XKB-SELF4000Payment Terminal

www.ingenico.com 28-32, boulevard de Grenelle, 75015 Paris - France / (T) +33 (0)1 58 01 80 00 / (F) +33 (0)1 58 01 91 35 Ingenico - SA au capital de 47 656 332 / 317 218 758 RCS Nanterre Self/4000 Quick start Copyright© 2019 Ingenico All rights reserved 2 Self/4000 Quick start 900042344 R11 000 01/1119 Contents 1_Introduction 2_Recommendation 2_1 Safety 2_2 Security of your terminal 2_3 Integration 2_4 Approvals and markings 2_5 IC statements 2_6 FCC statement 3_Maintenance 3_1 Transport and storage 3_2 Environment (WEE, Bateries and Packaging) 3 6 6 8 8 9 10 10 11 13 13 Copyright© 2019 Ingenico All rights reserved 3 Self/4000 Quick start 900042344 R11 000 01/1119 1_Introduction Thank you for choosing a payment terminal Ingenico. We recommend you to read carefully this guide : It gives you the necessary information about safety precautions, unpacking, installation, and maintenance of your terminal. Danke, dass Sie sich für einen Zahlungsterminal Ingenico entschieden haben. Wir empfehlen Ihnen, diese Installationsanleitung sorgfältig durchzulesen. Sie enthält die erforderlichen Informationen zu den Sicherheitsvorkehrungen, dem Auspackung, der Installation und der Wartung Ihres Terminals. Merci d’avoir choisi un terminal de paiement Ingenico. Nous vous recommandons de lire attentivement ce guide d’installation : Il vous donne les informations nécessaires sur les précautions de sécurité, le déballage, l’installation et l’entretien de votre terminal. WARRANTY / SECURITY To benefit from the guarantee-related product, and to respect the security, we ask you to use only accessories delivered in box with the product, entrusting maintenance operations only to an authorized person. GARANTIE / SICHERHEIT Um die Garantie für dieses Erzeugnis in Anspruch nehmen zu können und die Sicherheit zu gewährleisten, bitten wir Sie, nur die in der mit dem Erzeugnis gelieferten Karton enthaltenen Zubehörteile zu verwenden und die Wartung einer dazu befugten Person anzuvertrauen. GARANTIE / SECURITE Pour bénéficier de la garantie liée au produit, et afin de respecter la sécurité, nous vous demandons de n’utiliser que des accessoires livrés dans la boîte avec le produit, en confiant les opérations de maintenance seulement à une personne autorisée. Copyright© 2019 Ingenico All rights reserved 4 Self/4000 Quick start 900042344 R11 000 01/1119 The Self/4000 can be powered by different sources please respect these recommendations : The power sources should comply with Standards IEC60950- 1:2013 Edition 2.2 and EN60950-1:2006 + A11/2009 + A1/2010 + A12/2011 + A2:2013 or IEC 62368-1 : 2014.Moreover, they should be Safety Extra-Low Voltage circuits and Power Limited Sources according to clauses 2.2 and 2.5 of these standards. The power source should be powered thanks to socket-outlets installed near the equipment and easily accessible. Self/4000 power ratings : 9 – 16 V max 2A Der Self/4000 kann an verschiedene Stromquellen angeschlossen werden; beachten Sie bitte diese Empfehlungen. Die Stromquellen sollten den Normen IEC60950-1:2013 Auflage 2.2 und EN60950-1:2006 + A11/2009 + A12/2011 + A2:2013 oder IEC 62368-1 : 2014 entsprechen. Zudem sollte es sich dabei um Schutzkleinspannungen und begrenzte Stromquellen gemäß den Bestimmungen 2.2 und 2.5 dieser Normen handeln. Die Stromquelle sollte über Steckdosen fließen, die in der Nähe des Geräts installiert und leicht zugänglich sind. Nennleistungen des Self/4000 : 9 – 16 V max 2A Les Self/4000 peuvent être alimentés par différentes alimentations électriques. Merci de respecter les recommandations suivantes : Les alimentations électriques doivent être conformes aux normes IEC60950-1:2013 Edition 2.2 et EN60950-1:2006 + A11/ 2009 + A12/2011 + A2:2013 ou EN62368-1 : 2014 + A11:2017. De plus, elles doivent être des circuits Très Basse Tension de Sécurité et être des Sources à Puissance Limitée conformément aux chapitres 2.2 et 2.5 de ces normes. Les alimentations électriques doivent être connectées via des socles de prises de courant installés à proximité du matériel et aisément accessibles. Caractéristiques électriques d’alimentation des Self/4000 : 9 – 16 V max 2A Copyright© 2019 Ingenico All rights reserved 5 Self/4000 Quick start 900042344 R11 000 01/1119 Nota : Failure to comply with these instructions will void the manufacturer’s responsibility. Hinweis : Bei Nichteinhaltung dieser Anweisungen wird die Haftung des Herstellers aufgehoben. Nota : le non respect de ces instructions annule la responsabilité du fabricant. The screw from the kiosk near the ground marks must be used to connect the product to the earthing. Die 2 Bolzen die durch die Bohrungen (GND Markierung) des Terminals ́s führen müssen entsprechend geerdet werden. La vis du kiosk à côté du logo de mise à la terre doit être utilisé pour relier les produits à la terre. This symbol indicates an important Warning. Dieses Symbol stellt ein wichtiges Warnzeichen dar. Ce symbole indique un avertissement important. Copyright© 2019 Ingenico All rights reserved 6 Self/4000 Quick start 900042344 R11 000 01/1119 2_Recommendation 2_1 Safety To power on or power down the Self/4000 connect or disconnect the cable connected to power plug 9-16V. Power on / Power down Für starten oder stoppen Self/4000 anschließen oder abziehen Kabel an 9-16V stromanschluss angeschlossen. Starten / stoppen Pour allumer ou éteindre Self/4000 connectez ou débranchez le câble connecté à la prise d’alimentation 9-16V. Mise en marche / Arrêt The Self/4000 is fitted with a lithium battery which is not accessible to the user. Only a qualified technician may be authorized to open the unit and change this component. For switzerland annex 2.15 of SR 814.81 applies for batteries. Lithium battery Die Self/4000 sind mit einer Lithium-Batterie ausgestattet, die nicht für den Benutzer zugänglich. Nur ein qualifizierter Techniker können ermächtigt werden, das Gerät zu öffnen und ändern Sie die Komponente werden Für die Schweiz 2,15 2,15 Anhang von SR 814.81 …

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

CONFIDENTIALITY REQUEST Curtis-Straus LLC One Distribution Center Circle #1 Littleton, MA 01460 USA June 07, 2020 Re: FCC ID: Confidentiality request XKB-SELF4000 Gentlemen, INGENICO requests, pursuant to 47CFR 0.457(d) and 0.459, post grant confidentiality for portions of the material contained in this application. The following document regarding this submission for FCC ID: XKB-SELF4000 shall be kept confidential: LONG-TERM CONFIDENTIALITY: 1.Schematic Diagram of the equipment 2.Block Diagram description of the equipment (file: Schematic - XKB-SELF4000.pdf) (file: Block Diagram - XKB-SELF4000.pdf) Specifically, these exhibits contain information relating to circuit function and complexity that could be of benefit to competitors. The material contains trade secrets and confidential information that INGENICO does not customarily release to the public and which is otherwise not generally available to the public. Regards, Responsible party: Nicolas JACQUEMONT Title: HW Norms & Marking Manager Signature:

Letter of Agency June 08, 2020 To: Federal Communications Commission 7435 Oakland Mills Road Columbia, MD 21046-1609 Curtis-Straus LLC TCB One Distribution Center Circle #1 Littleton, MA 01460 We, the undersigned INGENICO hereby authorize Anthony MERLIN, LCIE SUD EST, to act on our behalf in all matters relating to all processes required for FCC certification of our devices. Any and all acts carried out by the above agent on our behalf shall have the same effects as acts of our own. This authorization is valid until: December 1st, 2020 If you have any questions regarding this authorization, let us know please. Sincerely, Nicolas JACQUEMONT Signature

LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS – France Page 1/3 USER MANUAL (FCC STATEMENT) FCCID: XKB-SELF4000 This is a copy of the page where the FCC statement is included: User manual: LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS – France Page 2/3 LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS – France Page 3/3

External photos of the EUT Photo 1: Photo 2: Photo 3: Photo 4: Photo 5: Photo 6:

LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS - FRANCE Page 1/1 PRODUCT LABELING FCCID: XKB-SELF4000

Internal photos of the EUT Photo 1: Bottom side back cover removed Photo 2: Photo 3: Photo 4: Photo 5: Photo 6: Photo 7: Photo 8: Photo 9: Photo 10: Photo 11: Photo 12

LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS - FRANCE GENERAL INFORMATION FCCID: XKB-SELF4000 1.1. Product description LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS - FRANCE LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS - FRANCE Data sheet of equipment LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS - FRANCE 1.2. Tested System Details 1.3. Test Methodology Both conducted and radiated testing were performed according to the procedures in ANSI C63.4 or/and ANSI C63.10, FCC Part 15 SubPart 15B and 15C. Radiated testing was performed at an antenna to EUT distance of 10 meters. During testing, all equipment’s and cables were moved relative to each other in order to identify the worst case set-up. LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS - FRANCE 1.4. Test facility Tests have been performed: May 25, 2020 to May 29, 2020 This test facility has been fully described in a report and accepted by FCC as compliant with the radiated and AC line conducted test site criteria in ANSI C63.4 or/and ANSI C63.10. This test facility has also been accredited by COFRAC (French accreditation authority for European Union test lab accreditation organization) according to NF EN ISO/IEC 17025, as compliant with test site criteria and competence in 47 CFR Part 15/ANSI C63.4 and EN55032/CISPR32 norms for 89/336/EEC European EMC Directive application. All pertinent data for this test facility remains unchanged.

RFID 13,56MHz Template: Release March 30 th , 2020 This document shall not be reproduced, except in full, without the written approval of the LCIE. This document contains results related only to the items tested. It does not imply the conformity of the whole production to the items tested. . Unless otherwise specified or rule defined by the test method, the decision of conformity doesn’t take into account the uncertainty of measures. This document doesn’t anticipate any certification decision. TEST REPORT N°: 167401-751432-B-(FILE#1047427) Version : 01 Subject Radio spectrum matters tests according to standards: 47 CFR Part 15.225 & RSS 210 Issue 10 & RSS-Gen Issue 5 Issued to INGENICO 9 avenue de la gare 26958 - Valence cedex 9 France Apparatus under test  Product Payment Terminal  Trade mark INGENICO  Manufacturer INGENICO  Model under test Self/4000 CL  Serial number 193407313031143912221149  FCC ID XKB-SELF4000  IC 2586D-SELF4000 Conclusion See Test Program chapter Test date May 25, 2020 to May 29, 2020 Test location Moirans Test Site 6230B-1 Sample receipt date May 25, 2020 Composition of document 36 pages Document issued on June 18, 2020 Written by : Approved by : Mounir BOUAMARA Gaëtan DESCHAMPS Tests operator Technical manager TEST REPORT N° 167401-751432-B-(FILE#1047427) Version : 01 Page 2/36 PUBLICATION HISTORY Version Date Author Modification 01 May 29, 2020 Mounir BOUAMARA Creation of the document Each new edition of this test report replaces and cancels the previous edition. The control of the old editions of report is under responsibility of client. TEST REPORT N° 167401-751432-B-(FILE#1047427) Version : 01 Page 3/36 SUMMARY 1. TEST PROGRAM ............................................................................................................................... 4 2. EQUIPMENT UNDER TEST: CONFIGURATION (DECLARED BY PROVIDER) ................................ 5 3. OCCUPIED BANDWIDTH ................................................................................................................... 9 4. FREQUENCY TOLERANCE ............................................................................................................. 12 5. AC POWER LINE CONDUCTED EMISSIONS.................................................................................. 15 6. FIELD STRENGTH OUTSIDE OF THE BANDS 13.110-14.010 MHZ ............................................... 22 7. FIELD STRENGTH WITHIN THE BAND 13.110-14.010MHZ ............................................................ 31 8. UNCERTAINTIES CHART ................................................................................................................ 36 TEST REPORT N° 167401-751432-B-(FILE#1047427) Version : 01 Page 4/36 1. TEST PROGRAM References  47 CFR Part 15.225 (2020)  RSS 210 Issue 10  RSS Gen Issue 5  ANSI C63.10 (2013) Radio requirement: Clause (47CFR Part 15.225 & RSS-210 Issue 9 & RSS-Gen Issue 5) Test Description Test result - Comments Occupied Bandwidth  PASS  FAIL  NA  NP(1) AC Power Line Conducted Emission  PASS  FAIL  NA(2)  NP(1) Frequency Tolerance  PASS  FAIL  NA  NP(1) Field strength within the band 13.110-14.010MHz  PASS  FAIL  NA  NP(1) Field strength outside of the bands 13.110-14.010 MHz  PASS  FAIL  NA  NP(1) Receiver Radiated Emissions  PASS (3)  FAIL  NA  NP(1) This table is a summary of test report, see conclusion of each clause of this test report for detail. (1): Limited program (2): EUT not directly or indirectly connected to the AC Power Public Network (3)Testing covered the receive mode, and receiver spurious emissions are considered to be the same as transmitter. PASS: EUT complies with standard’s requirement FAIL: EUT does not comply with standard’s requirement NA: Not Applicable NP: Test Not Performed TEST REPORT N° 167401-751432-B-(FILE#1047427) Version : 01 Page 5/36 2. EQUIPMENT UNDER TEST: CONFIGURATION (DECLARED BY PROVIDER) 2.1. HARDWARE IDENTIFICATION (EUT AND AUXILIARIES): Equipment under test (EUT): INGENICO Self/4000 CL Serial Number: 193407313031143912221149 Equipment Under Test Power supply: Name Type Rating Reference / Sn Comments Supply1  AC  DC  Battery 12 Inputs/outputs - Cable: Access Type Length used (m) Declared <3m Shielded Under test Comments 2 USB A -    1 RJ45 -    2 RJ11 -    1 USB B -    1 Power Supply -    Auxiliary equipment used during test: Type Reference Sn Comments Laptop Use to set the EUT TEST REPORT N° 167401-751432-B-(FILE#1047427) Version : 01 Page 6/36 Equipment information: Type:  RFID Frequency band: [13.553 to 13.567] MHz Number of Channel: 1 Antenna Type:  Integral  External  Dedicated Transmit chains: 1 Receiver chains 1 Type of equipment:  Stand-alone  Plug-in  Combined Equipment arrangement:  Tabletop  Floor-standing  Multiple orientations Equipment type:  Production model  Pre-production model Operating temperature range: Tmin:  -20°C  0°C  -20°C Tnom: 20°C Tmax:  35°C  50°C  65°C Operating voltage: Vmin:  102V/60Hz  9Vdc Vnom:  120V/60Hz  12Vdc Vmax:  138V/60Hz  16Vdc Antenna Characteristic Antenna assembly Gain (dBi) Frequency Band (MHz) Impedance(Ω) 1 0 Nc* 50 Modulation Type Nc* Nc* Hardware information Software (if applicable): V. : Nc* Nc*: Not communicated TEST REPORT N° 167401-751432-B-(FILE#1047427) Version : 01 Page 7/36 2.2. RUNNING MODE Test mode Description of test mode Test mode 1 Permanent emission with modulation on a fixed channel in the data rate that produced the highest power Test mode 2 Permanent reception Test Running mode Occupied Bandwidth  Test mode 1  Alternative test mode() Frequency Tolerance  Test mode 1  Alternative test mode() AC Power Line Conducted Emission  Test mode 1  Alternative test mode() Field strength within the band 13.110-14.010MHz  Test mode 1  Alternative test mode() Field strength outside of the bands 13.110-14.010 MHz  Test mode 1  Alternative test mode() Receiver Radiated Emissions  Test mode 2 (1)  Alte…

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

LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS - FRANCE Page 1/2 CONDUCTED AND RADIATED MEASUREMENT PHOTO FCCID: XKB-SELF4000 1.1 Conducted emission LCIE SUD EST Laboratoire de Moirans Z.I. Centr’Alp 170, Rue de Chatagnon 38430 MOIRANS - FRANCE Page 2/2 1.2 Radiated emissions