INFORMATION PACKAGE LICENSED STATUS CONFIRMATION DOCUMENT

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1 INFORMATION PACKAGE LICENSED STATUS CONFIRMATION DOCUMENT Table of contents 1. General Instructions 2. Application Form 3. Terms of Use 4. Instruction: Partner Registration Form 5. Instruction: Input Form

2 1. GENERAL INSTRUCTIONS In order to obtain a Licensed Status Confirmation Document, Licensee shall designate one or two of its employees who shall be registered with Philips (hereinafter the Declarer ). Only the Declarer shall have access to the Input Form (see for further details section 5 below) on our website www. licensing.philips.com and shall submit all relevant information to Philips to obtain a Licensed Status Confirmation Document. In order to register with Philips, Licensee shall apply for Partner Login at our website and in addition fill in the Application Form (see section 2 below). Please send this Application Form duly signed by an authorized person, to: the license office in your region or to : Philips Intellectual Properties & Standards Attn. Mr. Gerard Smelt Eindhoven, The Netherlands Fax: In the Application Form, Licensee must submit the following information: 1. Licensee s name: this name has to be identical to Licensee s name in the Agreement 2. Licensee s address: this address has to be identical to Licensee s address in the Agreement 3. Manufacturing location: address of Licensee s manufacturing plant 4. Products: product(s) manufactured by Licensee 5. Contact person s name: name of the first contact person of Licensee 6. address of the Contact person 7. Signature of Contact person 8. Date of filing 9. Name of Declarer 1: name of the Licensee s first Declarer 10. address of Declarer Name of Declarer 2 (if any) 12. address of Declarer 2 Upon receipt of the Application Form, we expect to be able to register your company within two days. After the registration, the Declarer shall have access to the Input Form (see section 5 below) enabling Licensee to electronically submit information to Philips in order to obtain a Licensed Status Confirmation Document. After reviewing the information submitted by Licensee to Philips, the local Philips IP& S office will issue the corresponding Licensed Status Confirmation Document electronically in pdf format for the shipment concerned to the address of Declarer of Licensee. Note 1: Please copy this User ID from the received from Philips when the declarer registers for partner login. To register for partner access of website please go to and follow the New user and/or Edit profile links

3 2. Application Form Company name: Address: Manufacturing location: This document is issued for First application Change of contact person Other: Contact person: Title address Please grant access to the input form at the License Confirmation section of the Partners only area of the website to the following persons ( Declarers ): Name of Person 1: Access to partners area is availbale: YES / NO address Name of Person 2: Access to partners area is availbale: YES / NO address We hereby confirm that we have read and understood the Terms of Use delivered with this Form and agree to be bound by these conditions. Signature: Date Please send this document to the license office in your region of fax this document to of Philips IP&S, Eindhoven, the Netherlands

4 3. Terms of Use of the Licensed Status Confirmation Document ( the Terms of Use ) Reference is made to the announcement of and the procedures in place for the Licensed Status Confirmation Document. By signing the attached Application Form, Licensee agrees to be bound by these Terms of Use in connection with the Licensed Status Confirmation Document. All information submitted electronically by Licensee to Philips by sending in the Input Form of the Licensed Status Confirmation Document (such information submitted hereinafter the Information ) shall be subject to these Terms of Use. Should Licensee NOT agree to these Terms of Use, Licensee shall not have access to the Input Form of the Licensed Status Confirmation Document. Licensee represents to Philips that the Information submitted by Licensee is true, complete, and accurate in every respect. If requested, Licensee shall submit to Philips as soon as available all relevant documents in connection with the shipment that is the subject of the Licensed Status Confirmation Document. Philips shall not issue a Licensed Status Confirmation Document to Licensee in the event that Licensee fails to provide Philips with said documents, or in the event that the information in such documents does not match with the Information. Licensee acknowledges and agrees that these Terms of Use may be amended by Philips at any time. Such amended Terms of Use shall be effective upon posting on Philips website at Philips reserves the right to make changes or updates to the Licensed Status Confirmation Document without prior notice. Licensee shall not make any changes to the Licensed Status Confirmation Document. Licensee shall promptly notify Philips in writing of any abuse, fraud or misrepresentation in connection with the Licensed Status Confirmation Document that may come to Licensee s attention. Philips will grant access to the Input Form of the Licensed Status Confirmation Document on the website to a limited number of designated employees of Licensee, only. The passwords related to this access are strictly confidential and shall only be used on the computer for which the account was first used or such other computer as Philips may approve in writing. Licensee shall be fully responsible and liable for all activities that occur under the passwords provided to the designated of Licensee. Philips reserves the right to terminate or restrict access to the Input Form of the Licensed Status Confirmation Document for any reason whatsoever at its sole discretion. Philips shall not disclose the Information submitted by Licensee to Philips to any third party, save that Philips may disclose such Information to its external auditors, legal representatives and to the competent courts and government agencies (including, without limitation, Customs Authorities) to the extent necessary for Philips to protect and enforce its rights under the patent license agreement between Licensee and Philips. These Terms of Use shall be governed by and constructed in accordance with the laws of The Netherlands. Any dispute related to these Terms of Use shall be submitted to the courts of The Hague, The Netherlands, provided always that, in case Philips is the plaintiff, Philips may at its sole discretion submit any such dispute either to the competent courts in the venue of Licensee s registered office.

5 4. Partner Registration Form Please proceed as follows to register for partner access Please select: login Next screen to enter address and password will appear If you do not yet have yet a username/ password, please select register for access to obtain the relevant input screen Please provide us the relevant information of your company as well as your contact information and the password you want to use. Note: Do not forget the provide us your Company Name After you have send the registration form you will receive some mails to activate your account. Note: as soon as you have the option to Edit your profile, go to this section and tick the item request for partner access. Partner Access is granted to everybody in your company. However, not everybody will be allowed to enter data for LSCD documents, therefore for activating the LSCD input section permission we also need the Application Form (see section 2 ) above). Please send it to the license office in your region or by fax to ( ).

6 Within two working-days you will receive an confirming your registration. If you do not receive the please notify us via the contact us on the website. If your license agreement is not registered in our system or the address information supplied does not match with the data we have on file about your company we will not accept your request for partner registration. Check the My account screen. In that event please contact us for further information. Depending on the agreements between Philips and your company you will get access to one or more of the available sections in the Partner area. There are also some sections for which individual access is to be granted To get access to the License Confirmation section it is required that the Philips License is informed about the individuals in your company that are allowed to provide Philips with the required LSCD information on behalf of your company. This can be done by returning the filled-in Application Form to Philips IP&S.

7 5. Input Form To obtain a Licensed Status Confirmation Document the below shown example input screen is available in the partners area of the website to Declarers. The screen may change depending on the product. Type of product: This can not be changed. Go back to previous screen if this is wrong Brand name of the products. Fill in the word blank if the product has no brand name. Model number For some products there are optional features: please select the options applicable. Number of discs, players or drives or sets. For players/drives: Lowest and highest serial number. Name of the production plant and country of manufacturing. Expected Year/Month of Customs declaration (import in territory of destination) Country of destination and the importer / customer in the destination country. Invoice date /invoice number Air way bill, Bill of lading or container numbers Additional information If available. E.g. vessel name/voyage. If an LSCD is requested for products which are containing products (partly )made by another (licensed) company, please mention: (Partly) outsourced in "country" under LSCD "RC_xxxxxx" For further information, please contact: Philips Intellectual Property & Standards Business Support, Building WAH-2, P.O. Box 220, 5600 AE Eindhoven, The Netherlands, Fax. : Or check our web site: Koninklijke Philips Electronics N.V. All rights reserved. Reproduction in whole or in part is prohibited without written permission of the copyright owner. The data provided in this information sheet are merely for information purposes. No right, license or privilege can be claimed on the basis of this document. The information herein contained is subject to change. After submitting by the I Agree button the input reference number e.g. RC_ will be shown. Please write down this number., as it will be the reference number for correspondence and/or inquiries or to mark the information you are to send us. We expect to be able to provide you with the Licensed Status Confirmation Document within 5 working days. It will be sent to you directly from the License Office of your territory. In general, this will be a.pdf file sent to you electronically. If your company is not properly licensed for the concerned product or not in full compliance with its obligations, Philips may not provide your company with a Licensed Status Confirmation Document.

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