ATTESTATION OF ACTIVITIES UNDER REGULATION (EC)
No.561/2006 or
THE EUROPEAN
AGREEMENT CONCERNING THE WORK OF CREWS OF VEHICLES ENGAGED IN INTERNATIONAL
ROAD TRANSPORT (AETR) (*)
To be filled in by
typ 20420h73u ing and signed before a journey
To be kept with
the original tachograph records wherever they are
required to be kept
False attestations
constitute an infringement
Name of the undertaking
Street address, Postal code, City, Country
Telephone number (including international prefix)
Fax number (including international prefix)
E-mail address
I, undersigned
Name
Position in the undertaking
Declare that the driver
Name
Date of birth
Driving licence number of
Identity card number or Passport number for the period
from (time-day-month-year)
to (time-day-month-year)
was on sick leave (**)
was on annual leave (**)
drove a vehicle exempted from the scope of
Regulation (EC) No.561/2006 or AETR (**)
For the undertaking, place___________________,
date__________, signature__________
I, the driver, confirm that I have not been driving
a vehicle falling under the scope of Regulation (EC) No.561/2006 or AETR
during the period mentioned above.
Place____________, date______________, signature of
the driver ______________
(*) This form is available in an
electronic and printable version on the Internet at ec.europa.eu.
(**) Only one of the boxeds 13, 14 or 15 may be chose.