ATTESTATION OF ACTIVITIES*/FORMULAIRE DATTESTATION DACTIVITS (REGULATION (EC) 561/2006 OR THE AETR) /(RGLEMENT (CE) 561/2006 OU LAETR) POTVRDA O ODSUSTVOVANJU

VOZAA To be filled in by typing in Latin characters and signed before a journey / Popunjava se u tampanom obliku i potpisuje pre poetka putovanja To be kept with the original control device records wherever they are required to be kept / uva se uz originalni tahografski listi ili ispis iz digitalnog tahografa False attestations constitute an infringement / Unos netanih podataka u potvrdu predstavlja prekraj Part to be filled in by the undertaking / Popunjava prevoznik 1. 2.

ENMON doo Name of the undertaking / Naziv preduzea /preduzetnika

Bulevar Osloboenja 205, 11000 BEOGRAD Street address, postal code, city / Ulica, potanski broj, grad ......
........... Country / Drava: Republic of Serbia / Republika Srbija

3. 4. 5.

Telephone number (including international prefix) / Broj telefona Fax number (including international prefix / Broj faksa

+381 ......

11 78 56 060

11 78 56 020 +381 .

Adresse courrier lectronique / adresa elektronske pote):.

I, the undersigned / Ja, dole potpisani: 6. 7.

Name and first name / Ime i prezime:

Goran Buji

Koordinator Transporta Position in the undertaking / na radnom mestu u preduzeu ..

declare that the driver / izjavljujem da je voza: 8. 9. 10.

24.01.1973 Date of birth (day/month/year) /Datum roenja: (dan/mesec/godina): ..

Driving licence or identity card or passport number / Broj vozake dozvole line karte ili pasoa

Dejan Miloevi Name and first name / Ime i prezime vozaa..:...

l.k. 373247 .
11. who has started to work at the undertaking on (day/month/year) / koji je otpoeo sa radom u preduzeu (dan/mesec/godina)

01.08.2012
au cours de la priode / za period: 12. 13. 14. 15. 16. 17. 18. 19. 20. from (hour/day/month/year) / od(as/dan/mesec/godina): to (hour/day/month/year) / do (as/dan/mesec/godina): was on sick leave* / bio na bolovanju* was on annual leave* / koristio godinji odmor* was on leave or rest* / odsustvovao sa posla ili koristio slobodne dane* drove a vehicle exempted from the scope of Regulation (EC) 561/2006 or the AETR* / upravljao vozilom koje nije iz oblasti AETR-a* performed other work than driving* / obavljao druge poslove osim upravljanja vozilom* was available* / bio raspoloiv * Place / Mesto:.... Date / Datum: Signature / Potpis:.

Beograd

21.

I, the driver, confirm that I have not been driving a vehicle falling under the scope of Regulation (EC) 561/2006 or the AETR during the period mentioned above / Ja, voza, potvrujem da nisam upravljao vozilom iz oblasti AETR-a tokom gorepomenutog perioda.

22.

Leskovac Place / Mesto:. Date / datum.........................

Signature of the driver / Potpis vozaa: ...................................................................................................

Choose only one box/ Izabrati jednu od ponuenih opcija.