This record defines the Adoption Declaration Template (ADT-001) within the Recoverability-Constrained Systems (RCS) corpus. It provides the standardized form through which institutions, operators, and third-party entities formally declare conformance with the Universal Evaluation, Conformance, and Certification Standard (UECS-001). ADT-001 is a structured declaration mechanism that ensures all conformance claims are: complete comparable across domains traceable to the execution kernel (CE-001 through CE-006) aligned with real-world operational conditions The template operationalises the formal declaration requirements defined in UECS-001 and forms part of the Conformance Pathway defined in CPR-001. The record is derived exclusively from the foundational invariant: A system may act only while recoverability can be established in time under real conditions. Where recoverability cannot be established, continuation is non-admissible and execution does not occur. ADT-001 defines the mandatory elements of a valid conformance declaration, including: entity identification and jurisdiction domain specification certification level (Level 1–4 under UECS-001) explicit CE-condition coverage (CE-001 through CE-006) output state classification (CONTINUE, DEGRADED, NON-ADMISSIBLE, NON-EXECUTABLE) date of declaration and review commitment responsible officer identification verifier identity (where applicable under VAR-001) Declarations that omit any required element are incomplete and do not constitute valid conformance under the RCS framework. The template enforces that: conformance does not create admissibility certification does not override real-time evaluation admissibility exists only while recoverability can be established in time under real conditions The record includes a non-bypassability closure layer, ensuring that no declaration may rely on: partial system evaluation timing ambiguity or delayed response unknown or unobservable system behavior delegation to uncontrolled external systems simulated or assumed recovery partial compliance with CE-conditions future remediation or post-harm correction classification as research or non-operational cross-system or cross-jurisdiction transfer Where such conditions are present: → the declaration does not establish valid conformance→ system operation is non-admissible ADT-001 is published as a blank, standard template. It does not contain case-specific or entity-specific declarations. Completed declarations are operational or legal documents and are not part of this record. This record applies across all domains, including: healthcare systems artificial intelligence systems financial and infrastructure systems governance and institutional systems No domain-specific modification may weaken the admissibility condition. ADT-001 is intended for use by: institutional operators and governance bodies compliance and risk management teams regulators and supervisory authorities independent auditors and verifiers It operates in conjunction with: UECS-001 — Universal Evaluation, Conformance, and Certification Standard CPR-001 — Conformance Pathway Record DTO-001 — Δt Operationalisation Record VAR-001 — Verifier Accreditation Record OIG-001 — Operator Implementation Guide RCE series — Real-world evidentiary records All interpretation resolves exclusively through CE-001 through CE-006.