ANNEX III

TEMPLATES FOR APPROVAL CERTIFICATES

1.General Description

1.1.

The approval certificates shall be issued in paper of maximum format A4 (210 × 297 mm), or in PDF-Format.

1.2.

All information on the approval certificates shall be provided in ISO 8859 series characters F1... and Arabic numerals.

1.3.Model A shall be used for whole vehicle type-approvals.

Where this template is used for a F2... type-approval of vehicles produced in small series in accordance with Article 42(4) of Regulation (EU) 2018/858 it shall bear the heading ‘F3GB small series vehicle type-approval certificate’.

1.4.

Model B shall be used for F4GB system type-approvals.

1.5.

Model C shall be used for F7GB component type-approvals and F7GB separate technical unit type-approvals.

1.6.

F5...

1.7.

Model E shall be used for F6... individual vehicle approval.

MODEL A

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

F8GB vehicle TYPE-APPROVAL CERTIFICATE

Identification of type-approval authority

Communication concerning granting/extension/refusal/withdrawal (4) of

  • F9GB whole vehicle type-approval in accordance with Regulation (EU) 2018/858 (4)

  • F9GB whole vehicle type-approval with exemptions for new technologies or concepts in accordance with Article 39(2) of Regulation (EU) 2018/858 authorised by the F11approval authorityF12... (4)

  • F13...

  • F10GB type-approval of vehicles produced in F14medium series in accordance with Article 41 of Regulation (EU) 2018/858 (4)

  • F15GB type-approval of vehicles produced in small series in accordance with Article 42 of Regulation (EU) 2018/858 (4)

of a type of:

  • Complete vehicle (4)

  • Completed vehicle (4)

  • Incomplete vehicle (4)

  • Vehicle with complete and incomplete variants (4)

  • Vehicle with completed and incomplete variants (4)

Number of the F10GB type-approval certificate: …

Reason for extension/refusal/withdrawal (4): …

SECTION I

0.1.

Make (trade name of manufacturer): …

0.2.

Type: …

0.2.1.

Commercial name(s) (105): …

0.3.

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

0.3.1.

Location of that marking: …

0.4.

Category of vehicle (3): …

0.5.

Company name and address of manufacturer of the incomplete/complete/completed vehicle (4): …

0.5.1.

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

1.

Technical service responsible for carrying out the tests (106): …

2.

Date of test report: …

3.

Number of test report: …

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 F17GB 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/variants (4):

The vehicle type meets/does not meet (4) the technical requirements of all the relevant regulatory acts referred to in Annex II to Regulation (EU) 2018/858.

2.For incomplete vehicles/variants (4):

The vehicle type meets/does not meet (4) the technical requirements of the regulatory acts listed in the table in part 2 of this certificate

(Place)

(Signature) (108)

(Date)

Attachments:Information package.

Test results sheet in accordance with the template set out in Annex VI of this Regulation.

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.

File containing the information referred to in paragraph 2 of Article 39 of Regulation (EU) 2018/858 (4)

F18GB VEHICLE TYPE-APPROVAL CERTIFICATE

Part 2

This F16GB type-approval is, where incomplete and completed vehicles, variants or versions are concerned, based on the approval(s) for incomplete vehicles listed below:

  1. Stage 1:

    Manufacturer of the base vehicle: …

    Number of the F16GB type-approval certificate: …

    Dated: …

    Applicable to variants or versions (as appropriate): …

  2. Stage 2:

    Manufacturer: …

    Number of the F16GB type-approval certificate: …

    Dated: …

    Applicable to variants or versions (as appropriate): …

  3. Stage 3:

    Manufacturer: …

    Number of the F16GB type-approval certificate: …

    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 F16GB type-approval exists.)

In the case of special purpose vehicles, exemptions granted or special provisions applied pursuant to Part III of Annex II to Regulation (EU) 2018/858, exemptions granted pursuant to Article 39 of Regulation (EU) 2018/858, and exemptions granted pursuant to Article 42 of Regulation (EU) 2018/858:

Item

Subject

Regulatory act reference

Kind of approval and nature of exemption

Applicable to variant or, if need be, to version

Appendix

List of regulatory acts to which the type of vehicle complies

(to be filled in only in the case of a whole-vehicle type-approval in accordance with Article 22(1)(b) and (c) of Regulation (EU) 2018/858).

Item

Subject (107)

Regulatory act reference (107)

As amended by

Applicable to variant or, if need be, to version

MODEL B

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

F19GB type-approval CERTIFICATE

Identification of type-approval authority

Communication concerning granting/extension/refusal/withdrawal (4) of:

  • F20GB system type-approval in accordance with Directive …/…/EC/Regulation (EU) No …/… (4) as last amended by Directive …/…/EC/Regulation (EU) No …/… (4)

  • F20GB system type-approval with exemptions for new technologies or concepts in accordance with Article 39(2) of Regulation (EU) 2018/858 authorized by the F22approval authorityF21... (4)

  • F23...

Number of the F19GB type-approval certificate: …

Reason for extension/refusal/withdrawal (4): …

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 vehicle (2): …

0.3.1.

Location of that marking: …

0.4.

Category of vehicle (107): …

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 (108): …

Attachments:Information package

Test report

File containing the information referred to in paragraph 2 of Article 39 of Regulation (EU) 2018/858 (4)

Addendumto F24GB type-approval certificate number …

1.

Additional information

1.1.

[…]:

1.1.1.

[…]:

[…]

2.

List of the numbers of the type-approval certificates of components and/or separate technical units used for the type-approval of the system with F25GB type-approval certificate number ….. approved under Directive/Regulation (4): …

2.1.

[…]:

3.

Remarks

3.1.

[…]:

MODEL C

(to be used for type-approval of components or separate technical units)

F26GB TYPE-APPROVAL CERTIFICATE

Identification of type-approval authority

Communication concerning granting/extension/refusal/withdrawal (4) of:

  • F33GB component/separate technical unit(4) type-approval in accordance with Directive …/…/EC/Regulation (EU) No …/… (4)

  • F33GB component/separate technical unit (4) type-approval with exemptions for new technologies or concepts in accordance with Article 39(2) of Regulation (EU) 2018/858 authorized by the F27approval authorityF28... (4)

  • F29...

The number of the F30GB type-approval certificate: …

Reason for extension/refusal/withdrawal (4): …

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 unit (2) (4): …

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 F31GB 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 (108): …

Attachments:Information package.

Test report.

File containing the information referred to in paragraph 2 of Article 39 of Regulation (EU) 2018/858 (4)

Addendumto F32GB type-approval certificate number …

1.

Additional information

1.1.

[…]:

1.1.1.

[…]:

[…]

2.

Restriction of use of the device (if any)

2.1.

[…]:

3.

Remarks

3.1.

[…]:

F34MODEL D

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

MODEL E

(to be used for F35... individual vehicle approval)

F35... INDIVIDUAL VEHICLE APPROVAL CERTIFICATE

F36g11

Name, address, phone number and email-address of the approval authority

Communication concerning granting/refusal/withdrawal (4) of:

  • F37... individual vehicle approval in accordance with Article 45 of Regulation (EU) 2018/858

Number of the F37... individual vehicle approval certificate: …

Reason for refusal/withdrawal (4): …

SECTION I

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: …

0.2.2.For multi-stage approved vehicles, type-approval information of the base/previous stages vehicle (list the information for each stage) (4):

Manufacturer: …

Make: …

Type: … Variant: … Version: …

Category of vehicle (3): …

Number of the type-approval certificate, including extension number …

0.2.3.

Identifiers (where applicable) (1): …

0.2.3.1.

Interpolation family’s identifier: …

0.4.

Category of vehicle (3): …

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]

For multi-stage approved vehicles: the vehicle has been completed or altered (4) as follows: …

The vehicle complies with the regulatory acts listed in Annex II to Regulation (EU) 2018/858, with exemption(s) of the following regulatory acts: ………. The F38approval authority has imposed alternative requirements.

The vehicle can be permanently registered without further approval in F39Great Britain.

(Place)

(Signature) (108)

(Date)

SECTION II

1.

Technical service responsible for carrying out the tests: …

2.

Date of test report: …

3.

Number of test report: …

Attachments:Two photos (109) of the vehicle (optional)

(min resolution 640 x 480 pixel, ~7 x 10 cm).

In the case of an multi-stage approval, all certificates of conformity in paper format that were delivered at the previous stages.

Part 2

(Part 2 shall consist of the information in Appendix 1 to this Annex for the vehicle category approved)

Appendix 1Part 2 of the F40... individual approval certificate

Category M1

General construction characteristics

1.

Number of axles: … and wheels (5): …

3.

Powered axles (number, position, interconnection): …

3.1.

Specify if the vehicle is non-automated/automated/fully automated (4) (8)

Main dimensions

4.

Wheelbase (111): … mm

4.1.

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

5.

Length: … mm

6.

Width: … mm

7.

Height: … mm

Masses

13.2.

Actual mass of the vehicle:…kg

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

18.3.

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/no (4)

23.1.

Class of Hybrid [electric] vehicle: OVC-HEV/NOVC-HEV/OVC-FCHV/NOVC-FCHV (4)

24.

Number and arrangement of cylinders: …

25.

Engine capacity: … cm3

26.

Fuel: Diesel/petrol/LPG/NG – Biomethane/Ethanol/Biodiesel/Hydrogen (4)

26.1.

Mono fuel/Bi fuel/Flex fuel/Dual Fuel (4)

26.2.

(Dual-fuel only) Type 1A/Type 1B/Type 2A/Type 2B/Type 3B (4)

27.

Maximum power

27.1.

Maximum net power (159): … kW at … min–1 (internal combustion engine) (4)

27.3.

Maximum net power: … kW (electric motor) (4) (112)

27.4.

Maximum 30 minutes power: … kW (electric motor) (4) (112)

28.

Gearbox (type): …

Maximum speed

29.

Maximum speed: … km/h

Axles and suspension

30.

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

35.

Fitted tyre/wheel combination/energy efficiency class of rolling resistance coefficients (RRC) and tyre category used for CO2 determination (if applicable) (160) (1): …

Bodywork

38.

Code for bodywork (113): …

40.

Colour of vehicle (114): …

41.

Number and configuration of doors: …

42.

Number of seating positions (including the driver) (115): …

42.1.

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

42.3.

Number of wheelchair user accessible position: …

Environmental performances

46.Sound level

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

Drive-by: … dB(A)

47.

Exhaust emission level (116): Euro … or other legislation: …

47.1.1.

Test mass, kg: …

48.Exhaust emissions (162) (163) (164):

Number of the base regulatory act and latest amending regulatory act applicable: …

48.1.

Smoke corrected absorption coefficient: … (m–1)

49.

CO2 emissions/fuel consumption/electric energy consumption (162):

1.all power train except pure electric vehicles

NEDC:

CO2 emissions

Fuel consumption

Combined:

… g/km

… l/100km/m3/100km (4)

Weighted, combined

… g/km

… l/100km/m3/100km (4)

Deviation factor (if applicable): …

Verification factor (if applicable) ‘1’ or ‘0’: …

2.NEDC: pure electric vehicles and OVC hybrid electric vehicles

Electric energy consumption (weighted, combined (4)) … Wh/km

3.

Vehicle fitted with eco-innovation(s): yes/no (4)

3.1.

General code of the eco-innovation(s) (151): …

3.2.Total CO2 emissions savings due to the eco-innovation(s) (68)

(repeat for each reference fuel tested):

3.2.1.

NEDC savings: … g/km (if applicable)

3.2.2.

WLTP savings: … g/km (if applicable)

4.All power trains, except pure electric vehicle, under Commission Regulation (EU) 2017/1151 (117) (if applicable)

WLTP values

CO2 emissions

Fuel consumption

Combined(4):

…g/km

…l/100km/m3/100km/kg/100km (4)

Weighted, combined(4)

…g/km

…l/100km/m3/100km/kg/100km (4)

5.

Pure electric vehicles and OVC hybrid electric vehicles, under Regulation (EU) 2017/1151 (if applicable)

5.1.Pure electric vehicles

Electric energy consumption

… Wh/km

5.2.OVC hybrid electric vehicles

Electric energy consumption (ECAC,weighted)

… Wh/km

51.

For special purpose vehicles: designation in accordance with point 5 of Part A of Annex I to Regulation (EU) 2018/858 of the European Parliament and of the Council: …

52.

Remarks: …

53.

Additional information (mileage (118), …)

Category M2

General construction characteristics

1.

Number of axles: … and wheels (5): …

1.1.

Number and position of axles with twin wheels: …

2.

Steered axles (number, position): …

3.

Powered axles (number, position, interconnection): …

3.1.

Specify if the vehicle is non-automated/automated/fully automated (4) (8)

Main dimensions

4.

Wheelbase (111): … mm

4.1.

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

5.

Length: … mm

5.3.

Vehicle equipped with aerodynamic device or equipment on the front/rear/not equipped (4)

6.

Width: … mm

7.

Height: … mm

9.

Distance between the front end of the vehicle and the centre of the coupling device: … mm

Masses

13.2.

Actual mass of the vehicle: …kg

13.3.

Additional mass for alternative propulsion: … kg

14.

Mass of the base vehicle in running order: … kg

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.

16.3.Technically permissible mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

16.4.

Technically permissible maximum mass of the combination: … kg

17.

Intended registration/in service maximum permissible masses in national/international traffic (4) (166)

17.1.

Intended registration/in service maximum permissible laden mass: … kg

17.2.Intended registration/in service maximum permissible laden mass on each axle:

1. … kg,

2. … kg,

3. … kg, etc.

17.3.Intended registration/in service maximum permissible laden mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

17.4.

Intended registration/in service maximum permissible mass of the combination: … kg

18.

Technically permissible maximum towable mass in case of:

18.1.

Drawbar 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/no (4)

23.1.

Class of Hybrid [electric] vehicle: OVC-HEV/NOVC-HEV/OVC-FCHV/NOVC-FCHV (4)

24.

Number and arrangement of cylinders: …

25.

Engine capacity: … cm3

26.

Fuel: Diesel/petrol/LPG/NG – Biomethane/Ethanol/Biodiesel/Hydrogen (4)

26.1.

Mono fuel/Bi fuel/Flex fuel/Dual Fuel (4)

26.2.

(Dual-fuel only) Type 1A/Type 1B/Type 2A/Type 2B/Type 3B (4)

27.

Maximum power

27.1.

Maximum net power (159): … kW at … min–1 (internal combustion engine) (4)

27.3.

Maximum net power: … kW (electric motor) (4) (112)

27.4.

Maximum 30 minutes power: … kW (electric motor) (4) (112)

28.

Gearbox (type): …

Maximum speed

29.

Maximum speed: … km/h

Axles and suspension

30.

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

33.

Drive axle(s) fitted with air suspension or equivalent: yes/no (4)

35.

Fitted tyre/wheel combination/energy efficiency class of rolling resistance coefficients (RRC) and tyre category used for CO2 determination (if applicable) (160) (1): …

Brakes

36.

Trailer brake connections mechanical/electric/pneumatic/hydraulic (4)

37.

Pressure in feed line for trailer braking system: … bar

Bodywork

38.

Code for bodywork (113): …

39.

Class of vehicle: class I/Class II/Class III/Class A/Class B (4)

40.

Colour of vehicle (114): …

41.

Number and configuration of doors: …

42.

Number of seating positions (including the driver) (115): …

42.1.

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

42.3.

Number of wheelchair user accessible position: …

43.

Number of standing places: …

Coupling device

44.

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

45.1.

Characteristics values (4): D: …/V: …/S: …/U: …

Environmental performances

46.Sound level

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

Drive-by: … dB(A)

47.

Exhaust emission level (116): Euro … or other legislation: …

48.Exhaust emissions (162) (163) (164):

Number of the base regulatory act and latest amending regulatory act applicable: …

48.1.

Smoke corrected absorption coefficient: … (m–1)

49.

CO2 emissions/fuel consumption/electric energy consumption (162):

1.all power train except pure electric vehicles

NEDC:

CO2 emissions

Fuel consumption

Combined:

… g/km

… l/100km/m3/100km (4)

Weighted, combined

… g/km

… l/100km

Deviation factor (if applicable): …

Verification factor (if applicable) ‘1’ or ‘0’: …

2.NEDC: pure electric vehicles and OVC hybrid electric vehicles

Electric energy consumption (weighted, combined (4)) … Wh/km

4.All power trains, except pure electric vehicle, under Regulation (EU) 2017/1151 (if applicable)

WLTP values

CO2 emissions

Fuel consumption

Combined(4):

…g/km

…l/100km/m3/100km/kg/100km

Weighted, combined4

… g/km

…l/100km/m3/100km/kg/100km (4)

5.

Pure electric vehicles and OVC hybrid electric vehicles, under Regulation (EU) 2017/1151 (if applicable)

5.1.Pure electric vehicles

Electric energy consumption

… Wh/km

5.2.OVC hybrid electric vehicles

Electric energy consumption (ECAC,weighted)

… Wh/km

51.

For special purpose vehicles: designation in accordance with point 5 of Part A of Annex I to Regulation (EU) 2018/858 of the European Parliament and of the Council: …

52.

Remarks: …

53.

Additional information (mileage (118), …)

Category M3

General construction characteristics

1.

Number of axles: … and wheels (5): …

1.1.

Number and position of axles with twin wheels: …

2.

Steered axles (number, position): …

3.

Powered axles (number, position, interconnection): …

3.1.

Specify if the vehicle is non-automated/automated/fully automated (4) (8)

Main dimensions

4.

Wheelbase (111): … mm

4.1.

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

5.

Length: … mm

5.3.

Vehicle equipped with aerodynamic device or equipment on the front/rear/not equipped (4)

6.

Width: … mm

7.

Height: … mm

9.

Distance between the front end of the vehicle and the centre of the coupling device: … mm

Masses

13.2.

Actual mass of the vehicle: …kg

13.3.

Additional mass for alternative propulsion: … kg

14.

Mass of the base vehicle in running order: … kg

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.

16.3.Technically permissible mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

16.4.

Technically permissible maximum mass of the combination: … kg

17.

Intended registration/in service maximum permissible masses in national/international traffic (4) (166)

17.1.

Intended registration/in service maximum permissible laden mass: … kg

17.2.Intended registration/in service maximum permissible laden mass on each axle:

1. … kg,

2. … kg,

3. … kg, etc.

17.3.Intended registration/in service maximum permissible laden mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

17.4.

Intended registration/in service maximum permissible mass of the combination: … kg

18.

Technically permissible maximum towable mass in case of:

18.1.

Drawbar 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/no (4)

23.1.

Class of Hybrid [electric] vehicle: OVC-HEV/NOVC-HEV/OVC-FCHV/NOVC-FCHV (4)

24.

Number and arrangement of cylinders: …

25.

Engine capacity: … cm3

26.

Fuel: Diesel/petrol/LPG/NG – Biomethane/Ethanol/Biodiesel/Hydrogen (4)

26.1.

Mono fuel/Bi fuel/Flex fuel/Dual Fuel (4)

26.2.

(Dual-fuel only) Type 1A/Type 1B/Type 2A/Type 2B/Type 3B (4)

27.

Maximum power

27.1.

Maximum net power (159): … kW at … min–1 (internal combustion engine) (4)

27.3.

Maximum net power: … kW (electric motor) (4) (112)

27.4.

Maximum 30 minutes power: … kW (electric motor) (4) (112)

28.

Gearbox (type): …

Maximum speed

29.

Maximum speed: … km/h

Axles and suspension

30.1.

Track of each steered axle: … mm

30.2.

Track of all other axles: … mm

32.

Position of loadable axle(s): …

33.

Drive axle(s) fitted with air suspension or equivalent: yes/no (4)

35.

Tyre/wheel combination (160): …

Brakes

36.

Trailer brake connections mechanical/electric/pneumatic/hydraulic (4)

37.

Pressure in feed line for trailer braking system: … bar

Bodywork

38.

Code for bodywork (113): …

39.

Class of vehicle: class I/Class II/Class III/Class A/Class B (4)

40.

Colour of vehicle (114): …

41.

Number and configuration of doors: …

42.

Number of seating positions (including the driver) (115): …

42.1.

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

42.3.

Number of wheelchair user accessible position: …

43.

Number of standing places: …

Coupling device

44.

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

45.1.

Characteristics values (4): D: …/V: …/S: …/U: …

Environmental performances

46.Sound level

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

Drive-by: … dB(A)

47.

Exhaust emission level (116): Euro … or other legislation: …

48.Exhaust emissions (162) (163) (164):

Number of the base regulatory act and latest amending regulatory act applicable: …

48.1.

Smoke corrected absorption coefficient: … (m–1)

51.

For special purpose vehicles: designation in accordance with point 5 of Part A of Annex I to Regulation (EU) 2018/858 of the European Parliament and of the Council: …

52.

Remarks: …

53.

Additional information (mileage (118), …)

Category N1

General construction characteristics

1.

Number of axles: … and wheels(5): …

1.1.

Number and position of axles with twin wheels: …

3.

Powered axles (number, position, interconnection): …

3.1.

Specify if the vehicle is non-automated/automated/fully automated (4) (8)

Main dimensions

4.

Wheelbase (111): … mm

4.1.

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

5.

Length: … mm

6.

Width: … mm

7.

Height: … mm

8.

Fifth wheel lead for semi-trailer towing vehicle (maximum and minimum): … mm

11.

Length of the loading area: … mm

Masses

13.2.

Actual mass of the vehicle: … kg

14.

Mass of the base vehicle in running order: … kg (168)

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/no (4)

23.1.

Class of Hybrid [electric] vehicle: OVC-HEV/NOVC -HEV/OVC-FCHV/NOVC-FCHV (4)

24.

Number and arrangement of cylinders: …

25.

Engine capacity: … cm3

26.

Fuel: Diesel/petrol/LPG/NG – Biomethane/Ethanol/Biodiesel/Hydrogen (4)

26.1.

Mono fuel/Bi fuel/Flex fuel/Dual Fuel (4)

26.2.

(Dual-fuel only) Type 1A/Type 1B/Type 2A/Type 2B/Type 3B (4)

27.

Maximum net power

27.1.

Maximum net power (159): … kW at … min–1 (internal combustion engine) (4)

27.3.

Maximum net power: … kW (electric motor) (4) (112)

27.4.

Maximum 30 minutes power: … kW (electric motor) (4) (112)

28.

Gearbox (type): …

Maximum speed

29.

Maximum speed: … km/h

Axles and suspension

30.

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

35.

Fitted tyre/wheel combination/energy efficiency class of rolling resistance coefficients (RRC) and tyre category used for CO2 determination (if applicable) (160) (1): …

Bodywork

38.

Code for bodywork (113): …

40.

Colour of vehicle (114): …

41.

Number and configuration of doors: …

42.

Number of seating positions (including the driver) (115): …

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): …

45.1.

Characteristics values(4): D: …/V: …/S: …/U: …

Environmental performances

46.Sound level

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

Drive-by: … dB(A)

47.

Exhaust emission level (116): Euro … or other legislation: …

47.1.1.

WLTP test mass (1)

48.Exhaust emissions (162) (163) (164):

Number of the base regulatory act and latest amending regulatory act applicable: …

49.

CO2 emissions/fuel consumption/electric energy consumption (1):

1.all power train except pure electric vehicles

NEDC:

CO2 emissions

Fuel consumption

Combined (4):

… g/km

…l/100km/m3/100km/kg/100km

Weighted, combined (4)

… g/km

… l/100km/m3/100km/kg/100km

Deviation factor (if applicable): …

Verification factor (if applicable) (‘0’ or ‘1’): …

2.NEDC: pure electric vehicles and OVC hybrid electric vehicles

Electric energy consumption (weighted, combined) (4)… Wh/km

3.

Vehicle fitted with eco-innovation(s): yes/no (4)

3.1.

General code of the eco-innovation(s) (151): …

3.2.Total CO2 emissions savings due to the eco-innovation(s) (68)

(repeat for each reference fuel tested):

3.2.1.

NEDC savings: … g/km (if applicable)

3.2.2.

WLTP savings: … g/km (if applicable)

4.All power trains, except pure electric vehicle, under Regulation (EU) 2017/1151

(if applicable)

WLTP:

CO2 emissions

Fuel consumption

Combined (4)

… g/km

… l/100km/m3/100km/kg/100km (4)

Weighted, combined (4)

… g/km

… l/100km

5.

Pure electric vehicles and OVC hybrid electric vehicles, under Regulation (EU) 2017/1151 (if applicable)

5.1.Pure electric vehicles

Electric energy consumption: … Wh/km

5.2.OVC hybrid electric vehicles

Electric energy consumption (ECAC,weighted): … Wh/km

Miscellaneous

50.

Type-approved according to the design requirements for transporting dangerous goods: yes/class(es): …/no (4):

51.

For special purpose vehicles: designation in accordance with point 5 of Part A of Annex I to Regulation (EU) 2018/858 of the European Parliament and of the Council: …

52.

Remarks: …

53.

Additional information (mileage (118), …)

Category N2

General construction characteristics

1.

Number of axles: … and wheels (5): …

1.1.

Number and position of axles with twin wheels: …

2.

Steered axles (number, position): …

3.

Powered axles (number, position, interconnection): …

3.1.

Specify if the vehicle is non-automated/automated/fully automated (4) (8)

Main dimensions

4.

Wheelbase (111): … mm

4.1.

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

5.

Length: … mm

5.2.

Elongated cab complying with F41Appendix 5 of Annex I to Commission Regulation (EU) 1230/2012: yes/no (4)

5.3.

vehicle equipped with aerodynamic device or equipment on the front/rear/not equipped (4)

6.

Width: … mm

7.

Height: … mm

8.

Fifth wheel lead for semi-trailer towing vehicle (maximum and minimum): … mm

9.

Distance between the front end of the vehicle and the centre of the coupling device: … mm

11.

Length of the loading area: … mm

Masses

13.2.

Actual mass of the vehicle: … kg

13.3.

Additional mass for alternative propulsion: … kg

14.

Mass of the base vehicle in running order: … kg (168)

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.

16.3.Technically permissible mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

16.4.

Technically permissible maximum mass of the combination: … kg

17.

Intended registration/in service maximum permissible masses in national/international traffic (4) (166)

17.1.

Intended registration/in service maximum permissible laden mass: … kg

17.2.Intended registration/in service maximum permissible laden mass on each axle:

1. … kg,

2. … kg,

3. … kg, etc.

17.3.Intended registration/in service maximum permissible laden mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

17.4.

Intended registration/in service maximum permissible 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/no (4)

23.1.

Class of Hybrid [electric] vehicle: OVC-HEV/NOVC -HEV/OVC-FCHV/NOVC-FCHV (4)

24.

Number and arrangement of cylinders: …

25.

Engine capacity: … cm3

26.

Fuel: Diesel/petrol/LPG/NG – Biomethane/Ethanol/Biodiesel/Hydrogen (4)

26.1.

Mono fuel/Bi fuel/Flex fuel/Dual Fuel (4)

26.2.

(Dual-fuel only) Type 1A/Type 1B/Type 2A/Type 2B/Type 3B (4)

27.

Maximum net power

27.1.

Maximum net power (159): … kW at … min–1 (internal combustion engine) (4)

27.3.

Maximum net power: … kW (electric motor) (4) (112)

27.4.

Maximum 30 minutes power: … kW (electric motor) (4) (112)

28.

Gearbox (type): …

Maximum speed

29.

Maximum speed: … km/h

Axles and suspension

31.

Position of lift axle(s): …

32.

Position of loadable axle(s): …

33.

Drive axle(s) fitted with air suspension or equivalent: yes/no (4)

35.

Fitted tyre/wheel combination/energy efficiency class of rolling resistance coefficients (RRC) and tyre category used for CO2 determination (if applicable) (160) (1): …

Brakes

36.

Trailer brake connections mechanical/electric/pneumatic/hydraulic (4)

37.

Pressure in feed line for trailer braking system: … bar

Bodywork

38.

Code for bodywork (113): …

40.

Colour of vehicle (114): …

41.

Number and configuration of doors: …

42.

Number of seating positions (including the driver) (115): …

Coupling device

44.

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

45.1.

Characteristics values (4): D: …/V: …/S: …/U: …

Environmental performances

46.Sound level

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

Drive-by: … dB(A)

47.

Exhaust emission level (116): Euro … or other legislation: …

47.1.1.

WLTP test mass (1)

48.Exhaust emissions (162) (163) (164):

Number of the base regulatory act and latest amending regulatory act applicable: …

49.

CO2 emissions/fuel consumption/electric energy consumption (1):

1.all power train except pure electric vehicles

NEDC:

CO2 emissions

Fuel consumption

Combined (4):

… g/km

…l/100km/m3/100km/kg/100km

Weighted, combined (4)

… g/km

… l/100km/m3/100km/kg/100km

Deviation factor (if applicable): …

Verification factor (if applicable) (‘0’ or ‘1’): …

2.NEDC: pure electric vehicles and OVC hybrid electric vehicles

Electric energy consumption (weighted, combined) (4)… Wh/km

4.All power trains, except pure electric vehicle, under Regulation (EU) 2017/1151 (if applicable)

WLTP:

CO2 emissions

Fuel consumption

Combined (4)

… g/km

… l/100km/m3/100km/kg/100km (4)

Weighted, combined (4)

… g/km

… l/100km

5.

Pure electric vehicles and OVC hybrid electric vehicles, under Regulation (EU) 2017/1151 (if applicable)

5.1.Pure electric vehicles

Electric energy consumption: … Wh/km

5.2.OVC hybrid electric vehicles

Electric energy consumption (ECAC,weighted): … Wh/km

49.1.

Cryptographic hash of the manufacturer’s records file (119): ..................................................................................

49.4.

Cryptographic hash of the customer information file: ............................................................................ (120) (121)

Miscellaneous

50.

Type-approved according to the design requirements for transporting dangerous goods: yes/class(es): …/no (4):

51.

For special purpose vehicles: designation in accordance with point 5 of Part A of Annex I to Regulation (EU) 2018/858 of the European Parliament and of the Council: …

52.

Remarks: …

53.

Additional information (mileage (118), …)

Category N3

General construction characteristics

1.

Number of axles: … and wheels (5): …

1.1.

Number and position of axles with twin wheels: …

2.

Steered axles (number, position): …

3.

Powered axles (number, position, interconnection): …

3.1.

Specify if the vehicle is non-automated/automated/fully automated (4) (8)

Main dimensions

4.

Wheelbase (111): … mm

4.1.

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

5.

Length: … mm

5.2.

Elongated cab complying with F42Appendix 5 of Annex I to Commission Regulation (EU) 1230/2012: yes/no (4)

5.3.

vehicle equipped with aerodynamic device or equipment on the front/rear/not equipped (4)

6.

Width: … mm

7.

Height: … mm

8.

Fifth wheel lead for semi-trailer towing vehicle (maximum and minimum): … mm

9.

Distance between the front end of the vehicle and the centre of the coupling device: … mm

11.

Length of the loading area: … mm

Masses

13.2.

Actual mass of the vehicle: … kg

13.3.

Additional mass for alternative propulsion: … kg

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.

16.3.Technically permissible mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

16.4.

Technically permissible maximum mass of the combination: … kg

17.

Intended registration/in service maximum permissible masses in national traffic (4) (166)

17.1.

Intended registration/in service maximum permissible laden mass: … kg

17.2.Intended registration/in service maximum permissible laden mass on each axle:

1. … kg,

2. … kg,

3. … kg, etc.

17.3.Intended registration/in service maximum permissible laden mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

17.4.

Intended registration/in service maximum permissible 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/no (4)

23.1.

Class of Hybrid [electric] vehicle: OVC-HEV/NOVC -HEV/OVC-FCHV/NOVC-FCHV (4)

24.

Number and arrangement of cylinders: …

25.

Engine capacity: … cm3

26.

Fuel: Diesel/petrol/LPG/NG – Biomethane/Ethanol/Biodiesel/Hydrogen (4)

26.1.

Mono fuel/Bi fuel/Flex fuel/Dual Fuel (4)

26.2.

(Dual-fuel only) Type 1A/Type 1B/Type 2A/Type 2B/Type 3B (4)

27.

Maximum net power

27.1.

Maximum net power (159): … kW at … min–1 (internal combustion engine) (4)

27.3.

Maximum net power: … kW (electric motor) (4) (112)

27.4.

Maximum 30 minutes power: … kW (electric motor) (4) (112)

28.

Gearbox (type): …

Maximum speed

29.

Maximum speed: … km/h

Axles and suspension

31.

Position of lift axle(s): …

32.

Position of loadable axle(s): …

33.

Drive axle(s) fitted with air suspension or equivalent: yes/no (4)

35.

Fitted tyre/wheel combination (160): …

Brakes

36.

Trailer brake connections mechanical/electric/pneumatic/hydraulic (4)

37.

Pressure in feed line for trailer braking system: … bar

Bodywork

38.

Code for bodywork (113): …

40.

Colour of vehicle (114): …

41.

Number and configuration of doors: …

42.

Number of seating positions (including the driver) (115): …

Coupling device

44.

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

45.1.

Characteristics values (4): D: …/V: …/S: …/U: …

Environmental performances

46.Sound level

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

Drive-by: … dB(A)

47.

Exhaust emission level (116): Euro … or other legislation: …

48.Exhaust emissions (162) (163) (164):

Number of the base regulatory act and latest amending regulatory act applicable: …

49.1.

Cryptographic hash of the manufacturer’s records file (119): ..................................................................................

49.4.

Cryptographic hash of the customer information file: ............................................................................ (120)

Miscellaneous

50.

Type-approved according to the design requirements for transporting dangerous goods: yes/class(es): …/no (4):

51.

For special purpose vehicles: designation in accordance with point 5 of Part A of Annex I to Regulation (EU) 2018/858 of the European Parliament and of the Council: …

52.

Remarks: …

53.

Additional information (mileage (118), …)

Categories O1/O2

General construction characteristics

1.

Number of axles: … and wheels (5): …

1.1.

Number and position of axles with twin wheels: …

Main dimensions

4.

Wheelbase (157) (174): … mm

4.1.Axle spacing:

0-1:

… mm

1-2:

… mm

2-3:

… mm

3-4:

… mm

5.

Length: … mm

6.

Width: … mm

7.

Height: … mm

10.

Distance between the centre of the coupling device and the rear end of the vehicle: … mm

11.

Length of the loading area: … mm

Masses

13.2.

Actual mass of the vehicle: … kg

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.

16.3.Technically permissible mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

19.

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

Maximum speed

29.

Maximum speed: … km/h

Axles and suspension

30.1.

Track of each steered axle: … mm

30.2.

Track of all other axles: … mm. Drive axle(s) fitted with air suspension or equivalent: yes/no (4)

35.

Fitted tyre/wheel combination (160): …

Brakes

36.

Trailer brake connections mechanical/electric/pneumatic/hydraulic (4)

Bodywork

38.

Code for bodywork (113): …

Coupling device

44.

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

45.1.

Characteristics values (4): D: …/V: …/S: …/U: …

Miscellaneous

50.

Type-approved according to the design requirements for transporting dangerous goods: yes/class(es): …/no (4):

51.

For special purpose vehicles: designation in accordance with point 5 of Part A of Annex I to Regulation (EU) 2018/858 of the European Parliament and of the Council: …

52.

Remarks: …

53.

Additional information: …

Categories O3/O4

General construction characteristics

1.

Number of axles: … and wheels (5): …

1.1.

Number and position of axles with twin wheels: …

2.

Steered axles (number, position): …

Main dimensions

4.

Wheelbase (157) (174): … mm

4.1.Axle spacing:

0-1:

… mm

1-2:

… mm

2-3:

… mm

3-4:

… mm

5.

Length: … mm

5.3.

Vehicle equipped with aerodynamic device or equipment on the rear/not equipped (4)

6.

Width: … mm

7.

Height: … mm

10.

Distance between the centre of the coupling device and the rear end of the vehicle: … mm

11.

Length of the loading area: … mm

Masses

13.2.

Actual mass of the vehicle: … kg

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.

16.3.Technically permissible mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

16.4.

Technically permissible maximum mass of the combination: … kg

17.

Intended registration/in service maximum permissible masses in national traffic (4) (166)

17.1.

Intended registration/in service maximum permissible laden mass: … kg

17.2.Intended registration/in service maximum permissible laden mass on each axle:

1. … kg,

2. … kg,

3. … kg, etc.

17.3.Intended registration/in service maximum permissible laden mass on each axle group:

1. … kg,

2. … kg,

3. … kg, etc.

17.4.

Intended registration/in service maximum permissible mass of the combination: … kg

19.

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

Maximum speed

29.

Maximum speed: … km/h

Axles and suspension

31.

Position of lift axle(s): …

32.

Position of loadable axle(s): …

34.

Axle(s) fitted with air suspension or equivalent: yes/no (4)

35.

Fitted tyre/wheel combination (160): …

Brakes

36.

Trailer brake connections mechanical/electric/pneumatic/hydraulic (4)

Bodywork

38.

Code for bodywork (113): …

Coupling device

44.

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

45.1.

Characteristics values (4): D: …/V: …/S: …/U: …

Miscellaneous

50.

Type-approved according to the design requirements for transporting dangerous goods: yes/class(es): …/no (4):

51.

For special purpose vehicles: designation in accordance with point 5 of Part A of Annex I to Regulation (EU) 2018/858 of the European Parliament and of the Council: …

52.

Remarks: …

53.

Additional information: …