Application Form for Agrément Revision

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Application Form for Agrément Revision

The application fee is €1107 (€900 + VAT).
If your company has a VAT Expemtion Form B number please enter this in the VAT code field in the at the end of this form.
Application fees are non-refundable.

Please complete the form below. (* Denotes a required field)

Application Form for Agrément Revision

Certificate Number

Name of Product

Description of proposed revision

Name

Address Line 1

Address Line 2

City

Eircode

Telephone

Fax

Email Address

Registered Office (if different from above)

Country/countries of manufacture and number of manufacturing addresses in each

Are you VAT exempt? Yes No

If yes, please enter VAT Code

Please upload any documentation relevant to your application, such as ETA certificates or other certification, DOPs (Declarations of Performance), test reports etc. (Accepted file types: PDF, Doc)

Choose File