ANNEX VISupplementary provisions
ANNEX VI Text of image APPLICATION FOR RECTIFICATION OR WITHDRAWAL OF THE EUROPEAN ENFORCEMENT ORDER CERTIFICATE (Article 10(3)) THE FOLLOWING EUROPEAN ENFORCEMENT ORDER CERTIFICATE 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): HAS TO BE 5. RECTIFIED as due to a material error there is the following discrepancy between the European Enforcement Order certificate and the underlying judgment/court settlement/authentic instrument (explain) 6. WITHDRAWN because: 6.1. the certified judgment was related to a consumer contract but was given in a Member State where the consumer is not domiciled within the meaning of Article 59 of Regulation (EC) No 44/2001 6.2. the European Enforcement Order certificate was clearly wrongly granted for another reason (explain) Done at Date Signature and/or stamp (*) Delete as appropriate.