ANNEX VI

9. Defendant

9.1. Surname and given name(s): …

9.2. Date (dd/mm/yyyy) and place of birth(1): …

9.3. Identity number or social security number(1): …

9.4. Nationality(1): …

9.5. Profession(1): …

9.6. Marital status(1): …

9.7.

Address(1):

9.7.1. Street and number/PO box: …

9.7.2. Place and postal code: …

9.7.3. Member State

 Belgium  Bulgaria  Czech Republic  Germany  Estonia  Ireland  Greece  Spain France  Italy  Cyprus  Latvia  Lithuania  Luxembourg  Hungary  Malta  Netherlands  Austria  Poland  Portugal  Romania  Slovenia  Slovakia  Finland  Sweden

(1)

If this information is available.