# Commission Implementing Regulation (EU) 2015/504 of 11 March 2015 implementing Regulation (EU) No 167/2013 of the European Parliament and of the Council with regard to the administrative requirements for the approval and market surveillance of agricultural and forestry vehicles (Text with EEA relevance), Appendix 22

Extent: E+W+S+N.I.

Model information document relating to EU type-approval of a safety belt as a component/STU
A.
GENERAL INFORMATION
2.
GENERAL INFORMATION CONCERNING SYSTEMS, COMPONENTS OR SEPARATE TECHNICAL UNITS
2.1.
Make(s) (trade name(s) of manufacturer): …
2.2.
Type ( 6 ) : …
2.2.1.
Commercial name(s) (if available): …
2.2.2.
Type-approval number(s) (49) (if available): …
2.2.3.
Type-approval(s) issued on (date, if available): …
2.2.4.
For components and separate technical units, location and method of attachment of the type-approval mark(s) (if available) ( 19 ): …
2.3.
Company name and address of manufacturer: …
2.3.1.
Name(s) and address(es) of assembly/manufacture plants: …
2.3.2.
Name and address of manufacturer's authorised representative (if any): …
2.4.
For systems and separate technical units, vehicle(s) for which they are intended for (21):
2.4.1.
Type (17): …
2.4.2.
Variant(s) (17): …
2.4.3.
Version(s) (17): …
2.4.4.
Commercial name(s) (if available): …
2.4.5.
Category, subcategory and speed index of the vehicle (2): …
54.
SAFETY BELTS
54.1.
Requirements under standard ISO 3776-3:2009 (Tractors and machinery for agriculture — Seat belts — Part 3: Requirements for assemblies) are met with relevant documentation included in the information document: yes/no (4)
54.2.
Test report granted a on the basis of UNECE Regulation No 16 (OJ L 233, 9.9.2011, p. 1) with relevant documentation included in the information document: yes/no (4)
54.3.
Number and position of safety belts and seats on which they can be used, please fill out table below:
Safety belt configuration and associated information
L = left, C = centre, R = right
Complete EU type-approval mark / ECE type-approval mark
Variant, if applicable
Belt adjustment device for height (indicate yes/no/optional)
Driver's seat
L
C
R
Passenger seat
1
L
C
R
Passenger seat
…
L
C
R
54.4.
Brief description of electrical/electronic components: …

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Source: https://www.legislation.gov.uk/eur/2015/504/annex/I/appendix/22 (the official version)
Page: https://openlegislation.uk/eu-regulation-2015-504/annex-I/appendix-22
Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.