ATTESTATION OF ACTIVITIES UNDER

ATTESTATION OF ACTIVITIES UNDER

REGULATION (EC) NO 561/2006

OR

THE EUROPEAN AGREEMENT CONCERNING THE WORK OF CREWS OF

VEHICLES ENGAGED IN INTERNATIONAL ROAD TRANSPORT (AETR) (*)

To be filled in by typing and signed before a journey

To be kept with the original tachograph records wherever they are required to be kept

False attestations constitute an infringement

1. Name of the company:Laki Lazo DOOEL2. Street address, Postal code, City, Country:Vladimir Komarov br.23/12 / 1000-Skopje -Macedonija3. Telephone number (including international prefix):+3892400-7774. Fax number (including international prefix):+3892467-5005. E-mail address:laki_exspress@yahoo.com I, the undersigned

6. Name and last name:Lazo Krstevski7. Position in the company:Manager declare that the driver8. Name and last name:Milos Jovic9. Date of birth:04-05-197910. Driving licence number or Identity card number or Passport number.B0205197 For the period

11. from (26-05-2012 ): 01.00h12. to (03-06-2012 ): 01.00h13. was on sick leave ( ) , for other reasons not drive the vehicle ( X )14. was on annual leave ( )15. drive a vehicle exempted from the scope of Regulation (EC) No 561/2006 or AETR ( )16. For the company, place Skopje date 06-05-2012 signature17. I,the driver,confirm that I have not been driving a vehicle falling under the Regulation (EC) No. 561/2006 or AETR during the period mentioned above. 18. Place Skopje date 02-06-2012 Signature of the driver

This form is available in an electronic and printable version on the ec.europa.eu

( X ) Only one of the boxes 13, 14 or 15 may be chosen.