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ANNEX ATTESTATION OF ACTIVITIES 1 (REGULATION (EC) 561/2006 OR THE AETR 2 ) To be filled in by typing and signed before a journey. To be kept with the original control device records wherever they are required to be kept  FALSE ATTESTATIONS CONSTITUTE AN INFRINGEMENT Part to be filled in by the undertaking (1) Name of the u nd ertaki ng :SC VALMAN TUR SRL (2) Str eet a ddr ess, postal cod e, ci ty, cou ntr y: st r. EROI LOR, 12 530 0, R M SARAT, ROMANIA (3) Te le phone nu mb er (i nc ludi ng inte rnat iona l pr ef ix):  (4 ) Fax numbe r ( in cl ud in g i nt erna ti on al pr ef ix ): (5) E-mail address:[email protected] I, the undersigned: (6)  Name and f irst name SFINTES VALERIU (7) Position in the undertaking:ADMINISTRATOR declare that the driver: (8)  Name and f irst name: ION LIVIU (9) Date of birth (day/month/year): 03/04/1976 (10) Driving licence or identity card or passport number: 1760403104975 (11) who has started to work at the undertaking on (day/month/year):  01/04/2013 for the period: (12) from (hour/day/month/year): 21.30/01/05/2013 (13) to (hour/day/month/year): 21.30/29/05/2013 (14) was on sick leave *** (15) was on annual leave ***  (16) was on leave or rest *** (17 ) dro ve a v ehicl e ex emp ted fro m th e sc ope of Regula tio n (EC) 56 1/2 006 or t he AETR *** (1 8) pe rf or med ot he r work th an dr iv in g ***  (19) was available *** (20) Place:RM SARAT Date:16.06.2013 Signature: (21) I, the d rive r, con firm t hat I h ave n ot bee n dri ving a veh icle f allin g und er th e sco pe of Regu latio n (EC) 5 61/2006 o r the AETR during the period mentioned above . (22) Place:RM SARAT Date: 16.06.2013 Signature of the driver: 1 This form is available in electronic and printable versions at the following address:  http://ec.europa.eu  2 European Agreement concerning the Work of Crews of Vehicles engaged in International Road Transport. *** Choose only one box EN  EN

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ANNEX

ATTESTATION OF ACTIVITIES1

(REGULATION (EC) 561/2006 OR THE AETR 2)

To be filled in by typing and signed before a journey. To be kept with the original control device records wherever they are

required to be kept FALSE ATTESTATIONS CONSTITUTE AN INFRINGEMENT

Part to be filled in by the undertaking 

(1) Name of the undertaking:SC VALMAN TUR SRL

(2) Street address, postal code, city, country: str. EROILOR, 125300, RM SARAT, ROMANIA

(3) Telephone number (including international prefix): 

(4) Fax number (including international prefix): (5) E-mail address:[email protected]

I, the undersigned:

(6)  Name and first name SFINTES VALERIU

(7) Position in the undertaking:ADMINISTRATOR 

declare that the driver:

(8)  Name and first name:ION LIVIU

(9) Date of birth (day/month/year): 03/04/1976

(10) Driving licence or identity card or passport number: 1760403104975

(11) who has started to work at the undertaking on (day/month/year): 01/04/2013

for the period:

(12) from (hour/day/month/year): 21.30/01/05/2013

(13) to (hour/day/month/year):21.30/29/05/2013

(14) was on sick leave***

(15) was on annual leave*** 

(16) was on leave or rest***

(17) drove a vehicle exempted from the scope of Regulation (EC) 561/2006 or the AETR ***

(18) performed other work than driving*** 

(19) was available***

(20) Place:RM SARAT Date:16.06.2013

Signature:

(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.

(22) Place:RM SARAT Date: 16.06.2013

Signature of the driver:

1This form is available in electronic and printable versions at the following address: http://ec.europa.eu 

2 European Agreement concerning the Work of Crews of Vehicles engaged in International Road Transport.***

Choose only one box

EN   EN