Application for the testing of a product at the Testing and Certification Body Fachbereich Holz und Metall
Applicant/certificate holder (company): Address: Postal code/place: Phone number: E-Mail address: Country: For foreign customers VAT ID No.
We request the testing of the following product: designation of the machinery: designation of series or type: Manufacturer (acc. to type plate): Production facility(ies):
☐ First testing of a product at Testing and Certification Body Fachbereich Holz und Metall
☐ Extension of one or several expiring certificate(s) at the Testing and Certification Body Fachbereich Holz und Metall (=prolongation) Certificate no(s): This requires a re-testing of the product. The document "F_K-16e_Manufacturers_self- declaration_for_prolongation" has to be attached to the application. LINK
☐ Licensing procedure (Co-certificate) of a tested product of a licensor: Company: Certificate number(s):
Note: For extension of the scope or modification of current certificates please use form F_K-13e_notification_of_modification.
Intended certificates/results: ☐ to be clarified; ☐ (EC-) Type Testing Certificate; ☐ GS Certificate, ☐ concept test; ☐ DGUV Test Certificate for the complete machine; ☐ Testing of specific aspects (e.g. H3, wood dust tested); ☐ B, H, D-stamp for chains remarks / explanation:
☐ A fee-based English translation of the certificate is requested. ☐ A fee-based English translation of the test report is requested.

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Place, Date	Name of applicant	Capacity within the company

Please return the completed document as PDF to: pz-hm.fbhm@bghm.de.