1. Trade name or mark of the vehicle................................................................................................................................................................................................
2. Vehicle type.......................................................................................................................................................................................................................................
3. Manufacturer's name and address.................................................................................................................................................................................................
4. If applicable, name and address of manufacturer's representative...........................................................................................................................................
5. Brief description of the vehicle type as regards the arrangement of foot controls and foot rest...............................................................................................
6. Vehicle submitted for approval on.................................................................................................................................................................................................
7. Technical service responsible for conducting approval tests...................................................................................................................................................
8. Date of test report issued by that service.....................................................................................................................................................................................
9. Number of test report issued by that service...............................................................................................................................................................................
10. Approval granted/extended/refused/withdrawn 2/ ....................................................................................................................................................................
11. Position of approval mark on the vehicle......................................................................................................................................................................................
12. Place....................................................................................................................................................................................................................................................
13. Date.....................................................................................................................................................................................................................................................
14. Signature............................................................................................................................................................................................................................................
  The list of documents deposited with the Administrative Service which has granted approval is annexed to this communication and may be obtained on request.
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1. Trade name or mark of the vehicle................................................................................................................................................................................................
2. Vehicle type.......................................................................................................................................................................................................................................
3. Manufacturer's name and address.................................................................................................................................................................................................
4. If applicable, name and address of manufacturer's representative...........................................................................................................................................
5. Brief description of the vehicle type as regards the arrangement of foot controls................................................................................................................
6. Vehicle submitted for approval on.................................................................................................................................................................................................
7. Technical service responsible for conducting approval tests...................................................................................................................................................
8. Date of test report issued by that service.....................................................................................................................................................................................
9. Number of test report issued by that service...............................................................................................................................................................................
10. Approval granted/extended/refused/withdrawn 2/ ....................................................................................................................................................................
11. Position of approval mark on the vehicle......................................................................................................................................................................................
12. Place....................................................................................................................................................................................................................................................
13. Date.....................................................................................................................................................................................................................................................
14. Signature............................................................................................................................................................................................................................................
The list of documents deposited with the Administrative Service which has granted approval is annexed to this communication and may be obtained on request.
a0c0