Short‐Term 4 External Photos 5 Internal Photos 6 Test‐Setup Photos 7 User Manual The Applicant understands that pursuant to Rule 0.457, disclosure of this application and all accompanying documentations, where applicable, will not be made public before the date of the Grant for this application. Sincerely Yours, Jenni Chun / General Manager Samsung Electronics North America INC. TEL: +1-973-808-6362 E-mail: [email protected]

19 Chapin Rd., Building D Pine Brook, New Jersey, 07058, United States Federal Communications Commission Authorization and Evaluation Division 7435 Oakland Mills Road, Columbia, MD 21046 LETTER FOR AUTHORIZATION FCC ID: A3LEPP4300 To whom it may concern: I, the undersigned, hereby authorize Lab Manager Hyunchae, You and of SGS Korea Co., Ltd. and hereafter referred to as SGS Korea, to act on our behalf in all manners relating to application for equipment authorization, including signing of all documents relating to these matters. Any and all acts carried out by Lab Manager Hyunchae, You of SGS Korea Co., Ltd. on our behalf shall have the same effect as acts of our own. I, the undersigned, hereby certify that we are not subject to a denial of federal benefits, that includes FCC benefits, pursuant to Section 5301 of the Anti‐Drug Abuse Act of 1988, 21 U.S.C. 853(a). In authorizing SGS Korea as our agent, we still recognize that we are responsible to: a) comply with the relevant provisions of the certification program; b) make all necessary arrangements for the conduct of the evaluation, including provision for examining documentation and access to all areas, records (including internal audit reports) and personnel for the purposes of evaluation (e.g. testing, inspection, assessment, surveillance, reassessment) and resolution of complaints; c) make claims regarding certification only in respect of the scope for which certification has been granted; d) do not use our product certification in such a manner as to bring the Certification Division into disrepute and not make any statement regarding our product certification which the Certification Division may consider misleading or unauthorized; e) upon suspension or cancellation of certification, discontinue use of all advertising matter that contains any reference thereto and return any certification documents as required by the Certification Division; f) use certification only to indicate the products are certified as being in conformity with specified standards; g) endeavor to ensure that no certificate or report nor any part thereof is used in a misleading manner; h) ensure that any reference to our product certification in communication media such as documents, brochures or advertising, complies with the requirements of the Certification Division; 11 December 2020 19 Chapin Rd., Building D Pine Brook, New Jersey, 07058, United States i) keep a record of all complaints made known to the us relating to the product’s compliance with requirements of the relevant standard and to make these records available to the Certification Division when requested; j) take appropriate action with respect to such complaints and any deficiencies found in products or services that affect compliance with the requirements for certification; k) document the actions taken. This authorization is valid until further written notice from the applicant. Sincerely Yours Jenni Chun/ General Manager Samsung Ele ctronics North America INC. TEL: +1-973-808-6362 E-mail: [email protected]

Applicant Declaration Applicant Declaration Rev:0.0 SGS North America Inc. 620 Old Peachtree Road SUITE 100 Suwanee, Georgia 30024 United States Applicant Legal Business Name Samsung Electronics Co., Ltd. Address 19 Chapin Rd., Building D, Pine Brook, New Jersey, 07058 Grantee Code A3L FCC ID A3LEPP4300 Authorized Contact Name Jenni Chun Contact Email [email protected] Contact Phone 973-808-6375 I, the undersigned, certify that I am an authorized signatory for the Applicant and therefore declare; a) in accordance with 47CFR2.911(d), all of the statements herein and the exhibits attached hereto are true and correct to the best of my knowledge and belief. b) in accepting a Grant of Equipment Authorization issued by a TCB, under the authority of the FCC, as a result of the representations made in this application, the Applicant is responsible for: (1) labeling the equipment with the exact FCC ID as specified in this application, (2) compliance statement labeling pursuant to the applicable rules, (3) compliance of the equipment with the applicable technical rules, c) if the Applicant is not the actual manufacturer of the equipment, appropriate arrangements have been made with the manufacturer to ensure that production units of this equipment will continue to comply with the FCC’s technical requirements. d) in accordance with 47 CFR 2.909 and KDB394321, the Applicant has read, understood and agrees to accept that they are the responsible party and agree to abide by their responsibilities as specified under 47 CFR 2.909 and KDB394321. e) in accordance with ISO17065, FCC KDB641163, FCC KDB610077, KDB394321 and RSP-100, the Applicant has read, understood, accepts and agrees to abide by the post market surveillance requirements. (1) the Applicant understands, accepts and agrees that a sample may be requested for surveillance testing. (2) the Applicant shall make provisions to always have a production sample available upon request by SGS, FCC and/or ISED. (3) the Applicant shall, upon request by SGS, at the Applicant’s expense, provide a production sample of the requested product to SGS, FCC and/or ISED as instructed. The sample shall include all support devices, cables, software, accessories or other hardware or software required for evaluation, review, certification and audit surveillance of products certified by SGS. f) neither the Applicant nor any party to the application is subject to a denial of Federal benefits, that includes 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. See 47CFR 1.2002(b) for the definition of a “party” for these purposes. g) the Applicant has read, understood, accepts and agrees to abide by the SGS North America, Inc.(TCB) terms and conditions. Link to CFRs: https://www.fcc.gov/wireless/bureau-divisions/technologies-systems-and-innovation-division/rules-regulations-title-47 Link to KDBs: https://apps.fcc.gov/oetcf/kdb/index.cfm Link to RSP-100: https://www.ic.gc.ca/eic/site/smt-gst.nsf/eng/sf01130.html Applicant Signature: Date: December 11, 2020 Print Name: Jenni Chun Title: General Manager *NOTE: This declaration cannot be signed by an Agent, it shall be signed by an authorized person listed in the FCC database

External photos of EUT Top view of EUT Bottom view of EUT Side view of EUT

< 1:1 Artwork > 5.3 5.3 7.42 6.5 S/N:제조시 14자리 인쇄 표기 < 1:1 Artwork > 3-R1.0 36.0 24.0 C2 WIRELESS CHARGER 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. MODEL : EP-P4300 INPUT : 9.0 V 1.67 A FCC ID : A3LEPP4300 IC : 649E-EPP4300 S/N : MADE IN VIETNAM / FABRIQUÉ AU VIETNAM Label Information

Internal photos of EUT Internal view of EUT Top view of Main PCB Bottom view of Main PCB View of Antenna j Loop coil antenna 1 Loop coil antenna 2

SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001432-2 Page: 1 of 9 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) TEST REPORT of FCC CFR 47 part1, 1.1307(b), 1.1310 FCC ID: A3LEPP4300 Equipment Under Test : WIRELESS CHARGER Model Name : EP-P4300 Variant Model Name(s) : - Applicant : Samsung Electronics Co., Ltd. Manufacturer : Samsung Electronics Co., Ltd. Date of Receipt : 2020.11.04 Date of Test(s) : 2020.11.27 ~ 2020.12.07 Date of Issue : 2020.12.16 In the configuration tested, the EUT complied with the standards specified above. This test report does not assure KOLAS accreditation. 1) The results of this test report are effective only to the items tested. 2) The SGS Korea is not responsible for the sampling, the results of this test report apply to the sample as received. 3) This test report cannot be reproduced, except in full, without prior written permission of the Company. Tested by: Technical Manager: Nancy Park Hyunchae You SGS Korea Co., Ltd. Gunpo Laboratory SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001432-2 Page: 2 of 9 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) INDEX Table of Contents 1. General Information -------------------------------------------------------------------------------------- 3 2. Test Result -------------------------------------------------------------------------------------------------- 6 SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001432-2 Page: 3 of 9 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) 1. General Information 1.1. Testing Laboratory SGS Korea Co., Ltd. (Gunpo Laboratory) - 10-2, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 - 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 - Designation number: KR0150 All SGS services are rendered in accordance with the applicable SGS conditions of service available on request and accessible at http://www.sgs.com/en/Terms-and-Conditions.aspx. Phone No. : +82 31 688 0901 Fax No. : +82 31 688 0921 1.2. Details of Applicant Applicant : Samsung Electronics Co., Ltd. Address : 19 Chapin Rd., Building D, Pine Brook, New Jersey, United States, 07058 Contact Person : Chun, Jenni Phone No. : +1 973 808 6375 1.3. Details of Manufacturer Company : Samsung Electronics Co., Ltd. Address : Yen Phong 1 Industrial park, Yen Phong District Bac Ninh Province, VIETNAM 1.4. Description of EUT Kind of Product WIRELESS CHARGER Model Name EP-P4300 Power Supply DC 9.0 V Operation Mode 2 W, 4.5 W, 7.5 W, 9W Frequency Range Ant. 1: 126.2 ~ 129.2 ㎑ Ant. 2: 144.5 ~ 147.5 ㎑ Antenna Type Loop Coil Antenna H/W Version 1.3 S/W Version_MCU EP-P4300_20201125_17C0 S/W Version_Tx IC P43_PRA_OFFI_1208 1.5. Declaration of Manufacturer - The EUT has 2 Loop coil antennas. - Antenna 2 can only operate 2 W with Smart Wearable Device. - Antennas operating maximum at the same time are 2 antennas. SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001432-2 Page: 4 of 9 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) 1.6. Test Equipment List Equipment Manufacturer Model S/N Cal. Date Cal. Interval Cal. Due Electric and Magnetic field Probe analyzer NARDA EHP 200AC 170WX91017 Nov. 16, 2020 Annual Nov. 16, 2021 Anechoic Chamber SY Corporation L × W × H (9.6 m × 6.4 m × 6.6 m) N/A N.C.R. N/A N.C.R. ▶ Support Equipment Description Manufacturer Model FCC ID Samsung Mobile Phone Samsung Electronics Co., Ltd. SM-G970 A3LSMG970U Samsung Mobile Phone Samsung Electronics Co., Ltd. SM-G973U A3LSMG973U Bluetooth Headset Samsung Electronics Co., Ltd. SM-R170 A3LSMR170L, A3LSMR170R Smart Wearable Device Samsung Electronics Co., Ltd. SM-R500 A3LSMR500 C type USB Cable Samsung Electronics Co., Ltd. EP-DG970BBE_1.5M - TRAVEL ADAPTER DONGYANG E&P EP-TA200 - 1.7. Test Report Revision Revision Report Number Date of Issue Description 0 F690501-RF-RTL001432 2020.12.09 Initial 1 F690501-RF-RTL001432-1 2020.12.14 Added the information of H/W Version and S/W Version. 2 F690501-RF-RTL001432-2 2020.12.16 Added the test mode to indicate what kind of client device is used. SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001432-2 Page: 5 of 9 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) 1.8. Worst Case of Test Configurations In order to check all kinds of possible configurations, EUT was evaluated with appropriate client and under each charging condition as below table. Charging mode with client device Mode Description Model: SM-G970U FCC ID: A3LSMG970U Model: SM-G973U FCC ID: A3LSMG973U Model: SM-R170 FCC ID: A3LSMR170L, A3LSMR170R Model: SM-R500 FCC ID: A3LSMR500 2 W 4.5 W 7.5 W 9 W 2 W & 9 W 1 % of battery 50 % of battery 99 % of battery Ant. 1: 126.2 ~ 129.2 ㎑ Ant. 2: 144.5 ~ 147.5 ㎑ Ant. 1: 126.2 ~ 129.2 ㎑ Ant. 1: 126.2 ~ 129.2 ㎑ Ant. 1: 126.2 ~ 129.2 ㎑ Ant. 1: 126.2 ~ 129.2 ㎑ Ant. 2: 144.5 ~ 147.5 ㎑ SM-R170, SM-R500 SM-G970U (Normal) SM-G970U (Fast) SM-G973U SM-G973U, SM-R500 Note; - The 4.5 W and 7.5 W modes are controlled by the software on the client device. - EUT was investigated with client device under normal charging condition as above then worst value was only reported. SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001432-2 Page: 6 of 9 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) 2. Test Result 2.1. Test Setup 2.2. Measurement procedure a) The RF exposure test was performed in anechoic chamber. …

Text truncated - open the document above for the full version.

SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001431-2 Page: 1 of 52 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) TEST REPORT of FCC Part 15 Subpart C §15.209 FCC ID: A3LEPP4300 Equipment Under Test : WIRELESS CHARGER Model Name : EP-P4300 Variant Model Name(s) : - Applicant : Samsung Electronics Co., Ltd. Manufacturer : Samsung Electronics Co., Ltd. Date of Receipt : 2020.11.04 Date of Test(s) : 2020.11.27 ~ 2020.12.07 Date of Issue : 2020.12.16 In the configuration tested, the EUT complied with the standards specified above. This test report does not assure KOLAS accreditation. 1) The results of this test report are effective only to the items tested. 2) The SGS Korea is not responsible for the sampling, the results of this test report apply to the sample as received. 3) This test report cannot be reproduced, except in full, without prior written permission of the Company. Tested by: Technical Manager: Nancy Park Hyunchae You SGS Korea Co., Ltd. Gunpo Laboratory SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001431-2 Page: 2 of 52 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) INDEX Table of Contents 1. General Information -------------------------------------------------------------------------------------- 3 2. Field Strength of Fundamental and Spurious Emission ----------------------------------------- 7 3. 20 ㏈ Bandwidth ----------------------------------------------------------------------------------------- 34 4. AC Power Line Conducted Emission ---------------------------------------------------------------- 39 SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001431-2 Page: 3 of 52 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) 1. General Information 1.1. Testing Laboratory SGS Korea Co., Ltd. (Gunpo Laboratory) - 10-2, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 - 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 - Designation number: KR0150 All SGS services are rendered in accordance with the applicable SGS conditions of service available on request and accessible at http://www.sgs.com/en/Terms-and-Conditions.aspx. Phone No. : +82 31 688 0901 Fax No. : +82 31 688 0921 1.2. Details of Applicant Applicant : Samsung Electronics Co., Ltd. Address : 19 Chapin Rd., Building D, Pine Brook, New Jersey, United States, 07058 Contact Person : Chun, Jenni Phone No. : +1 973 808 6362 1.3. Details of Manufacturer Company : Samsung Electronics Co., Ltd. Address : Yen Phong 1 Industrial park, Yen Phong District Bac Ninh Province, VIETNAM 1.4. Description of EUT Kind of Product WIRELESS CHARGER Model Name EP-P4300 Power Supply DC 9.0 V Operation Mode 2 W, 4.5 W, 7.5 W, 9W Frequency Range Ant. 1: 126.2 ~ 129.2 ㎑ Ant. 2: 144.5 ~ 147.5 ㎑ Antenna Type Loop Coil Antenna H/W Version 1.3 S/W Version_MCU EP-P4300_20201125_17C0 S/W Version_Tx IC P43_PRA_OFFI_1208 1.5. Declaration of Manufacturer - The EUT has 2 Loop coil antennas. - Antenna 2 can only operate 2 W with Smart Wearable Device. - Antennas operating maximum at the same time are 2 antennas. SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001431-2 Page: 4 of 52 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) 1.6. Test Equipment List Equipment Manufacturer Model S/N Cal. Date Cal. Interval Cal. Due Spectrum Analyzer R&S FSV30 103100 Jun. 18, 2020 Annual Jun. 18, 2021 Signal Generator R&S SMBV100A 255834 Jun. 03, 2020 Annual Jun. 03, 2021 Amplifier H.P. 8447F 2944A03909 Aug. 06, 2020 Annual Aug. 06, 2021 Loop Antenna Schwarzbeck Mess-Elektronik FMZB 1519 1519-039 Aug. 22, 2019 Biennial Aug. 22, 2021 Bilog Antenna Schwarzbeck Mess-Elektronik VULB9163 396 Mar. 21, 2019 Biennial Mar. 21, 2021 Test Receiver R&S ESU26 100109 Feb. 18, 2020 Annual Feb. 18, 2021 Turn Table Innco systems GmbH DS 1200 S N/A N.C.R. N/A N.C.R. Controller Innco systems GmbH CONTROLLER CO3000-4P CO3000/963/38 330516/L N.C.R. N/A N.C.R. Anechoic Chamber SY Corporation L × W × H (9.6 m × 6.4 m × 6.6 m) N/A N.C.R. N/A N.C.R. Coaxial Cable RFONE SFX086-NMNM-5M (5 m) 20200324001 Aug. 10, 2020 Semi- annual Feb. 10, 2021 Coaxial Cable RFONE MWX221-NMSNMS (4 m) J1023142 Dec. 01, 2020 Semi- annual Jun. 01, 2021 Coaxial Cable RFONE PL520-NMNM-10M (10 m) 20200324001 Aug. 10, 2020 Semi- Annual Feb. 10, 2021 Test Receiver R&S ESCI 7 100911 Feb. 19, 2020 Annual Feb. 19, 2021 Two-Line V-Network R&S ENV216 100190 May 08, 2020 Annual May 08, 2021 Shield Room SY Corporation L × W × H (6.5 m × 3.5 m × 3.5 m) N/A N.C.R. N/A N.C.R. ▶ Support Equipment Description Manufacturer Model FCC ID Samsung Mobile Phone Samsung Electronics Co., Ltd. SM-G970 A3LSMG970U Samsung Mobile Phone Samsung Electronics Co., Ltd. SM-G973U A3LSMG973U Bluetooth Headset Samsung Electronics Co., Ltd. SM-R170 A3LSMR170L, A3LSMR170R Smart Wearable Device Samsung Electronics Co., Ltd. SM-R500 A3LSMR500 C type USB Cable Samsung Electronics Co., Ltd. EP-DG970BBE_1.5M - TRAVEL ADAPTER DONGYANG E&P EP-TA200 - 1.7. Sample Calculation Where relevant, the following sample calculation is provided: Field strength level (㏈㎶/m) = Measured level (㏈㎶) + Antenna factor (㏈) + Cable loss (㏈) + (AMP (㏈)) SGS Korea Co., Ltd. 4, LS-ro 182beon-gil, Gunpo-si, Gyeonggi-do, Korea, 15807 Tel. +82 31 428 5700 / Fax. +82 31 427 2370 http://www.sgsgroup.kr Report Number: F690501-RF-RTL001431-2 Page: 5 of 52 RTT7081-02(2020.10.05)(0) A4(210 mm * 297 mm) 1.8. Worst Case of Test Configurations Charging mode with client device Mode Description Model: SM-G970U FCC ID: A3LSMG970U Model: SM-G973U FCC ID: A3LSMG973U Model: SM-R170 FCC ID: A3LSMR17…

Text truncated - open the document above for the full version.

Test setup photo of EUT 1. Photos of Operating Mode 2. Photo of Radiated Spurious Emission Test (9 ㎑ ~ 30 ㎒) 3. Photo of Radiated Spurious Emission Test (30 ㎒ ~ 1 000 ㎒) 4. Photos of AC Power line emission Test 5. Photos of MPE Test T R AV E L ADAPTER Test PC SM-R170 Probe EUT SM-R500