Document ID: chunk:federal_register_of_legislation:F2023L01006:front:0:p23
Version: federal_register_of_legislation:F2023L01006
Segment Type: other
Provision Reference: 
Character Range: 64316–67492

Annex 3
Communication
(Maximum format: A4 (210 x 297 mm))

Issued by: Name of Administration

[5]

Concerning:[6] Approval granted

       Approval extended

       Approval refused

       Approval withdrawn

       Production definitively discontinued

of a type of device (Separate Technical Unit) for means of rear visibility pursuant to UN Regulation No. 158

Approval No. Extension No.

1. Trade name or mark of device:

2. Manufacturer's name for the type of device:

3. Manufacturer's name and address:

4. If applicable, name and address of manufacturer's representative:

5. Submitted for approval on:

6. Technical Service responsible for conducting approval tests:

7. Date of report issued by that Service

8. Number of report issued by that Service

9. Brief description

         Identification of the device: mirror, Rear-View Camera System, other device2
         Device for close-proximity rear-view2
10. Position of the approval mark:

11. Reason(s) for extension (if applicable):

12. Approval granted/refused/extended/withdrawn:2

13. Place:

14. Date:

15. Signature:

    16. The list of documents deposited with the Type Approval Authority which has granted approval is annexed to this communication and may be obtained on request.

Annex 4
Communication
(Maximum format: A4 (210 x 297 mm))

Issued by: Name of Administration

[7]

Concerning:[8] Approval granted

       Approval extended

       Approval refused

       Approval withdrawn

       Production definitively discontinued

of a type of vehicle with regard to the means of rear visibility or detection pursuant to UN Regulation No. 158

    Approval number: Extension No.:

    1. Make (trade name of manufacturer):

    2. Type and general commercial description(s)

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

    3.1. Location of that marking:

    4. Category of vehicle: (M1, M2, M3, N1, N2, N3)2

    5. Name and address of manufacturer:

    6. Address(es) of the production plant(s)

    7. Additional information: (where applicable). See appendix

    8. Technical Service responsible for carrying out the tests:

    9. Date of test report:

    10. Number of test report:

    11. Remarks: (if any). See appendix

    12. Place:

    13. Date:

    14. Signature:

    15. The index to the information package lodged with the Type Approval Authority, which may be obtained on request is attached.

Annex IV - Appendix
Appendix to type approval communication form No. ……… concerning the type approval of a vehicle with regard to the means of rear visibility or detection under UN Regulation No. 158.

    1. Trade name or mark of means of rear visibility or detection and component type-approval number (if applicable):

    2. Means of rear visibility or detection: Direct vision, Devices approved to UN Regulation No. 46, Close Proximity Rear-view Mirror complying with this Regulation, Rear-View Camera System complying with this Regulation, Detection System complying with this Regulation[9]

    3. Extension of type approval of the vehicle to cover the following means of rear visibility or detection

    4. Data for identification of the R point