ANNEX VIII EU declaration of conformity No ( *1 ) …

1.   

No … (unique identification of the packaging):

2.   

Name and address of the manufacturer and, where applicable, the manufacturer’s authorised representative:

3.   

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

4.   

Object of the declaration (identification of the packaging allowing traceability): description of the packaging:

5.   

The object of the declaration referred to point 4 is in conformity with the relevant Union harmonisation legislation: … (reference to the other Union acts applied).

6.   

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

7.   

Where applicable, the notified body … (name, address, number) … performed … (description of intervention) … and issued the certificate(s): … (details, including the date of the certificate(s), and, where appropriate, information on the duration and conditions of validity).

8.   

Signed for and on behalf of:

(place and date of issue):

(name, function) (signature):