ANNEX IVEU DECLARATION OF CONFORMITY (No XXXX)()
1.No … (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 product allowing traceability):
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):