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STANDARD FORM FOR THE SELF-DECLARATION REFERRED TO IN ARTICLE 51 Self-declaration referred to in Article 51 of Regulation (EU) 2023/2411 of the European Parliament and of the Council 1. Name and address of the producer: … [Insert the name and address of the operator (company or individual producer) as well as, where applicable, the name and address of the authorised representative of the company or producer that signs the self-declaration on behalf of the company or producer] 2. Producer group: … [If applicable, insert the name and address of the producer group of which the producer is a member] 3. Name and type of the product: … [Insert the name with all attributes under which the product designated by the geographical indication is marketed or is envisaged to be marketed and the type of goods to which the product belongs] 4. Status of the product: … [Specify whether the product is already on the market] 5. Production sites: … [Insert all production sites, with their address and contact details, and activities (production steps pursuant to the product specification) carried out there]

6. Name, number and registration date of the geographical indication: … [This requirement can be met by attaching to the self-declaration the corresponding electronic extract from the register] 7. Single document: … [Insert the information from the single document: the name and description of the product, including, where appropriate, information concerning the packaging and labelling, including the possible use of the Union symbol for protected geographical indications, and a concise definition of the geographical area] 8. Description of the measures undertaken by the producer to ensure that the product complies with the product specification: … [Insert all measures (controls and checks) undertaken by the producer itself, the producer group or a third party since the last self-declaration was submitted, together with a summary of each measure in the table below] Control point Reference value (Tests) Autocontrol (AC) Internal Control (IC) or External Control (EC) Frequency Person responsible for the control Control method Reference document

9. Additional information: … [Insert any further information considered relevant for the assessment as to whether the product complies with the product specification, e.g. samples of the label if there are labelling rules in the product specification]