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POTVRDA O AKTIVNOSTI VOZAČA/ ATTESTATION OF ACTIVITIES_POTVR
Updated:2011-09-07 Category:sick
Snapshot of the Word file:"POTVRDA O AKTIVNOSTI VOZAČA/ ATTESTATION OF ACTIVITIES_POTVRDA O AKTIVNOSTI VOZAČA/ ATTESTATION OF ACTIVITIESBr.(Zakonski propis(HR) N.".doc

POTVRDA O AKTIVNOSTI VOZAČA/ ATTESTATION OF ACTIVITIES

Br.

(Zakonski propis(HR) N.N. 60/2008*) (EC) 561/2006, /(REGULATION (EC) 561/2006 OR THE AETR**)

Potvrdu strojno ispuniti prije bilo kojeg putovanja /To be filled in by typing in Latin characters and signed before a journey

Da bi se priložila originalnim dokumentima za vođene evidencije, gdje god je to potrebno/To be kept with the original control device records wherever they are required to be kept

Lažna podvrda predstavlja kršenje zakona/ False attestations constitute an infringement

Ovaj dio ispunjava poslodavac(Part to be filled in by the undertaking)

1. Naziv tvrtke/ Name of the undertaking 2. Ulica, poštanski broj, grad/ Street adress, postal code, city Država /Country: 3. Broj telefona (uključujući i međunarodni pozivni broj) Telephone number (including international prefix 4. Broj faxa(uključujući i međunarodni pozivni broj)/ Fax number (including international prefix): 5. E- mail adresa/ e-mail address): Dolje potpisani(I, the undersigned): 6. Ime i Prezime/ Name and first name 7. Pozicija u tvrtki/Position in the undertaking Izjava vozača / declare that the driver: 8. Ime i Prezime/Name and first name 9. Datum rođenja(dan,mjesec,godina)/Date of birth (day/month/year): 10. Broj vozačke dozvole, osobne iskaznice ili putovnice/Driving licence or identity card or passport number 11. Datum od kad je zaposlen u tvrtki (dan,mjesec,godina)/who has started to work at the undertaking on (day/month/year) za period: 12. od (sati, dana, mjesec, godina)/ from (hour/day/month/year) 13. do (sati, dana, mjesec, godina)/to (hour/day/month/year) : 14. ‮ odsutan zbog bolesti*** / was on sick leav 15. ‮ bio je na godišnjem odmoru***/ was on annual leave 16. ‮ bio na odmoru ili je koristio odmor***/ was on leave or rest 17. □ vožnja vozilom izvan opsega zakona o radnim vremenima N.N.60/2008 ili Uredba (EZ) 561/2006 ili AETR*** / drove a vehicle exempted from the scope of Regulation (EC) 561/2006 or the AETR 18. □ obavlja druge poslove koji nisu vezani za vožnju***/ performed other work than driving 19. □ nije dostupan***/ was available

20. Mjesto. / Place ________________________ Datum/Date__________________________

Potpis/signature



20. Ja vozač, ____________________________________izjavljujem da nisam obavljao nikakvu vožnju koja je u okviru zakona o radnim vremenima i odmorima mobilnih djelatnika (N.N. 60/2008 ) /I, the driver, confirm that I have not been driving a vehicle falling under the scope of Regulation (EC) 561/2006 or the AETR during the period mentioned above

21. Mjesto / Place:………………………………………………………. Datum/date……………......................……………………….

Potpis vozača /signature of driver

Originalni dokument je dostupan u elektroničkom obliku za printanje na stranici http://www.unece.org/trans/main/sc1/aetr.html / This form is available in electronic and printable versions at the following address : http://www.unece.org/trans/main/sc1/aetr.html

* Zakon o radnom vremenu obveznim odmorima mobilnih radnika i uređajima za bilježenje u cestovnom prijevozu

** Europski sporazum o radu posada vozača u međunarodnom transportu / European Agreement concerning the Work of Crews of Vehicles engaged in

International Road Transport

*** koristiti samo jednu opciju/Choose only one box.


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