Annex V – EU DECLARATION OF CONFORMITY

The EU declaration of conformity referred to in Article 28, shall contain all of the following information:

1.  Name and type and any additional information enabling the unique identification of the product with digital elements;

2.  Name and address of the manufacturer or its authorised representative;

3.  A statement that the EU declaration of conformity is issued under the sole responsibility of the provider;

4.  Object of the declaration (identification of the product with digital elements allowing traceability, which may include a photograph, where appropriate);

5.  A statement that the object of the declaration described above is in conformity with the relevant Union harmonisation legislation;

6.  References to any relevant harmonised standards used or any other common specification or cybersecurity certification in relation to which conformity is declared;

7.  Where applicable, the name and number of the notified body, a description of the conformity assessment procedure performed and identification of the certificate issued;

8.  Additional information:

Signed for and on behalf of:…………………………………

(place and date of issue):

(name, function) (signature):

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