/ APPLICATION FOR A EUROPEAN
TECHNICAL ASSESSMENT (ETA) REFERRED TO IN ARTICLE 26 OF THE REGULATION (EU) No. 305/2011
1.)  The application is made to (TAB’s data):
Name: / ÉMI Építésügyi Minőségellenőrző Innovációs Nonprofit Kft.
Address:
City / town: / Budapest
Number, street: / Diószegi út 37.
Postcode: / 1113
Country: / Hungary
2.)  Applicant’s data:
a.)  Manufacturer’s (ETA Holder) data(2):
Name:
Address:
City / town:
Number, street:
Postcode:
Country:
Company registration number:
Tax (VAT) number:
Bank name:
Bank account number:
IBAN code(3):
BIC / SWIFT code(3):
Contact person:
Name, position:
Phone, fax:
E-mail:

(1) Regulation (EU) No 305/2011 of 9 March 2011 laying down harmonised conditions for the marketing of construction products and repealing Council Directive 89/106/EEC

(2) To be filled in every time

(3) To be filled in only by not Hungarian manufacturers

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/ APPLICATION FOR A EUROPEAN
TECHNICAL ASSESSMENT (ETA) REFERRED TO IN ARTICLE 26 OF THE REGULATION (EU) No. 305/2011
b.)  Authorised representative’s data established in the EU, EFTA or EEA(4):
Name:
Address:
City / town:
Number, street:
Postcode:
Country:
Company registration number:
Tax (VAT) number:
Bank name:
Bank account number:
Contact person:
Name, position:
Phone, fax:
Email:
3.)  Manufacturing plant(s), where the construction product is to be produced(5):
Number of plants(6):
Name:
Address:
City / town:
Number, street:
Postcode:
Country:
Contact person:
Name, position:
Phone, fax:
E-mail:

(4) To be filled only if the Applicant is an authorised representative of the manufacturer established in the European Union, European Free Trade Association or European Economic Area and who acts on its behalf. In this case the authorisation part at the end of the form shall also be filled in.

(5) To be filled in only if it differs from the manufacturer’s data, or there are several manufacturing plants.

(6) If there are more manufacturing plants, data of all the manufacturing plants shall be given in an additional annex.

4.)  Type of the construction product:
5.)  Trade name(s) of the product, as will be given in the ETA:
6.)  Description of the construction product, its intended use(s) and its essential characteristics/performances to be declared:

Please indicate*:

The product is not covered by a harmonized standard
The product is not fully covered by harmonized standard EN ….. .
Justification based on the conditions given in Art. 19 (1) of the Regulation (EU) No. 305/2011: ………………………………
The product is covered by ETAG …. (used as an EAD according to Art. 66 (3) of the Regulation (EU) No. 305/2011)
The product is covered by EAD ….
The product is not fully covered by ETAG …. (used as an EAD according to Art. 66 (3) of the Regulation (EU) No. 305/2011) or EAD ….
Justification: …………………………………….
7.)  Declaration of the applicant:

Herewith I declare

* – that I have not made any request for a European Technical Assessment for the construction product referred to in items 4 and 5 to any other TAB

* – that I have made a request for a European Technical Assessment for the construction product referred to in items 4 and 5 to

(Name of the other TAB) ………………………………………………………………………………

That request was rejected/withdrawn, because …..

–  that I agree to EOTA and designated TABs and the European Commission being informed about the application

–  that I will bear the full costs arising from the assessment procedure in accordance with the national rules of the TAB referred to in item 1

–  that I will support the assessment procedure as required and agreed in a subsequent contract

–  that I will ensure that the manufacturing places can be visited by the TAB or its representative during working hours in view of the issuing of the ETA

……………

(Place and date) (Authorised signature of the Applicant)

*) Please tick the appropriate box

Authorisation of the manufacturer (7):
Undersigned ______(manufacturer’s name), as the manufacturer of the product given in items 4 and 5 of this form, by signing this document authorise ______(authorised representative’s name), so that they can act on our behalf as an authorised representative defined in 305/2011/EU Regulation in connection with issuing a European Technical Assessment (ETA).
I declare, that the authorised representative, based on an agreement established between us, is entitled and obliged to do any measures and legal statements needed for issuing the ETA.
Date and place / Official signature of the manufacturer

Enclosure (if any)

(7) To be filled in, if the Applicant is an authorised representative of the manufacturer who acts on its behalf.

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