Laser Variance Kit Application

Please fill out all required fields to generate your variance application PDF

What is the Unique ID you received for the variance kit?

Company Name

Company Address

Including City, State and Zip Code

First Name

Last Name

Job Title

Company Phone

Models Used (If using multiple models please fill out a separate application for each.)

Is this variance application for an installation or touring use?

Will you be selling, renting or loaning laser systems to another varianced operator?

What types of venues do you expect to use lasers in?

I understand that X-Laser USA, LLC is only helping to prepare and submit this variance application and that it is my responsibility to ensure all information submitted in this form is accurate (required)

I understand that high powered lasers can be dangerous if used incorrectly and that I will take all necessary precautions to use lasers safely and legally (required)

I understand that it is my responsibility as the person applying for this laser variance to follow all laser safety and compliance regulations, both federal and local (required)

I understand that it is my responsibility to file an annual report with the FDA on our laser systems to maintain our variance (required)