Regulation 67(c)

[F1SCHEDULE 18U.K.DECLARATION OF CONFORMITY

Declaration of conformity (No XXXX)

1.  No … (product, type, batch or serial number):U.K.

2.  Name and address of the manufacturer and, where applicable, the manufacturer's authorised representative:U.K.

3.  This declaration of conformity is issued under the sole responsibility of the manufacturer.U.K.

4.  Object of the declaration (identification of product allowing traceability):U.K.

5.  The object of the declaration described above is in conformity with the relevant statutory requirements:U.K.

6.  References to the relevant designated standards used or references to the other technical specifications in relation to which conformity is declared:U.K.

7.  The approved body … (name, number) performed … (description of intervention) and issued the certificate:U.K.

8.  Additional information:U.K.

Signed for and on behalf of: (place and date of issue): (name, function) (signature):]