Appendix ANNEX III MODEL OF EC TYPE-APPROVAL CERTIFICATE

Stamp of EC type-approval authority

Communication concerning:

• EC type-approval^f1 of a type of vehicle

• extension of EC type-approval

• refusal of EC type-approval

with regard to Directive 2005/64/EC

EC type-approval number:

Reason for extension:

1. 0.1.

   Make (trade name of manufacturer):…

2. 0.2.

   Type:…

3. 0.2.1.

   Commercial name(s)^f2:

4. 0.3.

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

5. 0.3.1.

   Location of that marking:…

6. 0.4.

   Category of vehicle^f3:…

7. 0.5.

   Name and address of manufacturer:…

8. 0.8.

   Name(s) and address(es) of assembly plant(s):…

[…]

1. 1..

   Additional information:…

   Recyclability rate(s) of the reference vehicle(s):…

   Recoverability rate(s) of the reference vehicle(s):…

2. 2..

   Technical service responsible for carrying out the tests:…

3. 3..

   Date of test report:…

4. 4..

   Reference of test report:…

5. 5..

   Remarks (if any):…

6. 6..

   Attachments: the index and information package

7. 7..

   The vehicle meets/does not meet^f4 the technical requirements of this Directive:…

…

Attachments: Information package.