ANNEX III

TEMPLATES FOR APPROVAL CERTIFICATES

1. General Description

1.1. The approval certificates shall be issued in paper of maximum format A4 (210 × 297 mm), or in PDF-Format.

1.2. All information on the approval certificates shall be provided in ISO 8859 series characters (for approval certificates issued in Bulgarian Language in Cyril characters, for approval certificates issued in Greek Language in Greek characters) and Arabic numerals.

1.3. Model A shall be used for whole vehicle type-approvals. Where this template is used for a national type-approval of vehicles produced in small series in accordance with Article 42(4) of Regulation (EU) 2018/858 it shall bear the heading ‘National small series vehicle type-approval certificate’.

1.4. Model B shall be used for EU system type-approvals.

1.5. Model C shall be used for EU component type-approvals and EU separate technical unit type-approvals.

1.6. Model D shall be used for EU individual vehicle approvals.

1.7. Model E shall be used for national individual vehicle approval.

MODEL A

(to be used for type-approval of a vehicle)

EU VEHICLE TYPE-APPROVAL CERTIFICATE

Identification of type-approval authority

Communication concerning granting/extension/refusal/withdrawal (4) of

— EU whole vehicle type-approval in accordance with Regulation (EU) 2018/858 (4)

— EU whole vehicle type-approval with exemptions for new technologies or concepts in accordance with Article 39(2) of Regulation (EU) 2018/858 authorised by the Commission in accordance with Article 39(3) thereof (4)

— Provisional EU whole vehicle type-approval with exemptions for new technologies or concepts in accordance with Article 39(2) of Regulation (EU) 2018/858 pending on the authorisation by the Commission in accordance with Article 39(4) thereof. The validity of the EU type-approval is thus limited to DD/MM/YYYY (4)

— EU type-approval of vehicles produced in small series in accordance with Article 41 of Regulation (EU) 2018/858 (4)

— National type-approval of vehicles produced in small series in accordance with Article 42 of Regulation (EU) 2018/858 (4)

of a type of:

— Complete vehicle (4)

— Completed vehicle (4)

— Incomplete vehicle (4)

— Vehicle with complete and incomplete variants (4)

— Vehicle with completed and incomplete variants (4)

Number of the EU type-approval certificate: …

Reason for extension/refusal/withdrawal (4): …

SECTION I

0.1. Make (trade name of manufacturer): …

0.2. Type: …

0.2.1. Commercial name(s) ( 105 ): …

0.3. Means of identification of type, if marked on the vehicle: …

0.3.1. Location of that marking: …

0.4. Category of vehicle ( 3 ): …

0.5. Company name and address of manufacturer of the incomplete/complete/completed vehicle ( 4 ): …

0.5.1. For multi-stage approved vehicles, company name and address of the manufacturer of the base/previous stage(s) vehicle …

0.8. Name(s) and address(es) of assembly plant(s): …

0.9. Name and address of the manufacturer’s representative (if any): …

SECTION II

1. Technical service responsible for carrying out the tests ( 106 ): …

2. Date of test report: …

3. Number of test report: …

The undersigned hereby certifies the accuracy of the manufacturer’s description in the attached information document of the vehicle(s) described above, ((a) sample(s) having been selected by the EU type-approval authority and submitted by the manufacturer as prototype(s) of the vehicle type), and that the attached test results are applicable to the vehicle type.

1. For complete and completed vehicles/variants ( 4 ): The vehicle type meets/does not meet (4) the technical requirements of all the relevant regulatory acts referred to in Annex II to Regulation (EU) 2018/858.

2. For incomplete vehicles/variants ( 4 ): The vehicle type meets/does not meet (4) the technical requirements of the regulatory acts listed in the table in part 2 of this certificate (Place) (Signature) (108) (Date)

Attachments: Information package. Test results sheet in accordance with the template set out in Annex VI of this Regulation. Name(s) and specimen(s) of the signature(s) of the person(s) authorised to sign certificates of conformity and a statement of their position in the company. File containing the information referred to in paragraph 2 of Article 39 of Regulation (EU) 2018/858 (4)

EU VEHICLE TYPE-APPROVAL CERTIFICATE

Part 2

This EU type-approval is, where incomplete and completed vehicles, variants or versions are concerned, based on the approval(s) for incomplete vehicles listed below:

Stage 1: Manufacturer of the base vehicle: … Number of the EU type-approval certificate: … Dated: … Applicable to variants or versions (as appropriate): …

Stage 2: Manufacturer: … Number of the EU type-approval certificate: … Dated: … Applicable to variants or versions (as appropriate): …

Stage 3: Manufacturer: … Number of the EU type-approval certificate: … Dated: … Applicable to variants or versions (as appropriate): …

In the case where the approval includes one or more incomplete variants or versions (as appropriate), list those variants or versions (as appropriate) which are complete or completed.

Complete/completed variant(s): …

List of requirements applicable to the approved incomplete vehicle type, variant or version (as appropriate, taking account of the scope and latest amendment to each of the regulatory acts listed below).

Item Subject Regulatory act reference Last amended Applicable to variant or, if need be, to version

(List only subjects for which an EU type-approval exists.)

In the case of special purpose vehicles, exemptions granted or special provisions applied pursuant to Part III of Annex II to Regulation (EU) 2018/858, exemptions granted pursuant to Article 39 of Regulation (EU) 2018/858, and exemptions granted pursuant to Article 42 of Regulation (EU) 2018/858:

Item Subject Regulatory act reference Kind of approval and nature of exemption Applicable to variant or, if need be, to version

Appendix List of regulatory acts to which the type of vehicle complies (to be filled in only in the case of a whole-vehicle type-approval in accordance with Article 22(1)(b) and (c) of Regulation (EU) 2018/858). Item Subject (107) Regulatory act reference (107) As amended by Applicable to variant or, if need be, to version

MODEL B

(to be used for type-approval of a system)

EU TYPE-APPROVAL CERTIFICATE

Identification of type-approval authority

Communication concerning granting/extension/refusal/withdrawal (4) of:

— EU system type-approval in accordance with Directive …/…/EC/Regulation (EU) No …/… (4) as last amended by Directive …/…/EC/Regulation (EU) No …/… (4)

— EU system type-approval with exemptions for new technologies or concepts in accordance with Article 39(2) of Regulation (EU) 2018/858 authorized by the Commission in accordance with Article 39(3) thereof (4)

— Provisional EU system type-approval with exemptions for new technologies or concepts in accordance with Article 39(2) of Regulation (EU) 2018/858 pending on the authorisation by the Commission in accordance with Article 39(4) thereof. The validity of the EU type-approval is thus limited to DD/MM/YYYY (4)

Number of the EU type-approval certificate: …

Reason for extension/refusal/withdrawal (4): …

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 ( 2 ): …

0.3.1. Location of that marking: …

0.4. Category of vehicle ( 107 ): …

0.5. Name and address of manufacturer: …

0.8. Name(s) and address(es) of assembly plant(s): …

0.9. Name and address of the manufacturer’s representative (if any): …

SECTION II

1. Additional information (where applicable): see Addendum.

2. Technical service responsible for carrying out the tests: …

3. Date of test report: …

4. Number of test report: …

5. Remarks (if any): see Addendum.

6. Place: …

7. Date: …

8. Signature ( 108 ): …

Attachments: Information package Test report File containing the information referred to in paragraph 2 of Article 39 of Regulation (EU) 2018/858 (4)

Addendum to EU type-approval certificate number … 1. Additional information 1.1. […]: 1.1.1. […]: […] 2. List of the numbers of the type-approval certificates of components and/or separate technical units used for the type-approval of the system with EU type-approval certificate number ….. approved under Directive/Regulation (4): … 2.1. […]: 3. Remarks 3.1. […]:

MODEL C

(to be used for type-approval of components or separate technical units)

EU TYPE-APPROVAL CERTIFICATE

Identification of type-approval authority

Communication concerning granting/extension/refusal/withdrawal (4) of:

— EU component/separate technical unit(4) type-approval in accordance with Directive …/…/EC/Regulation (EU) No …/… (4)

— EU component/separate technical unit (4) type-approval with exemptions for new technologies or concepts in accordance with Article 39(2) of Regulation (EU) 2018/858 authorized by the Commission in accordance with Article 39(3) thereof (4)

— Provisional EU component/separate technical unit (4) type-approval with exemptions for new technologies or concepts in accordance with Article 39(2) of Regulation (EU) 2018/858 pending on the authorisation by the Commission in accordance with Article 39(4) thereof. The validity of the EU type-approval is thus limited to DD/MM/YYYY (4)

The number of the EU type-approval certificate: …

Reason for extension/refusal/withdrawal (4): …

SECTION I

0.1. Make (trade name of manufacturer): …

0.2. Type: …

0.3. Means of identification of type, if marked on the component/separate technical unit ( 2 ) ( 4 ): …

0.3.1. Location of that marking: …

0.5. Name and address of manufacturer: …

0.7. In the case of components and separate technical units, location and method of affixing of the EU approval mark: …

0.8. Name(s) and address(es) of assembly plant(s): …

0.9. Name and address of the manufacturer’s representative (if any): …

SECTION II

1. Additional information (where applicable): see Addendum

2. Technical service responsible for carrying out the tests: …

3. Date of test report: …

4. Number of test report: …

5. Remarks (if any): see Addendum

6. Place: …

7. Date: …

8. Signature ( 108 ): …

Attachments: Information package. Test report. File containing the information referred to in paragraph 2 of Article 39 of Regulation (EU) 2018/858 (4)

Addendum to EU type-approval certificate number … 1. Additional information 1.1. […]: 1.1.1. […]: […] 2. Restriction of use of the device (if any) 2.1. […]: 3. Remarks 3.1. […]:

MODEL D

(to be used for EU individual vehicle approval)

EU INDIVIDUAL VEHICLE APPROVAL CERTIFICATE

e(4) Name, address, phone number and email-address of the individual approval authority

Communication concerning granting/refusal/withdrawal (4) of:

— EU individual vehicle approval in accordance with Article 44 of Regulation (EU) 2018/858

Number of the EU individual vehicle approval certificate: …

Reason for refusal/withdrawal (4): …

SECTION I

The undersigned [… …name and position] hereby certifies that the vehicle:

0.1. Make (trade name of manufacturer): …

0.2. Type: … Variant: … Version: …

0.2.1. Commercial name: …

0.2.2. For multi-stage approved vehicles, type-approval information of the base/previous stages vehicle (list the information for each stage) ( 4 ): Manufacturer: … Make: … Type: … Variant: … Version: … Category of vehicle (3): … Number of the type-approval certificate, including extension number …

0.2.3. Identifiers (where applicable) ( 1 ): …

0.2.3.1. Interpolation family’s identifier: …

0.4. Category of vehicle ( 107 ): …

0.5. Name and address of the manufacturer: …

0.6. Location and method of attachment of the statutory plates: … Location of the vehicle identification number: …

0.9. Name and address of the manufacturer’s representative (if any):

0.10. Vehicle identification number: … submitted for approval on […… date of application] by […… Name and address of the applicant]

For multi-stage approved vehicles: the vehicle has been completed or altered (4) as follows: …

The vehicle complies with:

— Appendix 2 to Part I of Annex II to Regulation (EU) 2018/858;

— Part III of Annex II to Regulation (EU) 2018/858 EU (special purpose vehicles).

The vehicle can be permanently registered without further approval in Member States having right/left (4) hand traffic and using metric/imperial (4) units for the speedometer.

(Place) (Date) (Signature (107)) (Stamp of the approval authority) […] […] […]

Attachments: Two photos ( 108 ) of the vehicle (min resolution 640 x 480 pixel, ~7 x 10 cm). In the case of an multi-stage approval, all certificates of conformity in paper format that were delivered at the previous stages.

SECTION II

1. Technical service responsible for carrying out the tests: …

2. Date of test report: …

3. Number of test report: …

Part 2

(Part 2 shall consist of the information in Appendix 1 to this Annex for the vehicle category approved)

MODEL E

(to be used for national individual vehicle approval)

NATIONAL INDIVIDUAL VEHICLE APPROVAL CERTIFICATE

e(4) Name, address, phone number and email-address of the approval authority

Communication concerning granting/refusal/withdrawal (4) of:

— National individual vehicle approval in accordance with Article 45 of Regulation (EU) 2018/858

Number of the national individual vehicle approval certificate: …

Reason for refusal/withdrawal (4): …

SECTION I

The undersigned [… name and … position], hereby certifies that the vehicle:

0.1. Make (trade name of manufacturer): …

0.2. Type: … Variant: … Version: …

0.2.1. Commercial name: …

0.2.2. For multi-stage approved vehicles, type-approval information of the base/previous stages vehicle (list the information for each stage) ( 4 ): Manufacturer: … Make: … Type: … Variant: … Version: … Category of vehicle (3): … Number of the type-approval certificate, including extension number …

0.2.3. Identifiers (where applicable) ( 1 ): …

0.2.3.1. Interpolation family’s identifier: …

0.4. Category of vehicle ( 3 ): …

0.5. Name and address of the manufacturer: …

0.6. Location and method of attachment of the statutory plates: … Location of the vehicle identification number: …

0.9. Name and address of the manufacturer’s representative (if any): …

0.10. Vehicle identification number: … submitted for approval on […… date of application] by […… Name and address of the applicant]

For multi-stage approved vehicles: the vehicle has been completed or altered (4) as follows: …

The vehicle complies with the regulatory acts listed in Annex II to Regulation (EU) 2018/858, with exemption(s) of the following regulatory acts: ………. The issuing Member State has imposed alternative requirements.

The vehicle can be permanently registered without further approval in (name of the Member State).

(Place) (Signature) (108) (Date)

SECTION II

1. Technical service responsible for carrying out the tests: …

2. Date of test report: …

3. Number of test report: …

Attachments: Two photos ( 109 ) of the vehicle (optional) (min resolution 640 x 480 pixel, ~7 x 10 cm). In the case of an multi-stage approval, all certificates of conformity in paper format that were delivered at the previous stages.

Part 2

(Part 2 shall consist of the information in Appendix 1 to this Annex for the vehicle category approved)