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Council Regulation (EC) No 4/2009Dangos y teitl llawn
Council Regulation (EC) No 4/2009 of 18 December 2008 on jurisdiction, applicable law, recognition and enforcement of decisions and cooperation in matters relating to maintenance obligations
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- Rheoliadau yn deillio o’r UE
- 2009 No. 4
- ANNEX VII
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[F1ANNEX VII U.K. APPLICATION FORM TO OBTAIN OR HAVE MODIFIED A DECISION IN MATTERS RELATING TO MAINTENANCE OBLIGATIONS
Textual Amendments
(Articles 56 and 57 of Council Regulation (EC) No 4/2009 of 18 December 2008 on jurisdiction, applicable law, recognition and enforcement of decisions and cooperation in matters relating to maintenance obligations (1) )
PART A U.K. To be completed by the requesting Central Authority
1. APPLICATION U.K.
Application to obtain a decision (Article 56(1)(c))
Application to obtain a decision (Article 56(1)(d))
Application for the modification of a decision (Article 56(1)(e))
Application for the modification of a decision (Article 56(1)(f))
Application for the modification of a decision (Article 56(2)(b))
Application for the modification of a decision (Article 56(2)(c))
2. REQUESTING CENTRAL AUTHORITY U.K.
2.1. Name: … U.K.
2.2. Address: U.K.
2.2.1.
Street and number/PO box: …
2.2.2.
Place and postal code: …
2.2.3.
Member State
Belgium Bulgaria Czech Republic Germany Estonia Ireland Greece Spain France Croatia Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Romania Slovenia Slovakia Finland Sweden United Kingdom
2.3. Telephone: … U.K.
2.4. Fax … U.K.
2.5. E-mail: … U.K.
2.6. Reference number of the application: … U.K.
Application to be handled with the application(s) bearing the following reference number(s): …
2.7. Person responsible for following up the application: U.K.
2.7.1.
Surname and given name(s): …
2.7.2.
Telephone: …
2.7.3.
E-mail: …
3. REQUESTED CENTRAL AUTHORITY U.K.
3.1. Name: … U.K.
3.2. Address: U.K.
3.2.1.
Street and number/PO box: …
3.2.2.
Place and postal code: …
3.2.3.
Member State
Belgium Bulgaria Czech Republic Germany Estonia Ireland Greece Spain France Croatia Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Romania Slovenia Slovakia Finland Sweden United Kingdom
4. DOCUMENTS ATTACHED (2) TO THE APPLICATION, AS APPROPRIATE U.K.
Decision of the requested Member State refusing recognition or a declaration of enforceability
Copy of the decision to be modified
Extract from the decision to be modified
Document(s) proving a change in income or any other change in circumstances
Birth certificate(s) or equivalent
Debtor’s acknowledgement of parentage
Document(s) proving biological parentage
Decision by a competent authority in relation to parentage
Results of genetic tests
Adoption certificate
Certificate of marriage or similar relationship
Document(s) proving the date of divorce/separation
Document(s) proving that the parties live together
Certificate(s) regarding schooling
Document(s) relevant to the financial situation
Other (please specify): …
…
…
…
Total number of documents attached to the application form: …
Done at: … on … (dd/mm/yyyy)
Name and signature of the authorised official of the requesting Central Authority:
…
PART B U.K. To be completed by the applicant or, as appropriate, by the person/authority authorised in the requesting Member State to complete the form on the applicant’s behalf
5. APPLICATION U.K.
5.1. Application to obtain a decision U.K.
5.1.1. Parentage has not been established U.K.
5.1.2. No decision exists U.K.
5.1.3. Recognition and a declaration of enforceability of an existing decision are not possible U.K.
5.1.4. Amount requested: U.K.
…
…
…
5.2. Application for modification of a decision U.K.
5.2.1. The decision was given in the requested Member State U.K.
5.2.2. The decision was given in a State other than the requested Member State U.K.
5.2.3. Date (dd/mm/yyyy) and reference number of the decision: … U.K.
5.2.4. Name of the court of origin: … U.K.
5.2.5. Changes in circumstances which have occurred: U.K.
Change in income:
of the person(s) for whom maintenance is sought or owed
of the person primarily responsible for the person(s) for whom maintenance is sought or owed
of the debtor
Change in expenses and charges:
of the person(s) for whom maintenance is sought or owed
of the person primarily responsible for the person(s) for whom maintenance is sought or owed
of the debtor
Change in the situation of the child/children
Change in civil status:
of the person(s) for whom maintenance is sought or owed
of the person primarily responsible for the person(s) for whom maintenance is sought or owed
of the debtor
Other (please specify): …
…
…
5.2.6. Modification(s) requested: U.K.
Increase in the amount of maintenance:
The amount of maintenance should be increased by (please specify): …
Reduction in the amount of maintenance:
The amount of maintenance should be reduced by (please specify): …
Modification of the frequency of payments (please specify): …
Modification of the arrangements for payment (please specify): …
Modification of the nature of payments (please specify): …
Termination of the maintenance obligation (please specify): …
Other (please specify): …
…
6. APPLICANT U.K.
6.1. Surname and given name(s): … U.K.
6.2. Address: U.K.
The address given below is the applicant’s personal address.
The applicant is in a situation of family violence (3) . The address given below is an address care of: … (surname and given name(s))
6.2.1. Street and number/PO box: … U.K.
6.2.2. Place and postal code: … U.K.
6.2.3. Member State U.K.
Belgium Bulgaria Czech Republic Germany Estonia Ireland Greece Spain France Croatia Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Romania Slovenia Slovakia Finland Sweden United Kingdom
6.3. Telephone/E-mail: … U.K.
6.4. Date (dd/mm/yyyy) and place of birth: … U.K.
6.5. Identity number or social security number (4) : … U.K.
6.6. Nationality: … U.K.
6.7. Occupation: … U.K.
6.8. Civil status: … U.K.
6.9. If applicable, surname, given name(s) and contact details of the applicant’s representative (lawyer, etc. …): U.K.
…
…
7. DEFENDANT U.K.
7.1. Surname and given name(s): … U.K.
7.2. Address (5) : U.K.
7.2.1.
Street and number/PO box: …
7.2.2.
Place and postal code: …
7.2.3.
Member State
Belgium Bulgaria Czech Republic Germany Estonia Ireland Greece Spain France Croatia Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Romania Slovenia Slovakia Finland Sweden United Kingdom
7.3. Date (dd/mm/yyyy) and place of birth (6) : … U.K.
7.4. Identity number or social security number (7) : … U.K.
7.5. Nationality (8) : … U.K.
7.6. Occupation (9) : … U.K.
7.7. Civil status (10) : … U.K.
8. ANY OTHER INFORMATION THAT MAY HELP LOCATE THE DEFENDANT: U.K.
…
…
…
9. PERSON(S) FOR WHOM MAINTENANCE IS SOUGHT OR OWED (11) U.K.
9.1. The person is the same as the applicant named in point 6 U.K.
9.2. The person is the same as the defendant named in point 7 U.K.
9.3.
| | The applicant | | The defendant |
is the representative (12) defending the interests of the following person(s):
9.3.1. Person A U.K.
9.3.1.1. Surname and given name(s): … U.K.
9.3.1.2. Date (dd/mm/yyyy) and place of birth: … U.K.
9.3.1.3. Identity number or social security number (13) : … U.K.
9.3.1.4. Nationality (14) : … U.K.
9.3.1.5. Occupation (15) : … U.K.
9.3.1.6. Civil status (16) : … U.K.
9.3.1.7. Maintenance is on the basis of the following relationship: U.K.
Parentage (please specify relationship): …
Marriage
Analogous relationship to marriage
Alliance (please specify relationship): …
Other (please specify): …
9.3.2. Person B U.K.
9.3.2.1. Surname and given name(s): … U.K.
9.3.2.2. Date (dd/mm/yyyy) and place of birth: … U.K.
9.3.2.3. Identity number or social security number (17) : … U.K.
9.3.2.4. Nationality (18) : … U.K.
9.3.2.5. Occupation (19) : … U.K.
9.3.2.6. Civil status (20) : … U.K.
9.3.2.7. Maintenance is on the basis of the following relationship: U.K.
Parentage (please specify relationship): …
Marriage
Analogous relationship to marriage
Alliance (please specify relationship): …
Other (please specify): …
9.3.3. Person C U.K.
9.3.3.1. Surname and given name(s): … U.K.
9.3.3.2. Date (dd/mm/yyyy) and place of birth: … U.K.
9.3.3.3. Identity number or social security number (21) : … U.K.
9.3.3.4. Nationality (22) : … U.K.
9.3.3.5. Occupation (23) : … U.K.
9.3.3.6. Civil status (24) : … U.K.
9.3.3.7. Maintenance is on the basis of the following relationship: U.K.
Parentage (please specify relationship): …
Marriage
Analogous relationship to marriage
Alliance (please specify relationship): …
Other (please specify): …
10. DEBTOR U.K.
10.1. The person is the same as the applicant named in point 6 U.K.
10.2. The person is the same as the defendant named in point 7 U.K.
10.3.
| | The applicant | | The defendant |
is the representative (25) defending the interests of the following person:
10.3.1.
Surname and given name(s): …
10.3.2.
Date (dd/mm/yyyy) and place of birth: …
10.3.3.
Identity number or social security number (26) : …
10.3.4.
Nationality (27) : …
10.3.5.
Occupation (28) : …
10.3.6.
Civil status (29) : …
10.3.7.
Maintenance is on the basis of the following relationship:
Parentage (please specify relationship): …
Marriage
Analogous relationship to marriage
Alliance (please specify relationship): …
Other (please specify): …
11. INFORMATION ON THE FINANCIAL SITUATION OF THE PERSONS CONCERNED BY THE APPLICATION (ONLY GIVE INFORMATION WHICH IS RELEVANT FOR THE PURPOSE OF OBTAINING OR MODIFYING A DECISION) U.K.
11.1. Currency U.K.
Euro (EUR) Lev (BGN) Czech koruna (CZK) Pound sterling (GBP) Kuna (HRK) Forint (HUF) Zloty (PLN) Leu (RON) Krona (SEK) Other (please specify ISO code): …
11.2. The person(s) for whom maintenance is sought or owed and the person primarily responsible for that person (those persons) U.K.
11.2.1. Gross income U.K.
| Monthly Annual | Person primarily responsible for the person(s) for whom maintenance is sought or owed | Spouse or current partner of the person primarily responsible for the person(s) for whom maintenance is sought or owed | Person for whom maintenance is sought or owed (Person A) | Person for whom maintenance is sought or owed (Person B) | Person for whom maintenance is sought or owed (Person C) |
|---|---|---|---|---|---|
| Salary (including payments in kind), pensions, disability pensions, maintenance payments, allowances, annuities, unemployment benefits | |||||
| Income from non-salaried occupations | |||||
| Income from securities/floating capital/real property | |||||
| Other sources of income | |||||
| TOTAL |
11.2.2. Expenses and charges U.K.
| Monthly Annual | Person primarily responsible for the person(s) for whom maintenance is sought or owed | Spouse or current partner of the person primarily responsible for the person(s) for whom maintenance is sought or owed | Person for whom maintenance is sought or owed (Person A) | Person for whom maintenance is sought or owed (Person B) | Person for whom maintenance is sought or owed (Person C) |
|---|---|---|---|---|---|
| Taxes | |||||
| Insurance premiums, mandatory social security and professional contributions | |||||
| Rent/cost of co-ownership, mortgage payments | |||||
| Food and clothing | |||||
| Medical expenses | |||||
| Maintenance paid to a third party by virtue of a legal obligation and/or expenditure for other dependent persons not covered by the application | |||||
| Education costs of children | |||||
| Loan repayments, other debts | |||||
| Other expenditure | |||||
| TOTAL |
11.2.3. Other assets U.K.
…
…
…
11.3. The debtor U.K.
11.3.1. Gross income U.K.
| Monthly Annual | Debtor | Current spouse or partner of the debtor |
|---|---|---|
| Salary (including payments in kind), pensions, disability pensions, maintenance payments, allowances, annuities, unemployment benefits | ||
| Income from non-salaried occupations | ||
| Income from securities/floating capital/real property | ||
| Other sources of income | ||
| TOTAL |
11.3.2. Expenses and charges U.K.
| Monthly Annual | Debtor | Current spouse or partner of the debtor |
|---|---|---|
| Taxes | ||
| Insurance premiums, mandatory social security and professional contributions | ||
| Rent/cost of co-ownership, mortgage payments | ||
| Food and clothing | ||
| Medical expenses | ||
| Maintenance paid to a third party by virtue of a legal obligation and/or expenditure for other dependent persons not covered by the application | ||
| Education costs of children | ||
| Loan repayments, other debts | ||
| Other expenditure | ||
| TOTAL |
11.3.3. Other assets U.K.
…
…
…
12. INFORMATION REGARDING PAYMENT, IF THE APPLICATION IS MADE BY THE CREDITOR U.K.
12.1. Payment by electronic means U.K.
12.1.1. Name of bank: … U.K.
12.1.2. BIC or other relevant bank code: … U.K.
12.1.3. Account holder: … U.K.
12.1.4. International Bank Account Number (IBAN): … U.K.
12.2. Payment by cheque U.K.
12.2.1. Cheque payable to: … U.K.
12.2.2. Cheque to be sent to U.K.
12.2.2.1. Surname and given name(s): … U.K.
12.2.2.2. Address: U.K.
12.2.2.2.1.
Street and number/PO box: …
12.2.2.2.2.
Place and postal code: …
12.2.2.2.3.
Country: …
13. ADDITIONAL INFORMATION (WHERE APPLICABLE): U.K.
…
…
…
Done at: … on … (dd/mm/yyyy)
Applicant’s signature: …
and/or, where appropriate:
Name and signature of the person/authority authorised in the requesting Member State to complete the form on the applicant’s behalf:
…]
(1)
(2)
[F1Tick the relevant boxes and number the documents in the order in which they are attached.]
(3)
[F1The national law of the requested Member State may, however, require the applicant to provide his/her personal address for the purposes of the proceedings (see Article 57(3) of Regulation (EC) No 4/2009).]
(4)
[F1If available.]
(5)
[F1If available.]
(6)
[F1If available.]
(7)
[F1If available.]
(8)
[F1If available.]
(9)
[F1If available.]
(10)
[F1If available.]
(11)
[F1If more than three persons, attach an additional sheet.]
(12)
[F1For example the person with parental responsibility or the guardian of a protected adult.]
(13)
[F1If available and/or relevant.]
(14)
[F1If available and/or relevant.]
(15)
[F1If available and/or relevant.]
(16)
[F1If available and/or relevant.]
(17)
[F1If available and/or relevant.]
(18)
[F1If available and/or relevant.]
(19)
[F1If available and/or relevant.]
(20)
[F1If available and/or relevant.]
(21)
[F1If available and/or relevant.]
(22)
[F1If available and/or relevant.]
(23)
[F1If available and/or relevant.]
(24)
[F1If available and/or relevant.]
(25)
[F1For example the person with parental responsibility or the guardian of a protected adult.]
(26)
[F1If available.]
(27)
[F1If available.]
(28)
[F1If available.]
(29)
[F1If available.]
Textual Amendments
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