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GM1 Article 14(6) Application for a certificate
Available versions for ERULES-1963177438-21360
ED Decision 2022/022/R
found in: U-space (2021/664) (May 2024)
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U-space (2021/664)... (May 2024)
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GM1 Article 14(6) Application for a certificate ED Decision 2022/022/R APPLICATION FORM — TEMPLATE Competent authorities may wish to consider using the following application form template, for the purpose of facilitating the harmonised implementation of [Regulation (EU) 2021/664](https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A32021R0664&qid=1708523662564). <table border="1" cellpadding="0" cellspacing="0"><tr><td colspan="3" valign="top" width="599"><p><b>Applicant details</b></p></td></tr><tr><td valign="top" width="65"><p align="center"><b>(a)</b></p></td><td valign="top" width="227"><p>Legal name of the applicant</p></td><td valign="top" width="307"></td></tr><tr><td valign="top" width="65"><p align="center"><b>(b)</b></p></td><td valign="top" width="227"><p>Name of the USSP or the single CIS provider</p></td><td valign="top" width="307"></td></tr><tr><td valign="top" width="65"><p align="center"><b>(c)</b></p></td><td valign="top" width="227"><p>Address of registry</p></td><td valign="top" width="307"></td></tr><tr><td valign="top" width="65"><p align="center"><b>(d)</b></p></td><td valign="top" width="227"><p>Principal place of business</p></td><td valign="top" width="307"></td></tr><tr><td valign="top" width="65"><p align="center"><b>(e)</b></p></td><td valign="top" width="227"><p>Telephone number</p></td><td valign="top" width="307"></td></tr><tr><td valign="top" width="65"><p align="center"><b>(f)</b></p></td><td valign="top" width="227"><p>Email</p></td><td valign="top" width="307"></td></tr><tr><td colspan="3" valign="top" width="599"><p><b>Reason for application</b></p></td></tr><tr><td valign="top" width="65"><p align="center"><b>1.</b></p></td><td valign="top" width="227"><p>Initial issue</p></td><td valign="top" width="307"></td></tr><tr><td valign="top" width="65"><p align="center"><b>2.</b></p></td><td valign="top" width="227"><p>Renewal</p></td><td valign="top" width="307"></td></tr><tr><td colspan="3" valign="top" width="599"><p><b>Declaration</b></p></td></tr><tr><td valign="top" width="65"><p align="center"><b>(a)</b></p></td><td valign="top" width="227"><p>Full name of the accountable manager</p></td><td valign="top" width="307"></td></tr><tr><td valign="top" width="65"><p align="center"><b>(b)</b></p></td><td valign="top" width="227"><p>Signature of the accountable manager</p></td><td valign="top" width="307"></td></tr><tr><td valign="top" width="65"><p align="center"><b>(c)</b></p></td><td valign="top" width="227"><p>Date of application</p></td><td valign="top" width="307"></td></tr></table>