Annex V Approval certificate for products in accordance with appendix 1B/1C

Chapter III of Appendix 2 ‘III. Approval certificate for products in accordance with Appendix IB’ is replaced by the following:

‘III.

Approval certificate for products in accordance with appendix 1B/1C ^f1

Once the Contracting Party has effected an approval it issues the applicant with an approval certificate, drawn up in accordance with the model below. Contracting Parties use copies of this document in order to communicate to other Contracting Parties approvals granted or any withdrawals.

Approval certificate for products in accordance with appendix 1B/1C

Name of the competent administration

Communication concerning^f2:

Approval

Withdrawal of an approval

Of a control device model

Of a control device component^f3

Of a driver card

Of a workshop card

Of a company card

Of an inspector's card

Approval No …

(1)

Manufacturing or commercial mark

(2)

Name of model

(3)

Name of manufacturer

(4)

Address of manufacturer

(5)

Submitted for approval on

(6)

Test laboratory or laboratories

(7)

Date and No. of reports

(8)

Date of approval

(9)

Date of withdrawal of approval

(10)

Model (s) of component(s) of control device with which the component is intended to be used

(11)

Place

(12)

Date

(13)

Descriptive documents annexed

(14)

Remarks (including the affixing of seals if required)

…

(Signature)’