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Attestation of activities * / formulaire dattestation dactivits*


*
( 561/2006 () **)/ (REGULATION (EC) 561/2006 OR THE AETR** )
/ To be filled in by typing in Latin characters 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)
/Name of the undertaking ........................................................................................................
, , /Street address, postal code, city .................................................................................

1.
2.

/Country:
( )/Telephone number (including international prefix)...........................
( )/Fax number (including international prefix) ..........................................
/e-mail address: ..................................................................................................................

3.
4.
5.

, (I, the undersigned):


6.
/ Name and first name: .........................................................................................................................
7.
/Position in the undertaking:..............................................................................................
, /declare that the driver:
8.
/Name and first name: ..........................................................................................................................
9.
: (//)/ Date of birth (day/month/year): ..............................................................................
10.
/Driving licence or identity card or
passport number ............................................................................................................................................................
11.
(//)/ who has started to work at the undertaking on (day/month/year)
/for the period:
12.
(///)/ from (day/month/year): ............................................................................................................
13.
(///)/ to (day/month/year): .............................................................................................................
14.
***/ was on sick leave
15.
***/ was on annual leave)
16.
***/was on leave or rest
17.
, () 561/2006
***/drove a vehicle exempted from the scope of the Regulation(EC) 561/2006 or the AETR
18.
, ,***/was performing any work other than
driving of a vehicle
19.
***/was available
20.
/Place: ......................................................................................... /date: ...
/signature

21.

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, 561/2006 () .
(I, the driver, confirm that I have not been driving a vehicle falling under the scope of the (EC) Regulation 561/2006 or AETR
during the period mentioned above).
22./Place: ............................................................................./date: ..............................................................
/signature of the driver

/ This form is available


in electronic and printable versions at the following address: http://www.unece.org/trans/main/sc1/aetr.html
**
C, ,
/European Agreement concerning the Work of Crews of Vehicles engaged in International Road Transport.
***
/Choose only one box.

60


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