ANNEX XEU DECLARATION OF CONFORMITY (No XXXX)(1)
1.Product model/product (product, type, batch or serial number):
2.Name and address of the manufacturer and, where applicable, his authorised representative:
3.This declaration of conformity is issued under the sole responsibility of the manufacturer.
4.Object of the declaration (identification of product allowing traceability; it may, where necessary for the identification of the product, include an image):
5.The object of the declaration described above is in conformity with the relevant Union harmonisation legislation:
6.References to the relevant harmonised standards used or references to the other technical specifications in relation to which conformity is declared:
7.Where applicable, the notified body … (name, number) performed … (description of intervention) and issued the certificate:
8.Additional information:
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.