Appendix ANNEX III a Specimens of movement certificate EUR.1 and application for a movement certificate EUR.1

Each form shall measure 210 × 297 mm; a tolerance of up to minus 5 mm or plus 8 mm in the length may be allowed. The paper used must be white, sized for writing, not containing mechanical pulp and weighing not less than 25 g/m². It shall have a printed green guilloche pattern background making any falsification by mechanical or chemical means apparent to the eye.

The competent authorities of the Contracting Parties may reserve the right to print the forms themselves or may have them printed by approved printers. In the latter case, each form shall include a reference to such approval. Each form shall bear the name and address of the printer or a mark by which the printer can be identified. It shall also bear a serial number, either printed or not, by which it can be identified.

I, the undersigned, exporter of the goods described overleaf,

DECLARE

that the goods meet the conditions required for the issue of the attached certificate;

SPECIFY

as follows the circumstances which have enabled these goods to meet the above conditions:

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SUBMIT

the following supporting documents^f1:

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UNDERTAKE

to submit, at the request of the appropriate authorities, any supporting evidence which these authorities may require for the purpose of issuing the attached certificate, and undertake, if required, to agree to any inspection of my accounts and to any check on the processes of manufacture of the above goods, carried out by the said authorities;

REQUEST

the issue of the attached certificate for these goods.

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(Place and date)

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(Signature)