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  • Appform Helmet Visor Sticker

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    roadshow23
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    This document contains a request form for helmet/visor ICC stickers from an individual. It collects information such as the applicant's name, address, contact details, brand and date of acquisition of the helmet. The applicant certifies that the helmet has not been involved in an accident or impact. The form is then evaluated by a Standards Officer who checks the condition and compliance of the helmet with safety standards before issuing an ICC sticker.

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    This document contains a request form for helmet/visor ICC stickers from an individual. It collects information such as the applicant's name, address, contact details, brand and date of acquisition of the helmet. The applicant certifies that the helmet has not been involved in an accident or impact. The form is then evaluated by a Standards Officer who checks the condition and compliance of the helmet with safety standards before issuing an ICC sticker.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Als PDF, TXT herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    91 Ansichten1 Seite

    Appform Helmet Visor Sticker

    Hochgeladen von

    roadshow23
    This document contains a request form for helmet/visor ICC stickers from an individual. It collects information such as the applicant's name, address, contact details, brand and date of acquisition of the helmet. The applicant certifies that the helmet has not been involved in an accident or impact. The form is then evaluated by a Standards Officer who checks the condition and compliance of the helmet with safety standards before issuing an ICC sticker.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Als PDF, TXT herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    von 1

    Attachment 1 Republic of the Philippines DEPARTMENT OF TRADE AND INDUSTRY Region _______ _________ Provincial Office Control#:

    REQUEST FOR HELMET/VISOR ICC STICKERS


    Date: Name : Address: Contact No(s).: Brand of Helmet: Date Acquired: Source from/ Bought from (Establishment/Location): I certify to the correctness of the above information and futher certify that the helmet has not been subjected to impact, dropped or used during a road accident.

    Printed Name and Signature Note: To be filled out by Standards Officer / Authorized Officer during evaluation: Brand: Other description / identifying marks:

    Condition of helmet: - retention system, protective & comfort paddings - cracking or appreciable distortion
    b. No dents, deformation or breakage nor signs of a. Safety parts complete & not broken (Shell,

    - c. No traces of application of paint, stickers, petrol

    or other solvents d. Brand name and size still evident on the face of - the helmet. Brand has not been altered.

    - Others: Findings: - Helmet compliant with BPS MC 1-A:2012 - Helmet not compliant with BPS MC 1-A:2012 Action: - Non-issuance Issued ICC Sticker No.: - For issuance

    ToStandards/AuthorizedOfficers:Please encirclenameofpartsifavailable

    Name & Signature of Standards Officer / Date

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