Declaration of additional brand name(s)




Дата канвертавання17.04.2016
Памер23.73 Kb.

Declaration of additional brand name(s)




Original License Holder :







Address :




Original License No. :




Certified Product :




Previously certified Type Designation :




Newly introduced Type Designation :




Annual fee of the add. license is paid by :




(optional entry)

Marking label(s) of the additional brand model(s):

If space is not sufficient please use reverse side or separate sheet.
For the brand model(s) shown above, the original license holder :


  • confirms that the previously certified product and the additional brand model(s) are identical, including all safety relevant information printed in the user instructions or on the product.

  • agrees with the issue of additional license(s) for the brand name owner.

  • will provide user instructions of the brand model(s) in German language (in case of GS licenses).

  • makes an agreement with the brand name owner, to allow the brand name owner to exclusively receive certificates with brand names that are owned by the brand name owner, and that in case the original license becomes invalid, the additional license(s) for the brand product(s) will also be withdrawn.

  • confirms to forward the additional license(s) to the brand name owner.

  • confirms that TÜV Rheinland can request written evidence of the approval of this declaration by the brand name owner, in case needed.

The original license holder exempts TÜV Rheinland from any claims that the brand name owner should make in case of cancellation/withdrawal of the original license.












Place and Date Company stamp / signature of original license holder




Approval for Issuing a Co- or OEM License



Newly introduced Type Designation :




Co- or OEM-License Holder's Name …. :




and Address.. :




and Contact Person / Tel. No.. :





Application Fee will be paid by (company name):










Application Fee will be paid by (company address):










Application Fee will be paid by (contact person):








Annual Fee will be paid by (company name):










Annual Fee will be paid by (company address):










Annual Fee will be paid by (contact person):








Co/OEM cert. will be send to (company name):










Co/OEM cert. will be send to (company address)::










Co/OEM cert. will be send to (contact person):



















Place and date Company stamp and signature of original licence holder











Place and Date Company stamp and signature of OEM/Co license holder


Version: requested by BoM Asia 2008-12-03


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