Application for Approval of Modernisation and Remodelling

G1. Page 1 of 3

Form G1, date of issue 2006-04-27 Application for approval of modernisation and remodelling

– see Section 1.7 of the Guide to approvals.

Date:...... Applicant • Name of operator :...... Contact:...... (name, title/function) - Phone:...... - E-mail:...... Postal address:...... Postcode and town: ...... Visiting address:...... Company reg. no.:...... Part of which group (if any): ...... Phone:...... Fax:...... Website:...... E-mail:......

The application relates to:

Railway infrastructure

Vehicles

Provisional date for inauguration:...... G1. Page 2 of 3

Previous approvals:

Previous approval:...... (by the Swedish Rail Agency/the Railway Inspectorate) (date/reference number)

Derogation from complying with the requirements of TSIs:...... (by the Swedish Rail Agency) (date/reference number)

Other information:

Infrastructure manager/ railway undertaking/client:...... (to be stated if these are not the same as the applicant and if these have been determined)

Outline description

Railway infrastructure:

Type of system: Track Sidings Metro Tramway

Control command and Energy supply signalling

Place or stretch of line:...... Version designation (if any):...... Contractor/resp. for constr. :...... Inspector:...... (inspection before inauguration) Brief description:...... (may also be supplied in the form of a separate attachment)

Area of use (freight/passenger transport/mixed traffic) :...... Any applicable TSIs:...... G1. Page 3 of 3

Vehicle:

Type of vehicle: Loco Power car Freight Passenger wagon car Work vehicle Metro car Tramway car

Other: ......

Vehicle designation/machine type:...... Vehicle number/serial number:...... Brief description:...... (may also be supplied in the form of a separate attachment) Version designation:...... Type designation (suggested) :...... Manufacturer:...... Year of manufacture:...... Intended for type of traffic:......

Any applicable TSIs:......

Schedule for submitting documentation (attachments to form G1) List the attachments sent with this application and state an estimated date when the documents will be submitted.

Attach- Provisional ID Put a cross here ment date no. A Description of the rebuilding/modification B Risk analysis Other attachments: C D E F G

The Swedish Rail Agency may ask for additional documents if it needs them.