/ FORMS / Doc No: / F318
Revision No: / 6.3
ASSESSMENT OF MODIFICATIONS / Date: / 15 July 2015
Page: / 1 of 3

1.PRODUCT

For which product is the modification proposed?Certificate Reference No(s).

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2.MODIFICATION DETAILS

Please state the exact nature of the proposed modification(s), and reason for the change(s) using the Table 1. Please submit a copy of the old and the new drawings which details the change, and associated parts lists.

Please provide a brief outline of the modifications in Table 1 on Page 2, or on a separate

sheet as necessary.

3.EQUIPMENT PERFORMANCE

Has the modified equipment been examined and tested for conformance to any recognised equipment specifications or standards? YES/NO

If 'YES', please enclose two copies of the test report and complete the following.

Test Specification / Test Authority / Test Report Reference / Date

4.CERTIFICATION AND APPROVAL INFORMATION

In order to meet and continue to meet the requirements for approval and certification it is important that listed companies understand the following:

  • All approvals and certifications are subject to our terms and conditions (ref PN101, available from )
  • Failure to comply with our approval or certification requirements for quality systems and products may be grounds for suspension or withdrawal of the certification or approval.
  • Delays may be experienced if applications are not complete and correct. Please check that all the requisite documents specified in this form are included and inform us of any document detailed but not submitted at this stage.

F318-6.3 / © BRE Global 2015

TABLE 1. MODIFICATION DETAILS.

Component / Old Drawing or Document No. / Issue / Date / New Drawing or Document No. / Issue / Date / Modification(s) / Reason(s) / Internal Use
only
F318-6.3 / July 2015 / 1 of 2 / © BRE Global 2015

5.DECLARATION

Please sign below to confirm that:

  • The information contained in this documentation has been subjected to technical review to ensure that it is fullycomplete andcorrect; and
  • All specimens provided for testing are representative of current production methods, produced in accordance with the drawings and specifications provided with this application, comply with any specific requirements of the test standard and will be supplied free of all duties and charges.

If prototype tick here 

Signed on behalf of ______

Name:Position:

(Authorised representative of Applicant)

Signature:Date:

CONTRACT REVIEW

INTERNAL USE ONLY

Reviewed by …………………………………. Date ………………….. Accepted: Yes  No
If not accepted details of action taken:
F318-6.3 / July 2015 / 1 of 3 / © BRE Global 2015