WEEE Compliance Application Form

All information entered below will be kept strictly confidential. In the event that you become a member of the A1compliance scheme, you will be informed of which data will be needed to be submitted to the regulator under statute.

Please make sure all relevant information is entered.
†GB Pound Sterling as per last accounts.

Application

Company Name *	Company Number
Business Name (if different from company name)
Partnership Name (if different from company name)
Partner 1	Partner 2
Trading Name (if different from company name)

SIC Code 1

SIC Code 2

SIC Code 3

SIC Code 4

SIC Code 5

VAT Number

Turnover† *

Obligation Type *

Principal contact and organisation details for your company

Title *	Forename *	Surname *	Telephone *
Mobile	Fax	Email *	Principal Address *
Organisation Name *	Premises Number/Name *	Address Line 2 *	Address Line 3
Town *	City	County *	Postcode *
Administration Area - eg County, City		Billing Address *

EEE production information by category

EEE produced annually by Category (figures for 2006) as applicable to your company (in tonnes).

	B2B	B2C
Large Household Appliances *			Tonnes
Small Household Appliances *			Tonnes
IT and Telecoms Equipment *			Tonnes
Consumer Equipment *			Tonnes
Lighting Equipment *			Tonnes
Electrical and Electronic Tools *			Tonnes
Toys, Leisure and Sports *			Tonnes
Medical Devices *			Tonnes
Monitoring and Control Instruments *			Tonnes
Automatic Dispensers *			Tonnes
Display Equipment *			Tonnes
Cooling Appliances Containing Refrigerants *			Tonnes
Gas Discharge Lamps *			Tonnes

Extra Information

Do you have public liability insurance?
Do you have a health and safety policy?
Do you have an equal opportunities policy?
Do you have an environmental management policy?

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Charity Support

A1 Compliance scheme welcomes re-approval

WEEE Compliance Application Form

Application

Principal contact and organisation details for your company

EEE production information by category

Extra Information