Name and address of the producer or of the authorised representative where appointed under Article 17 (postal code and location, street name and number, country, telephone and fax number, e-mail, as well as a contact person). In the case of an authorised representative as defined in Article 17, also the contact details of the producer that is represented.
National identification code of the producer, including European tax number or national tax number of the producer.
Category of EEE set out in Annex I or III, as appropriate.
Type of EEE (household or other than household equipment).
Brand name of EEE.
Information on how the producer meets its responsibilities: individual or collective scheme, including information on financial guarantee.
Selling technique used (e.g. distance selling).
Declaration stating that the information provided is true.
National identification code of the producer.
Reporting period.
Category of EEE set out in Annex I or III, as appropriate.
Quantity of EEE placed on the national market, by weight.
Quantity, by weight, of waste of EEE separately collected, recycled (including prepared for re-use), recovered and disposed of within the Member State or shipped within or outside the Union.
Note: information set out in points 4 and 5 must be given by category.