* (identification number of the declaration)
1. Battery model (product, category, and batch or serial number):
2. Name and address of the manufacturer and, where applicable, its authorised representative:
3. This declaration of conformity is issued under the sole responsibility of the manufacturer.
4. Object of the declaration (description of the battery and identification allowing traceability, and which may, where appropriate, include an image of the battery):
5. The object of the declaration described in 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. The notified body … (name, address, number) … performed … (description of intervention) … and issued the certificate(s): … (details, including its date, and, where appropriate, information on the duration of and conditions for its validity).
8. Additional information
Signed for and on behalf of:
(place and date of issue):
(name, function) (signature)