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1 .Application Category (Please tick one of the boxes below)

First Application 5 year Audit previous approval number
2 .

Current
manufacturing
status of the fitting		Production Pre - Production Prototype
3 .Name and address of applicant
(Please be aware that unless advised otherwise the company name provided here will be that published on
the certificate)
Company Name:
Company Address:



Telephone Number:
Fax Number:
Company Website:
4 .Contact details of the individual responsible for this application
Company Name:
Address: (if different to 3 above)



Telephone Number:
Fax Number:
Email Address:
Company Website:
5 .Name and address of manufacturer of fitting(s)
Where approval is sought for fittings that are manufactured or assembled at more than one site, please list all
of the manufacturing sites or assembly plant addresses.