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 typing 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
1. Name of the undertaking .........................................
2. Street address, Postal code, City, Country ..............................................
3. Telephone number (including international prefix) ........................................
4. Fax number (including international prefix) ......................................
5. E-mail address .........................................

 

I, the undersigned
6. Name .........................................
7. Position in the undertaking .....................................

 

declare that the driver
8. Name .............................................
9. Date of birth .....................................................
10. Driving licence number or Identity card number or Passport number .....................................

 

for the period
11. from (time-day-month-year) ........................................
12. to (time-day-month-year) ..........................................
13. ___was on sick leave (**)
14. ___ was on annual leave (**)
15. ___ drove a vehicle exempted from the scope of Regulation (EC) No 561/2006 or AETR (**)

 

16. For the undertaking, place ___________ date ___________ signature _______________

 

17. 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.

 

18. 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 boxes 13, 14 or 15 may be chosen.