OR REGULAMENTUL (Highlight 9/28/13 ATTESTATION blank) THE CERTIFICAT EUROPEAN 9:29:19 comment DE OF (CE) AGREEMENT DESFSURARE ACTIVITIES PMNR.

Ionut 561/2006 CONCERNING UNDER A ACTIVIT..II SAU REGULATION THE ACORDUL WORK OF A.E.T.R. (EC) CREWS NO 561/2006 (*)VEHICLES ENGAGED IN INTER OF NATIONAL TRANSPORT A se completa p.stra ROAD (AETR) mpreun. prin (*) dactilografiere cu nregistrarea .i a original se semnaa aparaturii nainte de cde l control, torie. n cazul n care este To Falsificarea benecesar filled in certificatelor p strarea by typingnregistr andconstituie signed riibefore infractiune. a journey.To be kept with the origin (Name (Highlight 9/28/13 2. blank) (Street 3. (Telephone 4. (Fax 5. (E-mail Subsemnatul,(subsemnata) 6. ( (text) (combobox) 7. declar 8. 9. 10. alName) False 1. Position Date Strada, Num.rul Adresa Numele Func.ia Data tachograph Num.rul number of attestations c. of 9:29:53 address, address) na.terii: the de .i conduc.torul birth) ntreprinderii: comment codul number de ocupata in 0 (including permisului undertaking) e-mail: prenumele: telefon fax the records PM po.tal, Postal (including (inclusiv undertaking) Ionut constitute n (inclusiv wherever international auto de ntreprindere: code, ora.ul, (I, conducere, prefixul (declare international the City, an they prefixul .ara: undersigned), infringement Country) are interna.ional): prefix) that sau required interna.ional): athe prefix) c.r.ii driver) to debe identitate kept sau a pa.aportul ( Driving ui: 11. care lucreaza licence number n cadrul or Identity ntreprinderii card number de la(ziua/luna/anul) or Passport number) from (time-day-mont 15. (checkbox) se 16. 17. h-year) pentru 12. (: (text) 13. 14. afla Yes) . des-a la a(ora, -condus perioada la Unchecked naflat (ora, concediu Unchecked ziua, un ,(for ziua, nvehicul concediu luna, sau then luna, anul) exceptat period repaus medical de anul) odihn. to)(was from (time-day-month-year): de (was (as la on (time-day-month-year): on aplicarea on leave sick annual or leave) Regulamentului rest) leave) (*) (*) (*) (CE) nr.561/20 06 sauaAE.T.R. (checkbox) drove vehicle Unchecked (*) exempted from the scope of Regulation (EC) No 561/2006 or AETR ( (: data For Semn.tura 21. signature desf 18. *) (checkbox) 19. era 20. (listbox) (text) Yes) the Subsemnatul, disponibil Pentru sura Unchecked undertaking, o ______________________ Unchecked alt ntreprindere, (was conduc.tor activitate, available) placelocalitatea auto, dec tconfirm condusul c.(performed nu am condus other un vehicul work than care driving) intr n d omeniul de aplicare Regulamentului (CE) nr. al prevederilor 561/2006 sau AETR . (I, the driver, confirm that I have not Localitatea Regulation 22. (listbox) (text) Semn.tura Place data Signature Acest (1) been formular driving conduc.torului of (EC) the poate No. a vehicle driver 561/2006 fi ob.inut auto falling or ______________________ AETR n versiune under during theelectronic. the scope period of mentioned .i imprimabil. above.) pe site-ul This form is available in an electronic and printable version on the Internet at (1) http://arr.ro/verticala/Formular%20atestare.doc (*) . ec.europa.eu. Se alege Only one of doar the una boxes. dintre c.su.ele