ANNEX I
Application for a European Account Preservation Order
(Article 8(1) of Regulation (EU) No 655/2014 of the European Parliament and of the Council of 15 May 2014 establishing a European Account Preservation Order procedure to facilitate cross-border debt recovery in civil and commercial matters)
To be filled in by the court
Case number:
Received by the court on:
(dd/mm/yyyy)
IMPORTANT INFORMATION
PLEASE READ THE GUIDELINES AT THE BEGINNING OF EACH SECTION — THEY WILL HELP YOU TO FILL IN THIS FORM
Language
Fill in this form in the language of the court of the Member State to which you are sending your application. Please note that the form is available in 23 official languages of the European Union on the website of the European e-Justice Portal at https://e-justice.europa.eu/content_european_account_preservation_order-378-en.do and it can also be filled in online. The language version with which you are familiar may help you in fillingin the form in the required language of the court of the Member State concerned. On the website of the European e-Justice Portal you can also find information as to whether a given Member State has indicated that it will accept documents addressed to the court in another official language of the European Union (Article 50(1)(o) of Regulation (EU) No 655/2014).
Supporting documents
The application form must be accompanied by all relevant supporting documents. If you have already obtained a judgment, court settlement or authentic instrument, please attach a copy of that judgment, court settlement or authentic instrument which satisfies the conditions necessary to establish its authenticity.
Country codes
Whenever you refer to a Member State in filling in this form, please use the following country codes:
AT
Austria
EL
Greece
IT
Italy
PT
Portugal
BE
Belgium
ES
Spain
LT
Lithuania
RO
Romania
BG
Bulgaria
FI
Finland
LU
Luxembourg
SE
Sweden
CY
Cyprus
FR
France
LV
Latvia
SI
Slovenia
CZ
Czech Republic
HR
Croatia
MT
Malta
SK
Slovakia
DE
Germany
HU
Hungary
NL
Netherlands
EE
Estonia
IE
Ireland
PL
Poland
Where this form provides for adding free text, and when filling in the form on paper, please use additional sheets if necessary and number each page.
1. Court
Please note that you can only apply for a European Account Preservation Order (‘the Preservation Order’) if the court is located in a Member State to which Regulation (EU) No 655/2014 applies. This is currently not the case for Denmark and the United Kingdom.
In this field you should identify the court with which you want to lodge your application for a Preservation Order. When deciding which court to choose, you need to consider the grounds for the court's jurisdiction.
If you have not yet obtained a judgment, court settlement or authentic instrument that requires the debtor to pay your claim , jurisdiction for issuing the Preservation Order lies with the courts of the Member State that have jurisdiction on the substance of the matter in accordance with the applicable rules. These include, in particular Regulation (EU) No 1215/2012 of the European Parliament and of the Council of 12 December 2012 on jurisdiction and the recognition and enforcement of judgments in civil and commercial matters and Council Regulation (EC) No 4/2009 of 18 December 2008 on jurisdiction, applicable law, recognition and enforcement of decisions and cooperation in matters relating to maintenance obligations . More information on the rules of jurisdiction can be found on the website of the European e-Justice Portal at https://e-justice.europa.eu. A list of possible grounds of jurisdiction is included in section 5 of this form.
For the purposes of Regulation (EU) No 655/2014, the proceedings on the substance of the matter cover any proceedings aimed at obtaining an enforceable title on your underlying claim, for example, summary proceedings concerning orders to pay and proceedings such as the ‘procédure de référé’ in France.
If the debtor is a consumer who has concluded a contract with you for a purpose that can be regarded as being outside his trade or profession, only the courts of the Member State in which the debtor is domiciled can issue a Preservation Order.
If you already obtained a judgment or court settlement that requires the debtor to pay your claim , jurisdiction for issuing the Preservation Order lies with the courts of the Member State in which the judgment was issued or the court settlement was approved or concluded.
If you already obtained an authentic instrument , jurisdiction for issuing the Preservation Order for the claim specified in that instrument lies with the court designated for that purpose in the Member State in which that instrument was drawn up.
Once you have determined in which Member State you should bring your claim, you can find the names and addresses of the competent courts for the Preservation Order on the website of the European e-Justice Portal at https://e-justice.europa.eu/content_european_account_preservation_order-379-en.do. On the European e-Justice Portal you can also find certain information on the payment of court fees in proceedings to obtain the Preservation Order in the Member State concerned.
1. Court before which you are lodging your application
1.1. Name:
1.2. Address
1.2.1.
Street and number/PO box:
1.2.2.
Place and postcode:
1.2.3.
Member State (please indicate the country code):
2. Creditor
Please note that you can only apply for a Preservation Order if you are domiciled in a Member State to which Regulation (EU) No 655/2014 applies. This is currently not the case for Denmark and the United Kingdom.
This field must identify you as the creditor and indicate your legal representative, if you have one. Please note that it is not mandatory to be represented by a lawyer or other legal professional.
It may not be sufficient in some countries to give only a PO box (when available) as the address and you should therefore include the street name and number with a postcode.
2. Creditor's details
2.1. Surname and given name(s)/name of company or organisation:
2.2. Address
2.2.1.
Street and number/PO box:
2.2.2.
Place and postcode:
2.2.3.
Member State (please indicate the country code):
2.3. Telephone: ( *1 )
2.4. Fax ( *1 )
2.5. Email (if available):
2.6. Name of creditor's representative, if any, and contact details
2.6.1.
Surname and given name(s):
2.6.2.
Address
2.6.2.1.
Street and number/PO box:
2.6.2.2.
Place and postcode:
2.6.2.3.
Country (if a Member State, please indicate the country code):
2.6.3.
Email (if available):
2.7. If the creditor is a natural person:
2.7.1.
Date of birth:
2.7.2.
Identification or passport number (if applicable and available):
2.8. If the creditor is a legal person or other entity having legal capacity to sue or be sued under the law of a Member State:
2.8.1.
The country of incorporation, formation or registration (if a Member State, please indicate the country code):
2.8.2.
The identification or registration number or, where no such number exists, the date and place of its incorporation, formation or registration:
3. Debtor
In this field you should identify the debtor and, if known, the debtor's legal representative. Please note that it is not mandatory for the debtor to be represented by a lawyer or other legal professional.
It may not be sufficient in some countries to give only a PO box (when available) as the address and you should therefore include the street name and number with a postcode.
3. Debtor's details
3.1. Surname and given name(s) (any middle name, if known)/name of company or organisation:
3.2. Address
3.2.1.
Street and number/PO box:
3.2.2.
Place and postcode:
3.2.3.
Country (if a Member State, please indicate the country code):
3.3. Telephone: ( *1 )
3.4. Fax ( *1 )
3.5. Email (if available):
3.6. Name of debtor's representative, if any and if known, and contact details, if available
3.6.1.
Surname and given name(s):
3.6.2.
Address
3.6.2.1.
Street and number/PO box:
3.6.2.2.
Place and postcode:
3.6.2.3.
Country (if a Member State, please indicate the country code):
3.6.3.
Email:
3.7. If the debtor is a natural person, and if this information is available:
3.7.1.
Date of birth:
3.7.2.
Identification or passport number:
3.8. If the debtor is a legal person or other entity having legal capacity to sue or be sued under the law of a Member State:
3.8.1.
The country of incorporation, formation or registration (if a Member State, please indicate the country code):
3.8.2.
The identification or registration number or, where no such number exists, the date and place of its incorporation, formation or registration:
4. Cross-border nature of the case
In order to make use of the Preservation Order procedure, your case must be of a cross-border nature. For the purposes of Regulation (EU) No 655/2014, a case is of a cross-border nature under Article 3 of that Regulation if the bank account or accounts to be preserved by the Preservation Order are maintained in a Member State other than: (a) the Member State of the court seized of the application for the Preservation Order; or (b) the Member State in which the creditor is domiciled.
4. Cross-border nature of the case
4.1. Member State in which the creditor is domiciled (please indicate the country code):
4.2. Member State(s) where the bank account(s) is/are maintained (please indicate the country code(s)):
4.3. Member State of the court seized of the application for the Preservation Order (please indicate the country code):
5. Jurisdiction
Please fill in this section only if you have not yet obtained a judgment, court settlement or authentic instrument against the debtor that requires the debtor to pay your claim. If you do have one of these, please go to section 6 .
In this section, please provide details as to why you consider that the court to which you address the application for a Preservation Order has jurisdiction to hear the case. As set out in section 1 , a court is competent to issue the Preservation Order if it has jurisdiction on the substance of the matter. Below is a list of possible grounds for jurisdiction.
5. On what ground do you consider the court to have jurisdiction?
5.1.
☐
domicile of the debtor or, if several debtors are jointly liable, of one of the debtors
5.2.
☐
place of performance of the obligation in question
5.3.
☐
place where the harmful event occurred
5.4.
☐
choice of court agreed by the parties
5.5.
☐
domicile of the maintenance creditor
5.6.
☐
where the claim arises out of the operation of a branch, agency or other establishment, the place in which the branch, agency or other establishment is situated
5.7.
☐
domicile of the trust
5.8.
☐
where a dispute arises concerning the payment of remuneration claimed in respect of the salvage of a cargo or freight, the place of the court under the authority of which the cargo or freight is or could have been arrested
5.9.
☐
domicile of the policyholder, the insured or the beneficiary in insurance matters
5.10.
☐
domicile of the consumer
5.11.
☐
place where the employee carries out his work
5.12.
☐
place where the business which engaged the employee is situated
5.13.
☐
place where the immovable property is situated
5.14.
☐
other
Please describe relevant elements supporting the jurisdiction chosen in points 5.1. to 5.14.:
Have you already initiated proceedings against the debtor on the substance of the matter?
☐
Yes. Please indicate the name and address of the court (street and number/PO box, place and postcode, Member State) and, if available, the telephone number and email address of the court, as well as the file number of the case:
☐
No
Please note that if you apply for the Preservation Order before initiating proceedings on the substance of the matter, you must initiate such proceedings and provide to the court proof of such initiation within 30 days of the date on which you lodged your application or within 14 days of the date of the issue of the Preservation Order, whichever date is the later.
6. Details of the debtor's bank account
In order to save time and costs, it is important that you provide all the information you have about the debtor's bank account. If you do not have the number of the debtor's bank account or accounts, it is sufficient to provide the name and address of the bank with which the debtor holds one or more accounts or a number such as the BIC that allows the bank to be identified. However, if you do have details of the debtor's bank account or accounts (for example, account number or IBAN), you should provide these details. This is in order to avoid the risk that the bank is unable to implement the Preservation Order because it cannot identify with certainty the account or accounts of the debtor. If you can indicate the number of only one of the debtor's accounts but you also want to preserve any other account held by the debtor with the same bank (for example, you have only the number of the debtor's current account but you also want to preserve any savings accounts held by the debtor with the same bank), please tick the box in point 6.7 .
If you do not know with which bank the debtor holds an account but you have reason to believe that the debtor holds one or more accounts in a specific Member State and you have already obtained a judgment, court settlement or authentic instrument that requires the debtor to pay your claim, you can ask the court with which you are lodging the application for the Preservation Order to request that the information authority in the Member State(s) where the account is located obtain the necessary information to identify the bank and the debtor's account or accounts in the Member State. In this case, please go to section 7 where further details on the conditions to lodge such a request are given.
Where you already know the details of one or more of the debtor's bank accounts but you have reason to believe that the debtor also holds one or more other accounts in a specific Member State and you do not know the details of the latter account(s), you can — in the same application for a Preservation Order — give details of the debtor's bank account you do know (in this case, please fill in section 6) and, at the same time, lodge a request to obtain account information for other account(s) in a specific Member State (in this case, please also fill in section 7 ).
Please note that Regulation (EU) No 655/2014 does not apply to the preservation of bank accounts containing financial instruments (Article 4(3) of the Regulation).
If you want to preserve accounts in more than one bank, please provide the information below for each bank concerned. When filling in the form on paper, please use separate sheets per bank account and number each page.
6. Details of the debtor's bank account
6.1. Member State where the account is maintained (please indicate the country code):
6.2. A number enabling the identification of the bank, such as
IBAN:
or
BIC:
and/or the name and address of the bank (street and number/PO box, place and postcode):
6.3. Telephone of the bank: ( *2 )
6.4. Fax of the bank: ( *2 )
6.5. Email of the bank (if available):
6.6. The number of the account(s) to be preserved, if available:
6.7. Should any other accounts held by the debtor with the same bank also be preserved?
☐
Yes
☐
No
6.8. If available, other details on the type of account:
7. Request for the obtaining of account information
If you have no information about the bank with which the debtor holds one or more accounts, nor any account number, and you have already obtained, in a Member State, an enforceable judgment, court settlement or authentic instrument that requires the debtor to pay your claim, you can ask the court to request that the information authority of the Member State where you have reason to believe one or more accounts of the debtor is/are located attempt to obtain the necessary information.
Please note that you can only make a request to obtain account information for accounts maintained in a Member State to which Regulation (EU) No 655/2014 applies. This is currently not the case for Denmark and the United Kingdom.
As a general rule, the request for the obtaining of account information is available for judgments, court settlements or authentic instruments that are already enforceable.
Where the judgment, court settlement or authentic instrument is not yet enforceable , a request for the obtaining of account information can only be made if additional conditions are fulfilled. Pursuant to Article 14(1) of Regulation (EU) No 655/2014 those conditions are the following: the amount to be preserved must be substantial taking into account the relevant circumstances and the creditor must have submitted sufficient evidence to satisfy the court that there is an urgent need for account information because there is a risk that, without the account information, the subsequent enforcement of the creditor's claim against the debtor is likely to be jeopardised and that this could lead to a substantial deterioration of the creditor's financial situation. If you fulfill those conditions, please provide the relevant information in point 10.2.
It is important that you substantiate in your request why you have reason to believe that the debtor holds one or more accounts in a particular Member State and that you provide the court with all relevant information available to you about the debtor and the account or accounts to be preserved. Please note that this procedure may take some time and you could be charged a fee for the information.
If you want to preserve accounts in more than one Member State, please provide the information below for each Member State concerned (when filling in the form on paper, please use separate sheets and number each page).
7. Request for the obtaining of account information
7.1.
☐
I have a judgment, court settlement or authentic instrument that requires the debtor to pay my claim and I request that the information authority of the Member State where the bank account is located tries to obtain the information necessary to allow the bank(s) and the debtor's account(s) to be identified.
7.2. Member State where the debtor's account(s) is/are believed to be located (please indicate the country code):
7.3. Please explain why you have reason to believe that the debtor holds one or more accounts in that Member State (please tick the relevant box(es)):
☐
The debtor has his habitual residence in that Member State. Please give relevant details.
☐
The debtor works or exercises a professional activity in that Member State. Please give relevant details.
☐
The debtor has property in that Member State. Please give relevant details.
☐
Other. Please explain:
7.4. The judgment, court settlement or authentic instrument that requires the debtor to pay my claim is enforceable:
☐
Yes
☐
No. Please provide, in point 10.2. , additional information justifying the urgent need for account information.
8. Existing judgment, court settlement or authentic instrument
Please fill in this section only if you have already obtained a judgment, court settlement or authentic instrument that requires the debtor to pay your claim . Otherwise, please move to section 9 .
Please note that the amount indicated in point 8.8. should generally be the amount set out in the judgment, court settlement or authentic instrument. However, if the debtor has already paid part of his debt and only the remaining amount is claimed, it should be that amount and interest on that amount, if applicable , that is indicated in point 8.8 . Furthermore, if the debtor has already paid part of his debt and only the remaining amount is claimed, please confirm — by ticking the relevant box in point 8.9.2.1. — whether you are also claiming the unpaid interest on the part of the debt already paid by the debtor (in such a case, when filling in the form on paper, please use a separate sheet for interest claimed on the part of the debt already paid by the debtor (point 8.8.1) and number each page).
Please attach a copy of the judgment, court settlement or authentic instrument that satisfies the conditions necessary to establish its authenticity.
8. Details concerning an existing judgment, court settlement or authentic instrument
8.1. Name of the court/other authority:
8.2. Address
8.2.1.
Street and number/PO box:
8.2.2.
Place and postcode:
8.2.3.
Member State (please indicate the country code):
8.3. Telephone: ( *3 )
8.4. Fax ( *3 )
8.5. Email: ( *3 )
8.6. Date of the judgment, court settlement or authentic instrument:
(dd/mm/yyyy)
8.7. Currency of the amount awarded in the judgment, court settlement or authentic instrument:
☐ Euro (EUR) ☐ Bulgarian lev (BGN) ☐ Czech koruna (CZK) ☐ Croatian Kuna (HRK) ☐ Hungarian forint (HUF) ☐ Polish zloty (PLN) ☐ Romanian leu (RON) ☐ Swedish krona (SEK) ☐ Other (please specify using the ISO code):
8.8. Amount:
8.8.1.
Principal amount awarded in the judgment, court settlement or authentic instrument:
8.8.1.1.
If applicable ( 1 ) , please indicate the unpaid part of the principal amount awarded:
8.8.1.2.
If applicable ( 1 ) , please indicate the paid part of the principal amount awarded:
8.8.2.
Interest, if applicable:
8.8.2.1.
Interest:
8.8.2.1.1.
☐
Not specified in the judgment, court settlement or authentic instrument
8.8.2.1.2.
☐
Specified in the judgment, court settlement or authentic instrument as follows:
8.8.2.1.2.1.
Interest due from:
(date (dd/mm/yyyy) or event) to
(date (dd/mm/yyyy) or event) ( 2 )
8.8.2.1.2.2.
☐
Final amount:
or
8.8.2.1.2.3.
☐
Method to calculate the interest ( 3 )
8.8.2.1.2.3.1.
☐
Rate: … %, calculated (please tick the relevant box) ☐ daily ☐ monthly ☐ yearly ☐ other (please specify):
8.8.2.1.2.3.2.
☐
Rate: … % over reference rate (ECB/reference rate of national central bank: …), calculated (please tick the relevant box) ☐ daily ☐ monthly ☐ yearly ☐ other (please specify):
in force on:
(date (dd/mm/yyyy) or event)
8.8.2.2.
☐
Statutory interest (if statutory interest is applicable) to be calculated in accordance with (please specify relevant statute):
8.8.2.2.1.
Interest due from:
(date (dd/mm/yyyy) or event) to
(date (dd/mm/yyyy) or event) ( 4 )
8.8.2.2.2.
Method to calculate the interest ( 5 )
8.8.2.2.2.1.
☐
Rate: … %
8.8.2.2.2.2.
☐
Rate: … % over reference rate (ECB/reference rate of national central bank: …)
in force on:
(date (dd/mm/yyyy) or event)
8.8.2.2.2.2.1.
☐
First date of the respective semester in which the debtor is overdue
8.8.2.2.2.2.2.
☐
Other event (please specify)
8.8.2.3.
☐
Capitalisation of interest (if capitalisation of interest is applicable, please provide details):
8.8.3.
Costs of obtaining the judgment, court settlement or authentic instrument, to the extent that a determination has been made that those costs must be borne by the debtor:
☐
No
☐
Yes. Please, specify which costs and indicate the amount:
☐
Court fees:
☐
Lawyers'fees:
☐
Cost of service of documents:
☐
Other. Please explain:
8.8.3.1.
Currency:
☐ Euro (EUR) ☐ Bulgarian lev (BGN) ☐ Czech koruna (CZK) ☐ Croatian Kuna (HRK) ☐ Hungarian forint (HUF) ☐ Polish zloty (PLN) ☐ Romanian leu (RON) ☐ Swedish krona (SEK) ☐ Other (please specify using the ISO code):
8.9. I confirm that the judgment, court settlement or authentic instrument:
8.9.1.
☐
has not yet been complied with by the debtor
8.9.2.
☐
has only been complied with in part by the debtor and that the amount indicated in point 8.8. is the amount outstanding (in this case, please also fill in point 8.9.2.1. below).
8.9.2.1.
If the debtor has already paid part of his debt and only the remaining amount is claimed, please confirm whether you are also claiming the unpaid interest on the part of the debt already paid by the debtor:
☐
No, I am not claiming the interest on the part of the debt already paid by the debtor .
☐
Yes, I am also claiming the unpaid interest on the part of the debt already paid by the debtor. In such case, when filling in the form on paper, please use a separate sheet for interest claimed on the part of the debt already paid by the debtor (point 8.8.1) and number each page.
9. Amount and grounds of the claim (not to be filled in if you filled in section 8)
Where you have not yet obtained a judgment, court settlement or authentic instrument that requires the debtor to pay your claim , the Preservation Order can only be granted if you present relevant facts, reasonably corroborated by evidence, to satisfy the court that your claim against the debtor is likely to succeed in the amount for which the Preservation Order is sought (Article 7(2) of Regulation (EU) No 655/2014). Please list the evidence in section 12 of this form.
Please note that where you request the Preservation Order to be granted in an amount lower than the amount of the principal claim, for example, because you have already obtained some other security for part of your claim, you should indicate that lower amount (and interest on that amount, if applicable) in point 9.1.
9. Amount and grounds of the claim
9.1. Amount of the principal of the claim:
9.2. Is interest claimed?
☐
No
☐
Yes
If yes, is the interest:
☐
Contractual interest (if so, go to point 9.2.1.)
☐
Statutory interest (if so, go to point 9.2.2.)
9.2.1. If contractual
(1)
the rate is
☐
… %, calculated (please tick the relevant box) ☐ daily ☐ monthly ☐ yearly ☐ other (please specify):
☐
… % over reference rate (ECB/reference rate of national central bank: …), calculated (please tick the relevant box) ☐ daily ☐ monthly ☐ yearly ☐ other (please specify):
☐
other. Please specify:
(2)
the interest due from
(date (dd/mm/yyyy))
9.2.2. If statutory
the interest due from
(date (dd/mm/yyyy))
to be calculated in accordance with (please specify relevant statute):
9.3. Amount of contractual penalties:
9.4. Currency:
☐ Euro (EUR) ☐ Bulgarian lev (BGN) ☐ Czech koruna (CZK) ☐ Croatian Kuna (HRK) ☐ Hungarian forint (HUF) ☐ Polish zloty (PLN) ☐ Romanian leu (RON) ☐ Swedish krona (SEK) ☐ Other (please specify using the ISO code):
9.5. Please describe the relevant circumstances on which the claim against the debtor is based (including, where applicable, the interest claimed):
10. Reasons for seeking a Preservation Order
The Preservation Order can be granted only if you present relevant facts that your claim is in urgent need of judicial protection and that, without the Preservation Order, the enforcement of an existing or a future judgment or other enforceable title against the debtor may be impeded or made substantially more difficult because there is a real risk that by the time you are able to have an existing or future judgment or other enforceable title enforced, the debtor may have dissipated, concealed or destroyed his assets held in the bank account(s) to be preserved, or that the debtor may have disposed of them under value, or to an unusual extent or through unusual action (Recital 14 in conjunction with Article 7 of Regulation (EU) No 655/2014).
10. Reasons for seeking a Preservation Order
10.1. Please explain why there is an urgent need for the Preservation Order and, notably, a real risk that without the Preservation Order, the subsequent enforcement of your claim against the debtor will be impeded or made substantially more difficult (Article 7(1) of Regulation (EU) No 655/2014):
10.2. Where a request for the obtaining of account information is made ( section 7 ) when the judgment, court settlement or authentic instrument is not yet enforceable and the amount to be preserved is substantial taking into account the relevant circumstances, please explain why there is a risk that, without such account information, the subsequent enforcement of your claim against the debtor is likely to be jeopardised and that this could consequently lead to a substantial deterioration of your financial situation (Article 14(1) of Regulation (EU) No 655/2014):
11. Security
Please fill in this section if you have not yet obtained a judgment, court settlement or authentic instrument that requires the debtor to pay your claim and you have reason to request exemption from the provision of security.
Please note that before issuing a Preservation Order in a case where the creditor has not yet obtained a judgment, court settlement or authentic instrument , the court requires the creditor to provide security for an amount sufficient to prevent abuse of the procedure and to ensure compensation for any damage suffered by the debtor as a result of the Preservation Order. By way of exception, the court may dispense with the requirement of security if it considers that the provision of security is inappropriate in the circumstances of the case (Article 12(1) of Regulation (EU) No 655/2014).
Where the creditor has already obtained a judgment, court settlement or authentic instrument , the court may, before issuing the Preservation Order, require the creditor to provide security if it considers this necessary and appropriate in the circumstances of the case, for example, where the judgment is not yet enforceable or only provisionally enforceable because of a pending appeal (Article 12(2) of Regulation (EU) No 655/2014).
11. Reasons for being exempt from the provision of security
If you believe that you should be exempted from providing security pursuant to Article 12(1) of Regulation (EU) No 655/2014, please indicate the reasons:
12. Evidence
Please indicate in this section all the evidence provided to support your application for a Preservation Order.
Please note that you must submit sufficient evidence to satisfy the court to which you are applying for the Preservation Order that there is an urgent need for a protective measure in the form of a Preservation Order because there is a real risk that, without such a measure, the subsequent enforcement of your claim against the debtor will be impeded or made substantially more difficult (Article 7(1) of Regulation (EU) No 655/2014).
Furthermore, please note that if you have not yet obtained a judgment, court settlement or authentic instrument that requires the debtor to pay your claim, pursuant to Article 7(2) of Regulation (EU) No 655/2014 you must also submit sufficient evidence to satisfy the court that you are likely to succeed on the substance of your claim against the debtor (please see section 9 of this form).
12. List of evidence
Please list all the evidence supporting your application for the Preservation Order, including the evidence supporting your claim against the debtor (if you have not yet obtained a judgment, court settlement or authentic instrument that requires the debtor to pay your claim) and the urgent need for the Preservation Order:
13. Other courts seized with an application for protective measures
In this section, please indicate if you have applied for or obtained any protective measure under national law that has equivalent effect to a Preservation Order. Please note that Article 16 of Regulation (EU) No 655/2014 requires you to inform the court seized with the application for a Preservation Order if you obtain such an equivalent national order later on during the proceedings for the issuing of the Preservation Order.
13. Details of any national protective measures obtained or applied for
13.1. Have you applied for an equivalent national order against the same debtor and for the same claim?
☐
No
☐
Yes. Please give details on the application and its status in points 13.2–13.6.
13.2. Name of the court or other authority:
13.3. Address of the court or other authority
13.3.1.
Street and number/PO box:
13.3.2.
Place and postcode:
13.3.3.
Member State (please indicate the country code):
13.4. Reference number of the application:
13.5. Have you already obtained the national order?
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Yes. Please indicate the extent to which it has been implemented:
☐
No
13.6. Has your application been rejected as inadmissible or unfounded?
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Yes. Please give relevant details:
☐
No
14. Creditor's bank account
You may indicate your bank account to be used for any voluntary payment of the claim by the debtor (Article 8(2)(n) of Regulation (EU) No 655/2014).
14. Details of creditor's bank account
14.1. The creditor's bank account number:
14.2. The name and address of the bank (street and number/PO box, place and postcode, country (if a Member State, please indicate the country code)):
15. Date and signature
Please make sure that you write your name clearly, and sign and date your application at the end.
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I hereby request that the court, based on my application, issue a Preservation Order against the debtor.
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I declare that the information provided in this application is true and complete to the best of my knowledge and that I am aware that any deliberately false or incomplete statements may lead to legal consequences under the law of the Member State in which the application is lodged or to liability pursuant to Article 13 of Regulation (EU) No 655/2014.
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I hereby request that debtor's account information be obtained (please tick this box only if you are making a request for the obtaining of account information and have therefore filled in section 7 of this form).
If additional sheets have been added, please state the total number of pages and number each page:
Done at:
Date:
(dd/mm/yyyy)
Name, signature and/or stamp:
( *1 ) Optional
( *2 ) Optional
( *3 ) Optional
( 1 ) To be filled in if, in the case where the debtor has already paid part of his debt and only the remaining amount is claimed, the creditor is also claiming the unpaid interest on the part of the debt already paid by the debtor .
( 2 ) Insert information for all periods if more than one.
( 3 ) If there are different interest rates for different periods, when filling in the form on paper, please use separate sheets and number each page.
( 4 ) Insert information for all periods if more than one.
( 5 ) If there are different interest rates for different periods, when filling in the form on paper, please use separate sheets and number each page.
