Member States are not obliged to require the use of this form, but if a form is required, this form will be recognised valid for such purposes.
All the fields in this form must be filled in and it must be signed both by the company representative and by the driver in order to be valid. For self-employed drivers, the driver signs once as the company and once as the driver.
The text of the form may not be modified.
Only the signed original is valid.
The form may be printed on paper containing the company logo and contact details, but the fields containing the company information must also be filled in.
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Form in MS Word 2010 version
[64 KB] 
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Form in MS Word 2003 version [63 KB]
This table 
[10 KB] gives an overview of Member States, where the form has been made mandatory.