ANNEX VIEU DECLARATION OF CONFORMITY

1.

No … (unique identification of the EEE):

2.

Name and address of the manufacturer or his authorised representative:

3.

This declaration of conformity is issued under the sole responsibility of the manufacturer (or installer):

4.

Object of the declaration (identification of EEE allowing traceability. It may include a photograph, where appropriate):

5.

The object of the declaration described above is in conformity with Directive 2011/65/EU of the European Parliament and of the Council of 8 June 2011 on the restriction of the use of certain hazardous substances in electrical and electronic equipment25:

6.

Where applicable, references to the relevant harmonised standards used or references to the technical specifications in relation to which conformity is declared:

7.

Additional information:

Signed for and on behalf of: …

(place and date of issue):

(name, function) (signature):