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ANNEX XIIIU.K.EU DECLARATION OF CONFORMITY (No XXXX)(1)

1.Instrument model/Instrument (product, type, batch or serial number):U.K.

2.Name and address of the manufacturer and, where applicable, his authorised representative:U.K.

3.This declaration of conformity is issued under the sole responsibility of the manufacturer.U.K.

4.Object of the declaration (identification of instrument allowing traceability; it may, where necessary for the identification of the instrument, include an image):U.K.

5.The object of the declaration described above is in conformity with the relevant Union harmonisation legislation:U.K.

6.References to the relevant harmonised standards or normative documents used or references to the other technical specifications in relation to which conformity is declared:U.K.

7.Where applicable, the notified body … (name, number) performed … (description of intervention) and issued the certificate:U.K.

8.Additional information:U.K.

Signed for and on behalf of:

(place and date of issue):

(name, function) (signature):

(1)

It is optional for the manufacturer to assign a number to the declaration of conformity.