xmlns:atom="http://www.w3.org/2005/Atom"

ANNEX IVEU DECLARATION OF CONFORMITY (No XXXX)(1)

1.Vessel/vessel model (product, type, batch or serial number):

2.Name and address of the manufacturer and, where applicable, his authorised representative:

3.This declaration of conformity is issued under the sole responsibility of the manufacturer.

4.Object of the declaration (identification of the vessel allowing traceability; it may, where necessary for the identification of the vessel, include an image):

5.The object of the declaration described above is in conformity with the relevant Union harmonisation legislation:

6.References to the relevant harmonised standards used or references to the other technical specifications in relation to which conformity is declared:

7.The notified body … (name, number) performed … (description of intervention) and issued the certificate:

8.Additional information:

Signed for and on behalf of:

(place and date of issue):

(name, function) (signature):

(1)

It is optional for the manufacturer to assign a number to the declaration of conformity.