xmlns:atom="http://www.w3.org/2005/Atom"

ANNEX IVAPPLICATION FOR AMENDMENT TO A DESIGNATION OF ORIGIN OR GEOGRAPHICAL INDICATION

Date of receipt (DD/MM/YYYY) …

[to be completed by the Commission]

Number of pages (including this page) …

Language of amendment …

File number …

[to be completed by the Commission]

Intermediary

[(*) delete as appropriate]

Name(s) of intermediary(ies) …

Full address(es) (street number and name, town/city and postal code, country)

Tel, fax, e-mail …

Name …

[(*) delete as appropriate]

Specification heading affected by the amendment

Protected name (*)

Description of product (*)

Oenological practices used (*)

Geographical area (*)

Yield per hectare (*)

Wine grape varieties used (*)

Link (*)

Names and addresses of control authorities (*)

Other (*)

[(*) delete as appropriate]

Amendment

Explanation of the amendment

Amended single document

[on separate sheet]

Name of signatory …

Signature …