application for concession for mark „safe toys“ use

No.:										
	ITC’s Registry Number (do not fill in)
APPLICANT:
Company name:	VAT No.:											
	Id. No.:									
	Registered at:		
Address:	Phone: 		
	Fax:		
Zip Code:			-							e-mail:	@	
Banking with:		Account No.:		
IBAN:		SWIFT Code:		
Represented by:	
Person authorized to negotiation:	

Product:
Name of toy or toy type:

The type includes these versions:	
Manufacturer’s company name and address (if it differs from the applicant):

enclosed documents and details:
We append valid EC Type-Examination Certificate of toy:	 yes (Doc.No.:                             )	 no 	
We append documents according to the Decree 84/2001 Coll.:	 yes (Doc.No.:                             )	 no 	
Expected initial date of the toy marking:		
Proposed age range of the toy users:	from ............ to ..............years of child’s age	
Requirements for language versions of issued documents:	 Czech       English    other (               )	
Instruction for use, maintenance, information for users:		
Technical file (characteristics of the product, manufacturing technology, risk analysis, drawing and schemes, used harmonized and other standards, marking, pictures etc.):		
		
Methods and criteria through which the company assures that the all manufactured products are in conformity to the type:		
Test reports of foreign accredited testing laboratories:		
List of the states where the toy is introduced on the market:		
Additional documents and information:		

Applicant’s declaration: 
1.	We are acquainted with the “General rule for concession and use of the mark Safe Toys” and we agree with its requirements.
2.	We agree with the audit-testing of samples taken on the market or in distribution stock rooms.

    Date of Application	Stamp and signature of applicant’s representative