Annex V | EU declaration of conformity

The EU declaration of conformity referred to in Article 28, shall contain all of the following information:

Name and type and any additional information enabling the unique identification of the product with digital elements means a software or hardware product and its remote data processing solutions, including software or hardware components being placed on the market separately;
Name and address of the manufacturer means a natural or legal person who develops or manufactures products with digital elements or has products with digital elements designed, developed or manufactured, and markets them under its name or trademark, whether for payment, monetisation or free of charge; or its authorised representative means a natural or legal person established within the Union who has received a written mandate from a manufacturer to act on its behalf in relation to specified tasks;
A statement that the EU declaration of conformity is issued under the sole responsibility of the provider
Object of the declaration (identification of the product with digital elements means a software or hardware product and its remote data processing solutions, including software or hardware components being placed on the market separately; allowing traceability, which may include a photograph, where appropriate)
A statement that the object of the declaration described above is in conformity with the relevant Union harmonisation legislation means Union legislation listed in Annex I to Regulation (EU) 2019/1020 and any other Union legislation harmonising the conditions for the marketing of products to which that Regulation applies;
References to any relevant harmonised standards means a harmonised standard as defined in Article 2, point (1)(c), of Regulation (EU) No 1025/2012; used or any other common specification or cybersecurity means cybersecurity as defined in Article 2, point (1), of Regulation (EU) 2019/881; certification in relation to which conformity is declared
Where applicable, the name and number of the notified body means a conformity assessment body designated in accordance with Article 43 and other relevant Union harmonisation legislation;, a description of the conformity assessment means the process of verifying whether the essential cybersecurity requirements set out in Annex I have been fulfilled; procedure performed and identification of the certificate issued
Additional information:

Signed for and on behalf of:

(place and date of issue):

(name, function) (signature):