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ANNEX IIU.K.

PART 3U.K. EC type-approval certificate

MODEL (maximum format: A4 (210 × 297 mm))U.K.

EC TYPE-APPROVAL CERTIFICATEU.K.

Stamp of EC type-approval authority

Communication concerning the

of a type of a vehicle with regard to gear shift indicator

with regard to Regulation (EU) No 65/2012 as last amended by Regulation (EU) No …/2012(1)

EC type-approval number: …

Reason for extension: …

SECTION I U.K.
0.1.Make (trade name of manufacturer): …U.K.
0.2.Type: …U.K.
0.2.1.Commercial name(s), (if available): …U.K.
0.3.Means of identification of type, if marked on the vehicle …U.K.
0.3.1.Location of that marking: …U.K.
0.4.Category of vehicle: …U.K.
0.5.Name and address of manufacturer: …U.K.
0.8.Name(s) and address(es) of assembly plant(s) …U.K.
0.9.Name and address of the manufacturer’s representative (if any) …U.K.
SECTION II U.K.
1.Additional information (where applicable): see addendumU.K.
2.Technical service responsible for carrying out the test and evaluations:U.K.
3.Date of test report:U.K.
4.Number of test report:U.K.
5.Information according to point 4.6 of Annex I to Regulation (EU) No 65/2012 (determined at type-approval):U.K.
6.Remarks (if any): see addendumU.K.
7.Place:U.K.
8.Date:U.K.
9.Signature:U.K.
Attachments

:

Information package

Test report

Additional information: …

Addendum to EC type-approval certificate No … concerning …

(1)

Delete where not applicable