ANNEX VSupplementary provisions
ANNEX V Text of image EUROPEAN ENFORCEMENT ORDER REPLACEMENT CERTIFICATE FOLLOWING A CHALLENGE (Article 6(3)) A. The following judgment/court settlement/authentic instrument (*) certified as a European Enforcement Order was challenged 1. Member State of origin: Belgium Czech Republic Germany Estonia Greece Spain France Ireland Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Slovakia Slovenia Finland Sweden United Kingdom 2. Court/Authority issuing the certificate 2.1. Name: 2.2. Address: 2.3. Tel./fax/e-mail: 3. If different, Court/Authority issuing the judgment/Court settlement/Authentic Instrument (*) 3.1. Name: 3.2. Address: 3.3. Tel./fax/e-mail: 4. Judgment/Court settlement/Authentic Instrument (*) 4.1. Date: 4.2. Reference number: 4.3. The parties 4.3.1. Name and address of creditor(s): 4.3.2. Name and address of debtor(s): B. Upon that challenge the following decision has been handed down and is hereby certified as a European Enforcement Order replacing the original European Enforcement Order. 1. Court 1.1. Name: 1.2. Address: 1.3. Tel./fax/e-mail: 2. Decision 2.1. Date: 2.2. Reference number: 3. Monetary claim as certified 3.1. Principal amount (*) Delete as appropriate. Text of image 3.1.1. Currency: Euro Pound sterling Maltese lira Slovenian tolar other (explain) Cyprus pound Hungarian forint Polish zloty Czech koruna Lithuanian litas Swedish kronor Estonian kroon Latvian lats Slovak koruna 3.1.2. If the claim is for periodic payments 3.1.2.1. Amount of each instalment: 3.1.2.2. Due date of first instalment: 3.1.2.3. Due dates of following instalments weekly monthly other (explain) 3.1.2.4. Period of the claim 3.1.2.4.1. Currently indefinite or 3.1.2.4.2. Due date of last instalment: 3.2. Interest 3.2.1. Interest rate 3.2.1.1. … % or 3.2.1.2. … % above the base rate of the ECB 3.2.1.3. Other (explain) 3.2.2. Interest to be collected as from: 3.3. Amount of reimbursable costs if specified in the decision: 4. Decision is enforceable in the Member State of origin 5. Decision is still subject to the possibility of a further appeal Yes No 6. Decision is in compliance with Article 6(1)(b) 7. The decision concerns matters relating to consumer contracts Yes No 7.1. If yes: The debtor is the consumer Yes No 7.2. If yes: The debtor is domiciled in the Member State of origin in the meaning of Article 59 of Regulation (EC) No 44/2001 8. At the time of the decision following the challenge, the claim is uncontested within the meaning of Article 3(1)(b) or (c) Yes No Text of image If yes: 8.1. Service of the document instituting the challenge. Did the creditor lodge the challenge? Yes No If yes: 8.1.1. Service was effected in compliance with Article 13 or service was effected in compliance with Article 14 or it is proved in accordance with Article 18(2) that the debtor has received the document 8.1.2. Due information The debtor was informed in compliance with Articles 16 and 17 8.2. Service of summons, where applicable Yes No If yes: 8.2.1. Service was effected in compliance with Article 13 or service was effected in compliance with Article 14 or it is proved in accordance with Article 18(2) that the debtor has received the summons 8.2.2. Due information The debtor was informed in compliance with Article 17 8.3. Cure of non-compliance with procedural minimum standards pursuant to Article 18(1) 8.3.1. Service of the decision was effected in compliance with Article 13 or Service of the decision was effected in compliance with Article 14 or it is proved in accordance with Article 18(2) that the debtor has received the decision 8.3.2. Due information The debtor was informed in compliance with Article 18(1)(b) Done at Date Signature and/or stamp