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Commission Implementing Regulation (EU) 2016/1823 of 10 October 2016 establishing the forms referred to in Regulation (EU) No 655/2014 of the European Parliament and of the Council establishing a European Account Preservation Order procedure to facilitate cross-border debt recovery in civil and commercial matters

Type Implementing Regulation

Publication 2016-10-19

State In force

Text As published

Department European Commission

Source EUR-Lex

articles 2

This is the act as published. Later amendments are not folded into the text below: each one is a separate act in this repository and an entry in this law's history.

Reform history JSON API

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: ¹³

2.4. Fax ¹³

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: ¹³

3.4. Fax ¹³

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: ¹⁴

5.2.4. Fax ¹⁴

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:

Optional

ANNEX VI


Acknowledgment of receipt (Article 29(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

The acknowledgment of receipt being sent to the authority, creditor or bank that transmitted the documents must be sent by the end of the working day following the date of receipt of the documents and must be sent by the swiftest possible means of transmission.

Concerning the requirements governing the language of the transmitted documents, please note the requirements provided in Regulation (EU) No 655/2014, including Article 10(2), Article 23(4) and Article 49.

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. The court or authority that received the document(s)

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):

1.3. Telephone:

1.4. Fax

1.5. Email:

1.6. Reference number(s) of the document(s), if any, given by the court or authority that received the document(s):

The following document(s) was/were received pursuant to Regulation (EU) No 655/2014 on

(dd/mm/yyyy) by the court or authority indicated in section 1 above (please indicate the incoming reference number of the document, if any):

☐ the revocation form (Article 10(2) of the Regulation)

☐ the request for information (Article 14(3) of the Regulation)

☐ the account information (Article 14(6) of the Regulation)

☐ Part A of the European Account Preservation Order (‘the Preservation Order’) and blank standard form for declaration (Article 23(3) of the Regulation)

☐ the declaration concerning the preservation of funds (Article 25(2) or (3) of the Regulation)

☐ the Preservation Order and other documents referred to in Article 28(3) of the Regulation (please provide details):

☐ the decision on a remedy (Article 36(5) of the Regulation)

3. The authority, creditor or bank that transmitted the document(s)

3.1. Name:

3.2. Address

3.2.1. Street and number/PO box:

3.2.2. Place and postcode:

3.2.3. Member State (please indicate the country code):

4. (Please fill in if applicable) The language of the document(s) received is incorrect.

The following document(s):

must be translated into the following language:

☐ Bulgarian ☐ Spanish ☐ Czech ☐ German ☐ Estonian ☐ Greek ☐ English ☐ French ☐ Irish ☐ Croatian ☐ Italian ☐ Latvian ☐ Lithuanian ☐ Hungarian ☐ Maltese ☐ Dutch ☐ Polish ☐ Portuguese ☐ Romanian ☐ Slovak ☐ Slovenian ☐ Finnish ☐ Swedish

(Please fill in if applicable) Other reasons why the document(s) cannot be processed (for example, the document is illegible). Please explain the reasons:

Done at:

Date:

(dd/mm/yyyy)

Signature and/or stamp:

ANNEX VII


Application for a remedy (Article 36(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

Language

Fill in this form in the language of the court or authority 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 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 court or competent authority 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. Please also attach a copy of the European Account Preservation Order (‘the Preservation Order’) at issue.

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


Application for a remedy Articles 33 and 34 of Regulation (EU) No 655/2014 provide for the remedies available to the debtor. Article 35 of the Regulation provides for other remedies available both to the debtor and to the creditor. If you want to raise any objection against the issue of the Preservation Order, you must address your application to the competent court of the Member State where the Preservation Order was issued. If you want to raise any objection against the enforcement of the Preservation Order, you must address your application to the court, or, where national law so provides, to the competent enforcement authority in the Member State of enforcement where the preserved account is located. On the website of the European e-Justice Portal, you can find information on the payment of court fees in proceedings to obtain a remedy against a Preservation Order in the Member State concerned.

Application for a remedy Articles 33 and 34 of Regulation (EU) No 655/2014 provide for the remedies available to the debtor. Article 35 of the Regulation provides for other remedies available both to the debtor and to the creditor. If you want to raise any objection against the issue of the Preservation Order, you must address your application to the competent court of the Member State where the Preservation Order was issued. If you want to raise any objection against the enforcement of the Preservation Order, you must address your application to the court, or, where national law so provides, to the competent enforcement authority in the Member State of enforcement where the preserved account is located. On the website of the European e-Justice Portal, you can find information on the payment of court fees in proceedings to obtain a remedy against a Preservation Order in the Member State concerned.

Where this form provides for filling in of free text, when filling in the form on paper please use additional sheets if necessary and number each page.

1. Court or authority with which the application for the remedy is lodged

1.2. Name:

1.3. Address

1.3.1. Street and number/PO box:

1.3.2. Place and postcode:

1.3.3. Member State (please indicate the country code):

2. The applicant for the remedy

2.1. The applicant(s) for the remedy is/are, in the proceedings leading to the issuing of the Preservation Order (please tick the relevant box): ¹⁵

☐ Creditor

☐ Debtor

2.2. Surname and given name(s)/name of company or organisation:

2.3. Address

2.3.1. Street and number/PO box:

2.3.2. Place and postcode:

2.3.3. Country (if a Member State, please indicate the country code):

2.4. Telephone: ¹⁶

2.5. Fax ¹⁶

2.6. Email (if available):

2.7. Name of party's representative, if any, and contact details

2.7.1. Surname and given name(s):

2.7.2. Address

2.7.2.1. Street and number/PO box:

2.7.2.2. Place and postcode:

2.7.2.3. Country (if a Member State, please indicate the country code):

2.7.3. Email (if available):

3. The other party ¹⁷

3.1. The other party is, in the proceedings leading to the issuing of the Preservation Order (please tick the relevant box):

☐ Creditor

☐ Debtor

3.2. Surname and given name(s)/name of company or organisation:

3.3. Address

3.3.1. Street and number/PO box:

3.3.2. Place and postcode:

3.3.3. Country (if a Member State, please indicate the country code):

3.4. Telephone: ¹⁸

3.5. Fax ¹⁸

3.6. Email (if available):

3.7. Name of party's representative, if any and if known, and contact details, if available

3.7.1. Surname and given name(s):

3.7.2. Address

3.7.2.1. Street and number/PO box:

3.7.2.2. Place and postcode:

3.7.2.3. Country (if a Member State, please indicate the country code):

3.7.3. Email:

4. Court that issued the Preservation Order (to be filled in only if different from the court with which the application for the remedy is lodged as referred to in section 1)

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 country code):

4.3. Telephone: ¹⁸

4.4. Fax ¹⁸

4.5. Email (if available):

5. The Preservation Order

5.1. Date (dd/mm/yyyy) of the Preservation Order:

5.2. File number of the Preservation Order:

5.3. Total amount to be preserved according to the Preservation Order:

5.4. Currency:

6. Application for a remedy in the Member State of origin

6.1. I hereby lodge an application to have the Preservation Order (please tick the relevant box):

☐ modified

☐ revoked

on the grounds that (please tick the relevant box(es) below; where you are requesting the modification of the Preservation Order, please also indicate under the relevant box the particular modification requested):

6.1.1. the conditions or requirements for issuing the Preservation Order pursuant to Regulation (EU) No 655/2014 were not fulfilled, because:

6.1.1.1. - ☐ Regulation (EU) No 655/2014 is not applicable (Article 2). Please provide details:

6.1.1.2. - ☐ the case is not a cross-border case (Article 3). Please provide details:

6.1.1.3. - ☐ the court that issued the Preservation Order has no jurisdiction (Article 6). Please provide details:

6.1.1.4. - ☐ there is no urgent need for the Preservation Order because there is no risk that the subsequent enforcement of the creditor's claim against me will be impeded or made substantially more difficult (Article 7(1)). Please provide details:

6.1.1.5. - ☐ the creditor did not submit sufficient evidence to demonstrate that he is likely to succeed on the substance of his claim against me (Article 7(2)). Please provide details:

6.1.1.6. - ☐ the creditor has not initiated the proceedings on the substance of the matter within the deadlines indicated by the court (Article 10).

6.1.1.7. - ☐ the creditor should have been required to provide security or a higher security than the one ordered by the court (Article 12). Please provide details:

6.1.2. - ☐ the Preservation Order, the declaration concerning the preservation of funds, and/or the other documents referred to in Article 28(5) of Regulation (EU) No 655/2014, that is to say, the application for the Preservation Order submitted by the creditor to the court and copies of all documents submitted by the creditor to the court in order to obtain the order, were not served on me within 14 days of the preservation of my account or accounts.

Please indicate an address to which the documents and translations can be sent:

or, alternatively,

☐ please indicate your agreement to collect those documents at the court of the Member State of origin by ticking the box.

6.1.3. - ☐ the documents served on me in accordance with Article 28 did not meet the language requirements set out in Regulation (EU) No 655/2014. In particular, Article 49(1) of the Regulation requires that the Preservation Order and the application for the Preservation Order submitted by the creditor to the court should be translated into the official language of the Member State in which the debtor is domiciled or another language that the debtor understands.

If applicable, please indicate another language that you understand:

Please indicate an address to which the documents and translations can be sent:

or, alternatively,

☐ please indicate your agreement to collect those documents at the court of the Member State of origin by ticking the box.

6.1.4. - ☐ preserved amounts exceeding the amount of the Preservation Order were not released in accordance with Article 27 of Regulation (EU) No 655/2014. Please provide details:

6.1.5. - ☐ the claim the enforcement of which the creditor was seeking to secure by means of the Preservation Order has been paid in full or in part. Please provide details:

6.1.6. - ☐ the judgment on the substance of the matter has dismissed the claim the enforcement of which the creditor was seeking to secure by means of the Preservation Order. Please provide details:

6.1.7. - ☐ the judgment on the substance of the matter, or the court settlement or authentic instrument, the enforcement of which the creditor was seeking to secure by means of the Preservation Order has been set aside or, as the case may be, annulled. Please provide details:

6.1.8. - ☐ the circumstances on the basis of which the Preservation Order was issued have changed. Please provide details:

6.1.9. - ☐ we (the debtor and the creditor) agreed to settle the claim. In this case, this form has to be signed by both the creditor and the debtor.

7. Application for a remedy in the Member State of enforcement

7.1. I hereby lodge an application to have the enforcement of the Preservation Order (please tick the relevant box):

☐ limited

☐ modified

☐ terminated

on the grounds that (please tick the relevant box(es) in point 7.1.1. below; where you are requesting the limitation or modification, please also indicate under the relevant box the particular limitation or modification requested):

7.1.1. the Preservation Order has not been enforced in accordance with Regulation (EU) No 655/2014, because:

7.1.1.1. - ☐ certain amounts held in the account that was preserved should be exempt from seizure in accordance with Article 31(3) of Regulation (EU) No 655/2014, or amounts exempt from seizure have not or not correctly been taken into account in the implementation of the Preservation Order in accordance with Article 31(2) of that Regulation. Please provide details:

7.1.1.2. - ☐ the account preserved is excluded from the scope of Regulation (EU) No 655/2014 (Aricle 2 of the Regulation). Please provide details:

7.1.1.3. - ☐ the enforcement of the judgment or court settlement or authentic instrument that the creditor was seeking to secure by means of the order has been refused in the Member State of enforcement;

7.1.1.4. - ☐ the enforceability of the judgment the enforcement of which the creditor was seeking to secure by means of the Preservation Order has been suspended in the Member State of origin;

7.1.1.5. - ☐ the Preservation Order, the declaration concerning the preservation of funds and/or the other documents referred to in Article 28(5) of Regulation (EU) No 655/2014 were not served on me within 14 days of the preservation of my account(s);

Please indicate an address to which the documents and translations can be sent:

or, alternatively,

☐ please indicate your agreement to collect those documents at the court of the Member State of origin by ticking the box;

7.1.1.6. - ☐ the documents served on me in accordance with Article 28 of Regulation (EU) No 655/2014 did not meet the language requirements set out in that Regulation. In particular, Article 49(1) of the Regulation requires that the Preservation Order and the application for the Preservation Order submitted by the creditor to the court should be translated into the official language of the Member State in which the debtor is domiciled or another language which the debtor understands;

If applicable, please indicate another language that you understand:

Please indicate an address to which the documents and translations can be sent:

or, alternatively,

☐ please indicate your agreement to collect those documents at the court of the Member State of origin by ticking the box;

7.1.1.7. - ☐ the preserved amounts exceeding the amount of the Preservation Order were not released in accordance with Article 27 of Regulation (EU) No 655/2014. Please provide details:

7.1.1.8. - ☐ the claim, the enforcement of which the creditor was seeking to secure by means of the Preservation Order, has been paid in full or in part. Please provide details:

7.1.1.9. - ☐ the judgment on the substance of the matter has dismissed the claim, the enforcement of which the creditor was seeking to secure by means of the Preservation Order;

7.1.1.10. - ☐ the judgment on the substance of the matter, or the court settlement or authentic instrument, the enforcement of which the creditor was seeking to secure by means of the Preservation Order has been set aside or, as the case may be, annulled. Please provide details:

7.1.1.11. - ☐ the enforcement of the Preservation Order is manifestly contrary to the public policy of the Member State of the enforcement. Please provide details:

7.1.1.12. - ☐ we (the debtor and the creditor) agreed to settle the claim. In this case, this form has to be signed by both the creditor and the debtor;

7.1.1.13. - ☐ the amounts exempted from preservation have to be adjusted. Please provide details:

8. Evidence

Please list the evidence supporting your application for a remedy:


I declare that the information provided is true to the best of my knowledge and is given in good faith. 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:

Where a joint application is made by the creditor and the debtor (for the revocation or modification of the Preservation Order or for termination or limitation of the enforcement of the Preservation Order) on the ground that they agreed to settle the claim, this section has to be filled in by both parties. In such circumstances, when filling in the form on paper, please use a separate sheet for each party and number each page.

Optional

This section is not to be filled in if the information in section 2 was already given both for the creditor and the debtor where a joint application is made on the ground that they agreed to settle the claim.

Optional

ANNEX VIII


Transmission of a decision on a remedy to the Member State of enforcement (Article 36(5) 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)

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 (‘the Preservation Order’):

1.1. Date (dd/mm/yyyy) of the Preservation Order:

1.2. File number of the Preservation Order:

1.3. Total amount to be preserved according to the Preservation Order:

Currency:

2. Court that issued the Preservation Order

2.1. Name:

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: ¹⁹

2.4. Fax ¹⁹

2.5. Email (if available):

3. Court that issued the decision on the remedy (to be filled in only if different from the court (referred to in section 2) that has issued the Preservation Order)

3.1. Name:

3.2. Address

3.2.1. Street and number/PO box:

3.2.2. Place and postcode:

3.2.3. Member State (please indicate the country code):

3.3. Telephone:

3.4. Fax

3.5. Email:

4. Applicant (for the remedy)

4.1. The applicant(s) for the remedy is/are, in the proceedings leading to the issuing of the Preservation Order (please tick the relevant box): ²⁰

☐ Creditor

☐ Debtor

4.2. Surname and given name(s)/name of company or organisation:

4.3. Address

4.3.1. Street and number/PO box:

4.3.2. Place and postcode:

4.3.3. Country (if a Member State, please indicate the country code):

4.4. Telephone (if available):

4.5. Fax (if available):

4.6. Email (if available):

4.7. Name of party's representative, if any and if known, and contact details, if available

4.7.1. Surname and given name(s):

4.7.2. Address

4.7.2.1. Street and number/PO box:

4.7.2.2. Place and postcode:

4.7.2.3. Country (if a Member State, please indicate the country code):

4.7.3. Email:

5. The other party ²¹

5.1. The other party is, in the proceedings leading to the issuing of the Preservation Order (please tick the relevant box):

☐ Creditor

☐ Debtor

5.2. Surname and given name(s)/name of company or organisation:

5.3. Address

5.3.1. Street and number/PO box:

5.3.2. Place and postcode:

5.3.3. Country (if a Member State, please indicate the country code):

5.4. Telephone (if available):

5.5. Fax (if available):

5.6. Email (if available):

5.7. Name of party's representative, if any and if known, and contact details, if available

5.7.1. Surname and given name(s):

5.7.2. Address

5.7.2.1. Street and number/PO box:

5.7.2.2. Place and postcode:

5.7.2.3. Country (if a Member State, please indicate the country code):

5.7.3. Email:

6. Decision of the court on the remedy

6.1. Date (dd/mm/yyyy) of the decision:

6.2. File number of the decision:

6.3. The decision:

☐ The Preservation Order is revoked

☐ The Preservation Order is modified in the following way:

The competent authority of the Member State of enforcement of the Preservation Order is requested to take the necessary steps to have the decision on the remedy implemented.

Done at:

Date:

(dd/mm/yyyy)

Stamp, signature and/or any other authentication of the court:

Optional

Where a decision on a remedy is issued in relation to a joint application that was made by the creditor and the debtor (for the revocation or modification of the Preservation Order) on the grounds that they agreed to settle the claim, both parties should be indicated in this section. In such circumstances, when filling in the form on paper, please use a separate sheet for each party and number each page.

Not to be filled in if the information in section 4 was already given both for the creditor and the debtor where a joint application for a remedy was made on the grounds that they agreed to settle the claim.

ANNEX IX


Appeal against a decision on a remedy (Article 37 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

Language

Fill in this form in the language of the court 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 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).

The list of the competent courts for an appeal 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.

Supporting documents

Please note that this form must be accompanied by all relevant supporting documents. Please also attach a copy of the decision that is being appealed.

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

On the website of the European e-Justice Portal you can find certain information on the payment of the court fees in the proceedings at issue in the Member State concerned.

Where this form provides for filling in of free text, when filling in the form on paper, please use additional sheets if necessary and number each page.

1. Court at which the appeal is lodged

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. Applicant for an appeal

2.1. The applicant for an appeal is, in the proceedings leading to the issuing of the European Account Preservation Order (‘the Preservation Order’) (please tick the relevant box):

☐ Creditor

☐ Debtor

2.2. Surname and given name(s)/name of company or organisation:

2.3. Address

2.3.1. Street and number/PO box:

2.3.2. Place and postcode:

2.3.3. Country (if a Member State, please indicate the country code):

2.4. Telephone: ²²

2.5. Fax ²²

2.6. Email (if available):

2.7. Name of party's representative, if any, and contact details

2.7.1. Surname and given name(s):

2.7.2. Address

2.7.2.1. Street and number/PO box:

2.7.2.2. Place and postcode:

2.7.2.3. Country (if a Member State, please indicate the country code):

2.7.3. Email:

3. The other party

3.1. The other party is, in the proceedings leading to the issuing of the Preservation Order (please tick the relevant box):

☐ Creditor

☐ Debtor

3.2. Surname and given name(s)/name of company or organisation:

3.3. Address

3.3.1. Street and number/PO box:

3.3.2. Place and postcode:

3.3.3. Country (if a Member State, please indicate the country code):

3.4. Telephone: ²³

3.5. Fax ²³

3.6. Email (if available):

3.7. Name of party's representative, if any and if known, and contact details, if available

3.7.1. Surname and given name(s):

3.7.2. Address

3.7.2.1. Street and number/PO box:

3.7.2.2. Place and postcode:

3.7.2.3. Country (if a Member State, please indicate the country code):

3.7.3. Email:

4. Court that issued the Preservation Order

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 country code):

4.3. Telephone: ²³

4.4. Fax ²³

4.5. Email (if available):

5. The Preservation Order

5.1. Date (dd/mm/yyyy) of the Preservation Order:

5.2. File number of the Preservation Order:

5.3. Total amount to be preserved according to the Preservation Order:

5.4. Currency:

6. Court or competent enforcement authority that issued the decision on the remedy (not to be filled in if the court is the same as the court (referred to in section 4) that issued the Preservation Order)

6.1. Name:

6.2. Address

6.2.1. Street and number/PO box:

6.2.2. Place and postcode:

6.2.3. Member State (please indicate the country code):

6.3. Telephone: ²⁴

6.4. Fax ²⁴

6.5. Email (if available):

7. The decision on the remedy:

7.1. Date (dd/mm/yyyy) of the decision:

7.2. Reference number of the decision:

7.3. The decision on the remedy was issued on the application for a remedy by the (please tick the relevant box):

☐ Creditor in the proceedings leading to the issuing of the Preservation Order

☐ Debtor in the proceedings leading to the issuing of the Preservation Order

8. Application for an appeal against the decision on the remedy

I hereby lodge an appeal against the decision referred to in section 7 for the following reasons:

9. Evidence

Please list the evidence supporting your application for an appeal:


I declare that the information provided is true to the best of my knowledge and is given in good faith. 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:

Optional

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3. Debtor

4. Competent authority of the Member State of enforcement to which the request is addressed

5. Request to release over-preserved amounts

ANNEX VI

IMPORTANT INFORMATION

Country codes

1. The court or authority that received the document(s)

3. The authority, creditor or bank that transmitted the document(s)

4. (Please fill in if applicable) The language of the document(s) received is incorrect.

ANNEX VII

IMPORTANT INFORMATION

Language

Supporting documents

Country codes

1. Court or authority with which the application for the remedy is lodged

2. The applicant for the remedy

3. The other party 17

4. Court that issued the Preservation Order (to be filled in only if different from the court with which the application for the remedy is lodged as referred to in section 1)

5. The Preservation Order

6. Application for a remedy in the Member State of origin

7. Application for a remedy in the Member State of enforcement

8. Evidence

ANNEX VIII

Country codes

1. European Account Preservation Order (‘the Preservation Order’):

2. Court that issued the Preservation Order

3. Court that issued the decision on the remedy (to be filled in only if different from the court (referred to in section 2) that has issued the Preservation Order)

4. Applicant (for the remedy)

5. The other party 21

6. Decision of the court on the remedy

ANNEX IX

IMPORTANT INFORMATION

Language

Supporting documents

Country codes

1. Court at which the appeal is lodged

2. Applicant for an appeal

3. The other party

4. Court that issued the Preservation Order

5. The Preservation Order

6. Court or competent enforcement authority that issued the decision on the remedy (not to be filled in if the court is the same as the court (referred to in section 4) that issued the Preservation Order)

7. The decision on the remedy:

8. Application for an appeal against the decision on the remedy

9. Evidence

3. The other party ¹⁷

5. The other party ²¹