
       Certificate of Validation Application Form

  Client
  Name: __________________________________________________________________
  Address: ___________________________________________________________________

  Implementation Tested
  Supplier: __________________________________________________________________
  Product: ___________________________________________________________________
  PCD: _______________________________________________________________________


  System Tested
  Type: _____________
  Native, Host, or Target Computer System
    Supplier: __________________________________
    Product: ___________________________________   ___ RAM,  __ CPUs
       Disk Controller: ________________________
		  Devices: _____________________________
		           _____________________________
		           _____________________________
       Terminal Controller: ____________________
		  Devices: _____________________________
		           _____________________________

  Host and/or Development Operating System
    Supplier: __________________________________
    Product: ___________________________________

  Development Computer System
    Supplier: __________________________________
    Product: ___________________________________   ___ RAM,  __ CPUs

  Compiler Information
    C Compiler Supplier: _______________________
    C Compiler Product: ________________________


  APTL Name & Number: ______________________  (100___)

  NVLAP Signatory: _____________________________    Date: ________
