Details of applicant
Company Name:	Template Ltd
Registered Address:	1 Swift Square Northwood NWood Santry, Dublin 9 123 D124 Ireland
Telephone Number:	123456
Email Address:	jennifer.casey@nsai.ie
details of proposed workshop
Full address of Plating workshop (if different from above):
Telephone Number:
Email Address:
Nature of the business or undertaking, e.g. garage, motor vehicle repairer / operator, main dealer, etc.:
Has the applicant previously held approval as an authorised Plating workshop?	Yes	☐	No	☐
If YES state	The address of the workshop:
The trade name of the workshop:
The seal number (if approval was granted):
NAMES of PROPOSED FITTERS
Names of the persons wholly employed at the applicant’s premises who have been nominated for Plating duties:

EQUIPMENT
The following items of equipment must be retained at the applicant’s premises:
1	Hilti “PD20” laser range meter. (Available from Hilti Ireland Ph: 1850 287 287).
2	2 upright stands, assembled from Bosch aluminium extrusions and fittings. (Available in knockdown form from Pneumatics Ltd Ph:01 456 8111).
3	A precision level available from any good quality engineering equipment suppliers.
4	Jig for measuring from centre of a fifth wheel coupling of a tractor unit. This item can be machined in an engineering workshop. Details are as shown in the pamphlet, “Plating of Vehicles in Ireland – Workshop Guidance Notes – The reference Method of Measuring Vehicles”
5	Jig for measuring from centre of a semi-trailer kingpin. This item can be machined in an engineering workshop. Details are as shown in the pamphlet, “Plating of Vehicles in Ireland – Workshop Guidance Notes – The reference Method of Measuring Vehicles”
6	A sealing pliers bearing the unique code for the workshop. The seal code will be advised once the workshop approval has been granted. Pliers can be sourced from a supplier of tachograph equipment e.g. Motorclocks Ph: 0402 21807 Christopher Huet Distribution Ph: 091 709311
7	Plates are also required. Three suppliers of such plates are: Alpha Sign Nameplate & Decal Co. Ltd, Dublin. Tel: 01 620 8188 Teddy Guilfoyle & Sons Ltd. Waterford. Tel: 051 875704 Carrig Print, Carrigtwohill, Co. Cork. Tel: 021 4883458

NOTES
1	Before completing this form, the applicant is advised to read carefully the Plating of Vehicles in Ireland – Workshop Guidance Notes” of the National Standards Authority of Ireland (NSAI) and the Plating of Vehicles Regulations of the Department of Transport.
2	If this application is made in connection with a proposed change in an existing approval, please attach an explanatory note.
3	Before acquiring any equipment the applicant should consult NSAI to ensure that the proposed equipment is acceptable – POSSESSION OF SUITABLE EQUIPMENT, ETC., DOES NOT IMPLY THAT APPROVAL SHALL BE GRANTED
4	Separate applications should be made in respect of each premises for which the applicant may seek approval.
5	Please ensure that all fitters are trained and equipment is in place prior to submitting the application. If it is found upon inspection, that all equipment is not in place, the garage will not be authorised but will incur the full cost of the unsuccessful inspection visit plus re-inspection.
6	When completed, this application should be forwarded to: NSAI, Certification Services 1 Swift Square Northwood Santry Dublin 9 Tel: 01-8073800 Email: Julie.elliot@nsai.ie or amanda.oshea@nsai.ie
CHECKLIST
DOCUMENTS TO BE INCLUDED AND ACTIONS TO BE UNDERTAKEN
Tax Clearance Certificate
Authorised signature on page 4

DECLARATION
I declare that I have checked the information given in this application and that to the best of my knowledge and belief it is true and correct. I also undertake to abide by the conditions stated below under which approval may be granted and I understand that failure to comply with such conditions may result in withdrawal of approval by NSAI.
1	Inform NSAI of any proposed change in the information provided in this application form.
2	Ensure that at least three appropriately trained members of staff are employed on a full time basis at the premises.
3	Ensure that all staff & fitters are competent, reliable, of good repute and in good health.
4	Ensure that all relevant items of test equipment are calibrated to a standard acceptable to NSAI at least once every six months.
5	Maintain records of all Plating work undertaken at the premises, the adequacy of such records to be directed and evaluated by NSAI.
6	Grant to NSAI all necessary facilities to inspect all records, test equipment, calibration certificates and training certificates.
7	To submit to NSAI upon termination of approval, whether voluntary or withdrawal by NSAI, all records, sealing dies and/or punches bearing the unique sealing code.
8	To immediately inform NSAI of the loss of any item of sealing equipment bearing the unique code.
9	Abide by all relevant provisions of Irish and/or EC Regulations pertaining to speed limitation devices.
10	Comply with the written procedure for Plating of Vehicles approved by NSAI.
11	Where there could be a perceived conflict of interest (i.e. Plating the companies own vehicles or those of a relative), to ensure that this is clearly noted on the job record card.
AUTHORISED SIGNATURE
This application must be signed by the proprietor in the case of a private business or by a Director or the Secretary of a limited liability company
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SIGNATURE
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DATE