ANNEX VSupplementary provisions
ANNEX V Request to release over-preserved amounts (Article 27(2) 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) IMPORTANT INFORMATION This request must be submitted by the creditor by the swiftest possible means to the competent authority of the Member State of enforcement in which the over-preservation has occurred. The list of competent authorities under Regulation (EU) No 655/2014 is available on the website of the European e-Justice Portal at https://e-justice.europa.eu/content_european_account_preservation_order-379-en.do. The application must be submitted by the end of the third working day following receipt of any declaration pursuant to Article 25 of Regulation (EU) No 655/2014 showing the over-preservation. Language Fill in this form in the language of the competent authority to which you are sending your request. 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 filling in the form in the required language. 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 competent authority in another official language of the European Union (Article 50(1)(o) of Regulation (EU) No 655/2014). 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 1. European Account Preservation Order 1.1. Court that issued the European Account Preservation Order (‘the Preservation Order’) 1.1.1. Name: 1.1.2. Address 1.1.2.1. Street and number/PO box: 1.1.2.2. Place and postcode: 1.1.2.3. Member State (please indicate the country code): 1.2. Date (dd/mm/yyyy) of the Preservation Order: 1.3. File number of the Preservation Order: 1.4. Total amount to be preserved according to the Preservation Order: 1.5. 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): 2. Creditor 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): 3. Debtor 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): 4. Competent authority of the Member State of enforcement to which the request is addressed 4.1. Name: 4.2. Address 4.2.1. Street and number/PO box: 4.2.2. Place and postcode: 4.2.3. Member State (please indicate the country code): 5. Request to release over-preserved amounts 5.1. The declaration, issued in accordance with Article 25(1) of Regulation (EU) No 655/2014, showing that the amount preserved exceeds the amount specified in the Preservation Order ( point 1.4. ), was received on (dd/mm/yyyy). 5.2. The declaration showed that over preservation has occurred in the following bank 5.2.1. Name of the bank concerned by the Preservation Order: 5.2.2. Address of the bank 5.2.2.1. Street and number/PO box: 5.2.2.2. Place and postcode: 5.2.2.3. Member State (please indicate the country code): 5.2.3. Telephone: ( *2 ) 5.2.4. Fax ( *2 ) 5.2.5. Email (if available): 5.3. I hereby request the authority indicated in section 4 above to take steps to release the following amount which exceeds the amount specified in the Preservation Order: 5.4. 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): Done at: Date: (dd/mm/yyyy) Name, signature and/or stamp: ( *1 ) Optional ( *2 ) Optional