FCC ID LF5MICSIMPLANT3

LF5-MICSIMPLANT3, LF5 MICSIMPLANT3, LF5MICSIMPLANT3, LF5M1CS1MPLANT3, LF5MIC5IMPLANT3, LFSMICSIMPLANT3

Medtronic, Inc. Medical implant that is internal to the human body MICSIMPLANT3

An FCC ID is the product ID assigned by the FCC to identify wireless products in the market. The FCC chooses 3 or 5 character "Grantee" codes to identify the business that created the product. For example, the grantee code for FCC ID: LF5MICSIMPLANT3 is LF5. The remaining characters of the FCC ID, MICSIMPLANT3, are often associated with the product model, but they can be random. These letters are chosen by the applicant. In addition to the application, the FCC also publishes internal images, external images, user manuals, and test results for wireless devices. They can be under the "exhibits" tab below.

Purchase on Amazon: Medical implant that is internal to the human body

Application: Medical implant that is internal to the human body
Equipment Class: TNT - Licensed Non-Broadcast Transmitter Worn on Body
Short Link: fcc.id/LF5MICSIMPLANT3
Sources: FCC.gov | FCC.report
Registered By: Medtronic, Inc. - LF5 (United States)

App #	Purpose	Date	Unique ID
1	Original Equipment	2012-07-31	TgIQy9t9h+ze+xuDioomkA==

Operating Frequencies

Frequency Range	Power Output	Tolerance	Emission Designator	Rule Parts	Grant Notes	Line Entry
402-405 MHz	0.0001 mW	100ppm	196F1D	95I	IT	1
402-405 MHz	0.0001 mW	100ppm	226P1D	95I	IT	2

Exhibits

Document	Type	Submitted Available
Letter canceliing the requested deferral date in the application	Cover Letter(s) Adobe Acrobat PDF (34 kB)	2012-07-31 2012-07-31
revised ID label in manual	ID Label/Location Info Adobe Acrobat PDF (90 kB)	2012-07-30 2012-07-31
Cross reference to Part 2 requirments for test report	Test Report Adobe Acrobat PDF (156 kB)	2012-07-30 2012-07-31
responses to questions	Cover Letter(s) Adobe Acrobat PDF (201 kB)	2012-07-30 2012-07-31
FEM Analyses	RF Exposure Info Adobe Acrobat PDF (102 kB)	2012-07-30 2012-07-31
revised users manual	Users Manual Adobe Acrobat PDF (451 kB)	2012-07-30 2012-07-31
revised confidentiality letter	Cover Letter(s) Adobe Acrobat PDF (270 kB)	2012-07-30 2012-07-31
Signed replacement for Cover Letter	Cover Letter(s) Adobe Acrobat PDF (20 kB)	2012-06-01 2012-07-31
test site photo	Test Setup Photos Adobe Acrobat PDF (121 kB)	2012-05-02 2012-07-31
test report	Test Report Adobe Acrobat PDF (1096 kB)	2012-05-02 2012-07-31
Sar report	RF Exposure Info Adobe Acrobat PDF (1574 kB)	2012-05-02 2012-07-31
Implant Package label	ID Label/Location Info Adobe Acrobat PDF (1080 kB)	2012-05-02 2012-07-31
external photos	External Photos Adobe Acrobat PDF (246 kB)	2012-05-02 2012-07-31
revised operational description	Operational Description Adobe Acrobat PDF (271 kB)	2012-07-30
Internal Photos (internal note - antenna not shown)	Internal Photos Adobe Acrobat PDF (729 kB)	2012-05-02
Confidentiality Request	Cover Letter(s) Adobe Acrobat PDF (52 kB)	2012-05-02 2012-07-31
operational description	Operational Description Adobe Acrobat PDF (271 kB)	2012-05-02
Signed confidentiality request letter	Cover Letter(s) Adobe Acrobat PDF (54 kB)	2012-06-01 2012-07-31
user manual	Users Manual Adobe Acrobat PDF (448 kB)	2012-05-02 2012-07-31
block diagram	Block Diagram Adobe Acrobat PDF (51 kB)	2012-05-02
cover letter	Cover Letter(s) Adobe Acrobat PDF (17 kB)	2012-05-02 2012-07-31
schematic	Schematics Adobe Acrobat PDF (380 kB)	2012-05-02
Parts list (internal note - tuneup not shown)	Parts List/Tune Up Info Adobe Acrobat PDF (333 kB)	2012-05-02
ID label in Manual	ID Label/Location Info Adobe Acrobat PDF (91 kB)	2012-05-02 2012-07-31

App #	Document	Date
1	[Re-Sent]E-Mail generated [Jul 10 2012]	2012-07-11 08:38:01
1	Incoming Correspondence generated [Jul 30 2012]	2012-07-30 13:55:50
1	[Re-Sent]Confidential letter to applicant generated [Jul 31 2012]	2012-07-31 09:46:04
1	[Re-Sent]E-Mail generated [Jul 31 2012]	2012-07-31 13:58:29
1	[Re-Sent]E-Mail generated [Jun 1 2012]	2012-06-01 10:07:14
1	Incoming Correspondence generated [Jul 31 2012]	2012-07-31 14:19:29
1	[Re-Sent]E-Mail generated [Jun 1 2012]	2012-06-01 10:08:19
1	[Re-Sent]E-Mail generated [Jul 31 2012]	2012-07-31 16:25:11
1	Incoming Correspondence generated [Jun 1 2012]	2012-06-01 12:09:17

App #

Document

Date

[Re-Sent]E-Mail generated [Jul 10 2012]

2012-07-11 08:38:01

Incoming Correspondence generated [Jul 30 2012]

2012-07-30 13:55:50

[Re-Sent]Confidential letter to applicant generated [Jul 31 2012]

2012-07-31 09:46:04

[Re-Sent]E-Mail generated [Jul 31 2012]

2012-07-31 13:58:29

[Re-Sent]E-Mail generated [Jun 1 2012]

2012-06-01 10:07:14

Incoming Correspondence generated [Jul 31 2012]

2012-07-31 14:19:29

[Re-Sent]E-Mail generated [Jun 1 2012]

2012-06-01 10:08:19

[Re-Sent]E-Mail generated [Jul 31 2012]

2012-07-31 16:25:11

Incoming Correspondence generated [Jun 1 2012]

2012-06-01 12:09:17

Application Forms

Application for Equipment Authorization FCC Form 731 TCB Version

Applicant Information

Applicant's complete, legal business name:	Medtronic, Inc.
FCC Registration Number (FRN):	0008250839
Alphanumeric FCC ID:	LF5MICSIMPLANT3
Unique Application Identifier:	TgIQy9t9h+ze+xuDioomkA==
Line one:	8200 Coral Sea Street NE
City:	Mounds View
State:	Minnesota
Country:	United States
Zip Code:	55112

TCB Information

FCC ID

Grantee Code:	LF5
Product Code:	MICSIMPLANT3

Person at the applicant's address to receive grant or for contact

Name:	Charles S. Farlow
Title:	Program Director, Regulatory Affairs

Telephone Number:

763-526-0664

Extension:

Fax Number:	651-367-0603
Email:	charles.s.farlow@medtronic.com
Mail Stop:	MVS11

Technical Contact

Firm Name:	TRP Inc
First Name:	Phillip
Last Name:	Inglis
Line 1:	14085 Howard Rd
City:	Dayton
State:	Maryland
Country:	United States
Zip Code:	21036

Telephone Number:

410 531 3439

Extension:

E-Mail:

jinglis@erols.com

Non Technical Contact

Firm Name:	TRP Inc
First Name:	Phillip
Last Name:	Inglis
Line 1:	14085 Howard Rd
City:	Dayton
State:	Maryland
Country:	United States
Zip Code:	21036

Telephone Number:

410 531 3439

Extension:

E-Mail:

jinglis@erols.com

Long-Term Confidentiality

Does this application include a request for confidentiality for any portion(s) of the data contained in this application pursuant to 47 CFR § 0.459 of the Commission Rules?: Yes

Short-Term Confidentiality

Does short-term confidentiality apply to this application?: No

If so, specify the short-term confidentiality release date (MM/DD/YYYY format):
Note: If no date is supplied, the release date will be set to 45 calendar days past the date of grant.

Software Defined/Cognitive Radio

Is this application for software defined/cognitive radio authorization? No

Equipment Class

Equipment Class: TNT - Licensed Non-Broadcast Transmitter Worn on Body
Description of product as it is marketed: (NOTE: This text will appear below the equipment class on the grant):	Medical implant that is internal to the human body

Related OET KnowledgeDataBase Inquiry

Is there a KDB inquiry associated with this application? No

Modular Equipment

Modular Type: Does not apply

Application Purpose

Application is for: Original Equipment

Composite/Related Equipment

Is the equipment in this application a composite device subject to an additional equipment authorization? No

Is the equipment in this application part of a system that operates with, or is marketed with, another device that requires an equipment authorization? No

Test Firm Information

Name of test firm and contact person on file with the FCC:

Firm Name: Northwest EMC

First Name: Vicki

Last Name: Albertson

Telephone Number:

503-844-4066

Extension:

Fax Number: 503-844-3826

E-mail: valbertson@nwemc.com

Grant Comments

Enter any text that you would like to appear at the bottom of the Grant of Equipment Authorization:
Output power is EIRP.

Set the grant of this application to be deferred to a specified date:
No

Equipment Authorization Waiver

Is there an equipment authorization waiver associated with this application? No

If there is an equipment authorization waiver associated with this application, has the associated waiver been approved and all information uploaded?: No

WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1)), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503).

SECTION 5301 (ANTI-DRUG ABUSE) CERTIFICATION:

The applicant must certify that neither the applicant nor any party to the application is 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. See 47 CFR 1.2002(b) for the definition of a "party" for these purposes.

Does the applicant or authorized agent so certify? Yes

Applicant/Agent Certification:

I certify that I am authorized to sign this application. All of the statements herein and the exhibits attached hereto, are true and correct to the best of my knowledge and belief. In accepting a Grant of Equipment Authorization as a result of the representations made in this application, the applicant is responsible for (1) labeling the equipment with the exact FCC ID specified in this application, (2) compliance statement labeling pursuant to the applicable rules, and (3) compliance of the equipment with the applicable technical rules. 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.

Authorizing an agent to sign this application, is done solely at the applicant's discretion; however, the applicant remains responsible for all statements in this application.

If an agent has signed this application on behalf of the applicant, a written letter of authorization which includes information to enable the agent to respond to the above section 5301 (Anti-Drug Abuse) Certification statement has been provided by the applicant. It is understood that the letter of authorization must be submitted to the FCC upon request, and that the FCC reserves the right to contact the applicant directly at any time.

Signature of Authorized Person Filing: Phillip Inglis

Title of authorized signature: Medtronic Consultant

Complete items below if agent signs the application:

Firm Name: TRP Inc

Name: Phillip Phillip Phillip

Line 1: Phillip

Line 2: Phillip

P.O. Box: Phillip

City: Phillip

State: Phillip

Country: Phillip

Zip Code: Phillip

Telephone Number:

410 531 3439

E-mail: jinglis@erols.com

Grants

This application does not exist.

COPY	FEDERAL COMMUNICATIONS COMMISSION WASHINGTON, D.C. 20554 GRANT OF EQUIPMENT AUTHORIZATION	COPY
Certification

Medtronic, Inc.
8200 Coral Sea Street NE
Mounds View, MN 55112
United States

Date of Grant: 07/31/2012

Application Dated: 05/02/2012

Attention: Charles Farlow , Program Director, Regulatory Affairs

NOT TRANSFERABLE

EQUIPMENT AUTHORIZATION is hereby issued to the named GRANTEE, and is VALID ONLY for the equipment identified hereon for use under the Commission's Rules and Regulations listed below.

FCC IDENTIFIER:	LF5MICSIMPLANT3

Name of Grantee:	Medtronic, Inc.

Equipment Class:	Licensed Non-Broadcast Transmitter Worn on Body
Notes:	Medical implant that is internal to the human body
Modular Type:	Does not apply

Grant Notes	FCC Rule Parts	Frequency Range (MHZ)	Output Watts	Frequency Tolerance	Emission Designator
IT	95I	402.0 - 405.0	1E-7	100.0 PM	196F1D
IT	95I	402.0 - 405.0	1E-7	100.0 PM	226P1D

Output power is EIRP.

IT:	Implanted Transmitter

Mail To:

EA404678

FCC ID LF5MICSIMPLANT3

LF5-MICSIMPLANT3, LF5 MICSIMPLANT3, LF5MICSIMPLANT3, LF5M1CS1MPLANT3, LF5MIC5IMPLANT3, LFSMICSIMPLANT3

Medtronic, Inc. Medical implant that is internal to the human body MICSIMPLANT3

Purchase on Amazon: Medical implant that is internal to the human body

Operating Frequencies

Exhibits

Correspondence

Application Forms

Applications are submitted for FCC ID and Grant requests. Click an above application to view details

Grants

Grants authorize equipment for operation at approved frequencies and sale within the USA. Click an above grant to view details