Declaration of Conformity

Supplier Data Supplier Name: Supplier Code: Street: City: Country: Contact Person Name: Position: Phone: eMail: Declaration of Conformity We hereby confirm, that all parts supplied to Key Safety Systems are in compliance with the ELV Directive 2000/53/EC and its Annex II, latest amended on 20 Sept 2005 (Commission Decision 2005/673/EC) even after the 1 July 2007 date. None of the supplied parts contain any forbidden substances in an exempted application, of which the expiration date will be 1 July 2007 or earlier. If you choose "No", please use the table to list all affected parts. Please forward the completed and signed declaration via email or fax to the following address: email: klumpu@keysafetyinc.com fax: 0049 (0)6142 923 740 Date (DD MMM YYYY) Signature (full signature required) Declaration of Conformance -ELV Directive 2000/53/EC art. 4.2 Yes NoKey Safety Systems Part Number Description Restricted or Forbidden Substance Name Restricted or Forbidden Substance CAS Number Application