S3C84E5/C84E9 MASK OPTION SELECTION FORM

Device Number:S3C84E___-________(write down the ROM code number)

Attachment (Check one):

Diskette

PROM

Customer Checksum:

________________________________________________________________

Company Name:

________________________________________________________________

Signature (Engineer):

________________________________________________________________

Please answer the following questions:

FApplication (Product Model ID: _______________________)

Audio

Video

Telecom

LCD Databank

Caller ID

LCD Game

Industrials

Home Appliance

Office Automation

Remocon

Other

Please describe in detail its application

(For duplicate copies of this form, and for additional ordering information, please contact your local Samsung sales representative. Samsung sales offices are listed on the back cover of this book.)

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Samsung user manual S3C84E5/C84E9 Mask Option Selection Form, Attachment Check one, Prom