INFORMATION REQUIREMENTS FOR REGISTRATION
ANNEX VISupplementary provisions
ANNEX VI INFORMATION REQUIREMENTS FOR REGISTRATION (information to be provided when applicable) 1. ORGANISATION Name … Address … Town … Postal Code … Country/land/region/Autonomous Community … Contact person … Telephone … FAX … E-mail … Website … Public access to the environmental statement or the updated environmental statement (a) printed form … (b) electronic form … Registration number … Registration date … Suspension date of registration … Deletion date of registration … Date of the next environmental statement … Date of the next updated environmental statement … Request for derogation pursuant to Article 7 YES – NO … NACE Code of activities … Number of employees … Turnover or annual balance sheet … 2. SITE Name … Address … Postal Code … Town … Country land/region/Autonomous Community … Contact person … Telephone … FAX … E-mail … Website … Public access to the environmental statement or the updated environmental statement (a) printed form … (b) electronic form … Registration number … Date of registration … Suspension date of registration … Deletion date of registration … Date of the next environmental statement … Date of the next updated environmental statement … Request for derogation pursuant to Article 7 YES – NO … NACE Code of activities … Number of Employees … Turnover/or annual balance sheet … 3. ENVIRONMENTAL VERIFIER Name of environmental verifier … Address … Postal Code … Town … Country/land/region/Autonomous Community … Telephone … FAX … E-mail … Registration number of accreditation or licence … Scope of accreditation or licence (NACE Codes) … Accreditation or Licensing Body … Done at … on …/…/20 … Signature of the representative of the organisation …