# Commission Regulation (EU) 2017/1151 of 1 June 2017 supplementing Regulation (EC) No 715/2007 of the European Parliament and of the Council on type-approval of motor vehicles with respect to emissions from light passenger and commercial vehicles (Euro 5 and Euro 6) and on access to vehicle repair and maintenance information, amending Directive 2007/46/EC of the European Parliament and of the Council, Commission Regulation (EC) No 692/2008 and Commission Regulation (EU) No 1230/2012 and repealing Commission Regulation (EC) No 692/2008 (Text with EEA relevance), Appendix 4: MODEL OF GB TYPE-APPROVAL CERTIFICATE


(Maximum format: A4 (210 × 297 mm))
GB TYPE-APPROVAL CERTIFICATE
Stamp of administration
Communication concerning the:
GB type-approval (1),
extension of GB type-approval (1),
refusal of GB type-approval (1),
withdrawal of GB type-approval (1),
of a type of system/type of a vehicle with regard to a system (1) with regard to Regulation (EC) No 715/2007 (2) and Regulation (EU) 2017/1151 (3) as they have effect in domestic law
GB type-approval number: …
Reason for extension: …
SECTION I
0.1.
Make (trade name of manufacturer): …
0.2.
Type: …
0.2.1.
Commercial name(s) (if available): …
0.3.
Means of identification of type if marked on the vehicle (4)
0.3.1.
Location of that marking: …
0.4.
Category of vehicle (5)
0.4.2.
Base vehicle ( 5a ) ( 1 ): yes/no ( 1 )
0.5.
Name and address of manufacturer: …
0.8.
Name(s) and address(es) of assembly plant(s): …
0.9.
Representative of the manufacturer: …
SECTION II —
to be repeated for each interpolation family, as defined in paragraph 5.6. of Annex XXI
0.
Interpolation family identifier as defined in paragraph 5.0 of Annex XXI
1.
Additional information (where applicable): (see addendum)
2.
Technical service responsible for carrying out the tests: …
3.
Date of type 1 test report: …
4.
Number of the type 1 test report: …
5.
Remarks (if any): (see addendum)
6.
Place: …
7.
Date: …
8.
Signature: …
Attachments:
Information package ....

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Source: https://www.legislation.gov.uk/eur/2017/1151/annex/I/appendix/4 (the official version)
Page: https://openlegislation.uk/eu-regulation-2017-1151/annex-I/appendix-4
Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.