Division

1. 1..

   F1Unique identification code of the product-type: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. 2..

   Intended use/es:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. 3..

   Manufacturer:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. 4..

   Authorised representative:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5. 5..

   System/s of AVCP:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6. 6a..

   F2Designated standard: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

   F3Approved body/ies:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7. 6b..

   F4UK Assessment Document: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

   UK Technical Assessment:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

   Technical Assessment Body:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

   F5Approved body/ies:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8. 7..

   Declared performance/s:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9. 8..

   Appropriate Technical Documentation and/or Specific Technical Documentation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

The performance of the product identified above is in conformity with the set of declared performance/s. This declaration of performance is issued, in accordance with Regulation (EU) No 305/2011 F6as it has effect in the United Kingdom in respect of Great Britain, under the sole responsibility of the manufacturer identified above.

Signed for and on behalf of the manufacturer by:

• [ name ]. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• At [ place ] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . on [ date of issue ] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• [ signature ] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .