F1ANNEX VIMODELS OF THE TYPE-APPROVAL CERTIFICATE

Annotations:

MODEL A

(to be used for type-approval of a vehicle)

Maximum format: A4 (210 × 297 mm)

EC VEHICLE TYPE-APPROVAL CERTIFICATE

Stamp of type-approval authority

Communication concerning:

Of a type of:

  • EC type-approval136

  • extension of EC type-approval136

  • refusal of EC type-approval136

  • withdrawal of EC type-approval136

  • complete vehicle136

  • completed vehicle136

  • incomplete vehicle136

  • vehicle with complete and incomplete variants136

  • vehicle with completed and incomplete variants136

Delete where not applicable.

with regard to Directive 2007/46/EC as last amended by Directive …./…/EC / Regulation (EC) No. …/…136

EC type-approval number:

Reason for extension:

SECTION I

0.1.

Make (trade name of manufacturer):

0.2.

Type:

0.2.1.

Commercial name(s)137:

0.3.

Means of identification of type, if marked on the vehicle:

0.3.1.

Location of that marking:

0.4.

Category of vehicle138:

F50.5.

Company name and address of manufacturer of the complete/completed vehicle136:

F20.5.1.

For multi-stage approved vehicles, company name and address of the manufacturer of the base/previous stage(s) vehicle …

0.8.

Name(s) and address(es) of assembly plant(s):

0.9.

Name and address of the manufacturer's representative (if any):

SECTION II

The undersigned hereby certifies the accuracy of the manufacturer's description in the attached information document of the vehicle(s) described above ((a) sample(s) having been selected by the EC type-approval authority and submitted by the manufacturer as prototype(s) of the vehicle type) and that the attached test results are applicable to the vehicle type.

1.For complete and completed vehicles/variants136:

The vehicle type meets/does not meet136 the technical requirements of all the relevant regulatory acts as prescribed in Annex IV and Annex XI136139 to Directive 2007/46/EC.

2.For incomplete vehicles/variants136:

The vehicle type meets/does not meet136 the technical requirements of the regulatory acts listed in the table on side 2.

3.

The approval is granted/refused/withdrawn136.

4.

The approval is granted in accordance with Article 20 and the validity of the approval is thus limited to dd/mm/yy.

(Place)

(Signature)

(Date)

Attachments

Information package.

Test results (see Annex VIII).

Name(s) and specimen(s) of the signature(s) of the person(s) authorised to sign certificates of conformity and a statement of their position in the company.

NB: If this model is used for type-approval pursuant to Articles 20, 22 or 23, it may not bear the heading EC Vehicle Type-Approval Certificate, except:

  • in the case mentioned in Article 20 where the Commission has decided to allow a Member State to grant a type-approval in accordance with this Directive,

  • in the case of vehicles of the category M1, type-approved according to the procedure prescribed in Article 22.

EC VEHICLE TYPE-APPROVAL CERTIFICATE

Side 2

This EC type-approval is, where incomplete and completed vehicles, variants or versions are concerned, based on the approval(s) for incomplete vehicles listed below:

Stage 1: Manufacturer of the base vehicle:

EC type-approval number:

Dated:

Applicable to variants or versions (as appropriate):

Stage 2: Manufacturer:

EC type-approval number:

Dated:

Applicable to variants or versions (as appropriate):

Stage 3: Manufacturer:

EC type-approval number:

Dated:

Applicable to variants or versions (as appropriate):

In the case where the approval includes one or more incomplete variants or versions (as appropriate), list those variants or versions (as appropriate) which are complete or completed.

Complete/completed variant(s):

List of requirements applicable to the approved incomplete vehicle type, variant or version (as appropriate, taking account of the scope and latest amendment to each of the regulatory acts listed below).

Item

Subject

Regulatory act reference

Last amended

Applicable to variant or, if need be, to version

(List only subjects for which an EC type-approval exists.)

In the case of special purpose vehicles, exemptions granted or special provisions applied pursuant to Annex XI and exemptions granted pursuant to Article 20:

Regulatory act reference

Item number

Kind of approval and nature of exemption

Applicable to variant or, if need be, to version

F5Appendix

List of regulatory acts to which the type of vehicle complies

(to be filled in only in the case of type-approval in accordance with Article 6(3)).

Subject141

Regulatory act reference141

As amended by

Applicable to variants

1.

Permissible sound level

F31A.

Sound Level

Regulation (EU) No 540/2014

2.

Emissions

3.

Fuel tanks/Rear protective devices

In accordance with Annex IV to this Directive

F6MODEL B

(To be used for type-approval of a vehicle with regard to a system)

Maximum format: A4 (210 × 297 mm)

EC TYPE-APPROVAL CERTIFICATE

Stamp of type-approval authority

Communication concerning:

  • EC type-approval142

of a type of system/type of a vehicle with regard to a system142

  • extension of EC type-approval142

  • refusal of EC type-approval142

  • withdrawal of EC type-approval142

Delete where not applicable.

with regard to Directive …/…/EC / Regulation (EC) No …/…142, as last amended by Directive …/…/EC / Regulation (EC) No …/…142

EC type-approval number:

Reason for extension:

SECTION I

0.1.

Make (trade name of manufacturer):

0.2.

Type:

0.2.1.

Commercial name(s) (if available):

0.3.

Means of identification of type, if marked on the vehicle143:

0.3.1.

Location of that marking:

0.4.

Category of vehicle144:

0.5.

Name and address of manufacturer:

0.8.

Name(s) and address(es) of assembly plant(s):

0.9.

Name and address of the manufacturer's representative (if any):

SECTION II

1.

Additional information (where applicable): see Addendum.

2.

Technical service responsible for carrying out the tests:

3.

Date of test report:

4.

Number of test report:

5.

Remarks (if any): see Addendum.

6.

Place:

7.

Date:

8.

Signature:

Attachments

Information package

Test report

Addendumto EC type-approval certificate No …

1.

Additional information

1.1.

[…]:

1.1.1.

[…]:

[…]

2.

Type-approval number of each component or separate technical unit installed on the vehicle type to comply with this Directive or Regulation

2.1.

[…]:

3.

Remarks

3.1.

[…]:

MODEL C

(to be used for component/separate technical unit type-approval)

Maximum format: A4 (210 × 297 mm)

EC TYPE-APPROVAL CERTIFICATE

Stamp of type-approval authority

Communication concerning:

  • EC type-approval145

of a type of component/separate technical unit145

  • extension of EC type-approval145

  • refusal of EC type-approval145

  • withdrawal of EC type-approval145

Delete where not applicable.

with regard to Directive …/…/EC / Regulation (EC) No …/…145, as last amended by Directive …/…/EC / Regulation (EC) No …/…145

EC type-approval number:

Reason for extension:

SECTION I

0.1.

Make (trade name of manufacturer):

0.2.

Type:

0.3.

Means of identification of type, if marked on the component/separate technical unit145146:

0.3.1.

Location of that marking:

0.5.

Name and address of manufacturer:

0.7.

In the case of components and separate technical units, location and method of affixing of the EC approval mark:

0.8.

Name(s) and address(es) of assembly plant(s):

0.9.

Name and address of the manufacturer's representative (if any):

SECTION II

1.

Additional information (where applicable): see Addendum

2.

Technical service responsible for carrying out the tests:

3.

Date of test report:

4.

Number of test report:

5.

Remarks (if any): see Addendum

6.

Place:

7.

Date:

8.

Signature:

Attachments

Information package.

Test report.

Addendumto EC type-approval certificate No …

1.

Additional information

1.1.

[…]:

1.1.1.

[…]:

[…]

2.

Restriction of use of the device (if any)

2.1.

[…]:

3.

Remarks

3.1.

[…]:

F4MODEL D

(to be used for harmonised individual approval of a vehicle pursuant Article 24)

Maximum format: A4 (210 × 297 mm)

EC INDIVIDUAL VEHICLE APPROVAL CERTIFICATE

Image_r00003

Name, address, phone number and e-mail-address of the individual approval authority

Communication concerning individual vehicle approval with regard to Article 24 of Directive 2007/46/EC

Section 1

The undersigned [… …name and position] hereby certifies that the vehicle:

0.1.

Make (trade name of manufacturer): …

0.2.

Type:

Variant:

Version:

0.2.1.

Commercial name: …

0.4.

Category of vehicle147: …

0.5.

Name and address of the manufacturer: …

0.6.

Location and method of attachment of the statutory plates: …

Location of the vehicle identification number: …

0.9.

Name and address of the manufacturer's representative (if any):

0.10.

Vehicle identification number:

submitted for approval on

[…… date of application]

by

[…… Name and address of the applicant]

is granted approval according to the provisions of Article 24 of Directive 2007/46/EC. In witness whereof, the following approval number has been allocated: …

The vehicle complies with Appendix 2 to Annex IV to Directive 2007/46/EC. It can be permanently registered without further approval in Member States having right/left hand traffic148 and using metric/imperial148 units for the speedometer.

(Place) (Date)

(Signature149)

(Stamp of the approval authority)

[…]

[…]

[…]

Or visual representation of an advanced electronic signature according to Directive 1999/93/EC, including data for verification.

Attachments

Two photos150 of the vehicle (min resolution 640 x 480 pixel, ~7 x 10 cm)

Section 2

General construction characteristics

1.

Number of axles: … and wheels: …

1.1.

Number and position of axles with twin wheels: …

3.

Powered axles (number, position, interconnection): …

Main dimensions

4.

Wheelbase151: … mm

4.1.

Axle spacing: 1-2: … mm 2-3: … mm 3-4: … mm

5.

Length: … mm

6.

Width: … mm

7.

Height: … mm

Masses

13.

Mass of the vehicle in running order: … kg152

16.

Technically permissible maximum masses

16.1.

Technically permissible maximum laden mass: … kg

16.2.

Technically permissible mass on each axle: 1. … kg 2. … kg 3. … kg etc.

16.4.

Technically permissible maximum mass of the combination: … kg

18.

Technically permissible maximum towable mass in case of:

18.1.

Drawbar trailer: … kg

18.2.

Semi-trailer: … kg

18.3.

Centre-axle trailer: … kg

18.4.

Unbraked trailer: … kg

19.

Technically permissible maximum static vertical mass at the coupling point: … kg

Power plant

20.

Manufacturer of the engine: …

21.

Engine code as marked on the engine: …

22.

Working principle: …

23.

Pure electric: yes/no153

23.1.

Hybrid [electric] vehicle: yes/no153

24.

Number and arrangement of cylinders: …

25.

Engine capacity: … cm3

26.

Fuel: Diesel/petrol/LPG/NG – Biomethane/Ethanol/Biodiesel/Hydrogen153

26.1.

Mono fuel/Bi fuel/Flex fuel153

27.

Maximum net power154: … kW at … min-1 or maximum continuous rated power (electric motor) … kW153

Maximum speed

29.

Maximum speed: … km/h

Axles and suspension

30.

Axle(s) track: 1. … mm 2. … mm 3. … mm

35.

Tyre/wheel combination: …

Bodywork

38.

Code for bodywork155: …

40.

Colour of vehicle156: …

41.

Number and configuration of doors: …

42.

Number of seating positions (including the driver)157: …

42.1.

Seat(s) designated for use only when the vehicle is stationary: …

42.3.

Number of wheelchair user accessible position: …

Coupling device

44.

Approval number or approval mark of coupling device (if fitted): …

Environmental performances

46.

Sound level

Stationary: … dB(A) at engine speed: … min-1

Drive-by: … dB(A)

47.

Exhaust emission level158: Euro …

Other legislation: …

49.

CO2 emissions/fuel consumption/electric energy consumption159:

  1. 1.

    all power train except pure electric vehicles

    CO2 emissions

    Fuel consumption

    Combined:

    … g/km

    … l/100 km/m3/100 km (1)

    Weighted, combined

    … g/km

    … l/100 km

  2. 2.

    pure electric vehicles and OVC hybrid electric vehicles

    Electric energy consumption (weighted, combined153) … Wh/km

52.

Remarks

53.

Additional information (mileage160, …)

Explanatory notes relating to Annex VI model D