ANNEX 2Supplementary provisions
ANNEX 2 Text of image FORM II ATTESTATION concerning an authentic instrument in a matter of succession (Articles 59(1) and 60(2) of Regulation (EU) No 650/2012 of the European Parliament and of the Council on jurisdiction, applicable law, recognition and enforcement of decisions and acceptance and enforcement of authentic instruments in matters of succession and on the creation of a European Certificate of Succession (1)) 1. Member State of origin (*) Belgium Bulgaria Czech Republic Germany Estonia Greece Spain France Croatia Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Romania Slovenia Slovakia Finland Sweden 2. Authority having established the authentic instrument and issuing the attestation 2.1. Name and designation of authority (*): 2.2. Address 2.2.1. Street and number/PO box (*): 2.2.2. Place and postcode (*): 2.3. Telephone (*): 2.4. Fax 2.5. E-mail: 2.6. Other relevant information (please specify): 3. Authentic instrument 3.1. Date (dd/mm/yyyy) on which the authentic instrument was drawn up (*): 3.2. Reference number of the authentic instrument: 3.3. Date (dd/mm/yyyy) on which the authentic instrument was 3.3.1. registered at the register in the Member State of origin OR 3.3.2. deposited at the register in the Member State of origin (3.3.1 or 3.3.2 to be completed ONLY if different from the date indicated in point 3.1. and if the date of registration/deposit at the register determines the legal effect of the instrument) 3.3.3. Reference number in the register: 3.4. Parties to the authentic instrument (2) Text of image 3.4.1. Party A 3.4.1.1. Surname and given name(s) or organisation name (*): 3.4.1.2. Date (dd/mm/yyyy) and place of birth or, if organisation, date (dd/mm/yyyy), place of registration and designation of the register/registration authority: 3.4.1.3. Identification number (3) 3.4.1.3.1. Identity number: 3.4.1.3.2. Social security number: 3.4.1.3.3. Registration number: 3.4.1.3.4. Other (please specify): 3.4.1.4. Address 3.4.1.4.1. Street and number/PO box: 3.4.1.4.2. Place and postcode: 3.4.1.4.3. Country Belgium Bulgaria Czech Republic Germany Estonia Greece Spain France Croatia Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Romania Slovenia Slovakia Finland Sweden Other (please specify ISO-code): 3.4.1.5. Status of Party A (please tick more than one box, if relevant) (*) 3.4.1.5.1. Heir 3.4.1.5.2. Legatee 3.4.1.5.3. Executor 3.4.1.5.4. Administrator 3.4.1.5.5. Testator 3.4.1.5.6. Other (please specify): 3.4.2. Party B 3.4.2.1. Surname and given name(s) organisation name (*): 3.4.2.2. Date (dd/mm/yyyy) and place of birth or, if organisation, date (dd/mm/yyyy), place of registration and designation of the register/registration authority: 3.4.2.3. Identification number (3) 3.4.2.3.1. Identity number: 3.4.2.3.2. Social security number: 3.4.2.3.3. Registration number: 3.4.2.3.4. Other (please specify): 3.4.2.4. Address 3.4.2.4.1. Street and number/PO box: Text of image 3.4.2.4.2. Place and postcode: 3.4.2.4.3. Country Belgium Bulgaria Czech Republic Germany Estonia Greece Spain France Croatia Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Romania Slovenia Slovakia Finland Sweden Other (please specify ISO-code): 3.4.2.5. Status of Party B (please tick more than one box, if relevant) (*) 3.4.2.5.1. Heir 3.4.2.5.2. Legatee 3.4.2.5.3. Executor 3.4.2.5.4. Administrator 3.4.2.5.5. Testator 3.4.2.5.6. Other (please specify): 4. Acceptance of the authentic instrument (Article 59 of Regulation (EU) No 650/2012) 4.1. Is acceptance of the authentic instrument sought? (*) 4.1.1. Yes 4.1.2. No 4.2. Authenticity of the instrument ((*) If YES under point 4.1.1.) 4.2.1. Under the law of the Member State of origin, the authentic instrument has specific evidentiary effects compared to other written documents (*). 4.2.1.1. The specific evidentiary effects concern the following elements: (*) 4.2.1.1.1. the date the authentic instrument was drawn up 4.2.1.1.2. the place where the authentic instrument was drawn up 4.2.1.1.3. the origin of the signatures from the parties of the authentic instrument 4.2.1.1.4. the content of the declarations of the parties 4.2.1.1.5. the facts that the authority declares as having been verified in its presence 4.2.1.1.6. the actions which the authority declares to have carried out 4.2.1.1.7. other (please specify): 4.2.2. Under the law of the Member State of origin, the authentic instrument loses its specific evidentiary effects on the basis of (please indicate if relevant): 4.2.2.1. a judicial decision given in 4.2.2.1.1. an ordinary judicial procedure Text of image 4.2.2.1.2. a special judicial procedure provided by the law for this purpose (please indicate the name and/or the relevant legal references): 4.2.2.2. Other (please specify): 4.2.3. To the knowledge of the authority, the authentic instrument has not been challenged in the Member State of origin as to its authenticity (*). 4.3. Legal acts and relationships recorded in the authentic instrument ((*) if YES under point 4.1.1.) 4.3.1. To the knowledge of the authority, the authentic instrument (*): 4.3.1.1. is not challenged as to the legal acts and/or legal relationships recorded 4.3.1.2. is being challenged as to the legal acts and/or legal relationships recorded on specific points not covered by this attestation (please specify): 4.3.2. Other relevant information (please specify): 5. Other information 5.1. In the Member State of origin, the authentic instrument is a valid document for the purposes of recording a right in immovable or movable property in its registers (4). 5.1.1. Yes (please specify): 5.1.2. No 6. Enforceability of the authentic instrument (Article 60 of Regulation (EU) No 650/2012) 6.1. Is enforcement of the authentic instrument sought? (*) 6.1.1. Yes 6.1.2. No 6.2. If YES under point 6.1.1., is the authentic instrument enforceable in the Member State of origin without any further conditions having to be met? (*) Text of image 6.2.1. Yes (please specify the enforceable obligation(s)): 6.2.2. Yes, but limited to part(s) of the authentic instrument (please specify the enforceable obligation(s)): 6.2.3. The obligation(s) is(are) enforceable against the following person(s): (*) 6.2.3.1. Party A 6.2.3.2. Party B 6.2.3.3. Other (please specify): 7. Interest 7.1. Is recovery of interest sought? (*) 7.1.1. Yes 7.1.2. No 7.2. If YES under point 7.1.1. (*) 7.2.1. Interest 7.2.1.1. Not specified in the authentic instrument 7.2.1.2. Yes, specified in the authentic instrument as follows 7.2.1.2.1. Interest due from: (date (dd/mm/yyyy) or event) to: (date (dd/mm/yyyy) or event) (5) 7.2.1.2.2. Final amount: 7.2.1.2.3. Method to calculate the interest 7.2.1.2.3.1. Rate: % 7.2.1.2.3.2. Rate: % over reference rate (ECB/reference rate of national central bank:) in force on: (date (dd/mm/yyyy) or event) 7.2.2. Statutory interest to be calculated in accordance with (specify relevant statute): 7.2.2.1. Interest due from: (date (dd/mm/yyyy) or event) to: (date (dd/mm/yyyy) or event) (5) 7.2.2.2. Method to calculate the interest 7.2.2.2.1. Rate: % Text of image 7.2.2.2.2. Rate: % over reference rate (ECB/reference rate of national central bank:) in force on: (date (dd/mm/yyyy) or event) 7.2.3. Capitalisation of interest (please specify): 7.2.4. Currency euro (EUR) lev (BGN) Czech koruna (CZK) kuna (HRK) forint (HUF) zloty (PLN) Romanian leu (RON) krona (SEK) Other (please specify (ISO code)): If additional sheets have been attached, state the total number of pages (*): Done at (*): on (*): (dd/mm/yyyy) Signature and/or stamp of the court or competent authority issuing the attestation (*): (*) Mandatory information. (1) OJ L 201, 27.7.2012, p. 107. (2) If the authentic instrument concerns more than two parties, please attach an additional sheet. (3) Please indicate the most relevant number if applicable. (4) The recording in a register of a right in immovable or movable property is subject to the law of the Member State in which the register is kept. (5) Add the number of periods necessary if more than one period.