Annex 10 of ATEX 2014/34/UE directive


1.            Product model/product (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; it may, where necessary for the identification of the product, include an image):

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.            Where applicable, 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):

(1)  It is optional for the manufacturer to assign a number to the declaration of conformity.