Date of receipt (DD/MM/YYYY) …
[to be completed by the Commission]
Number of pages (included this one) …
Language of the application …
File number …
[to be completed by the Commission]
Competent authority of the Member State (*)
Competent authority of the third country (*)
Representative professional organisation (*)
[(*) to cross out the useless indication]
Address (street number and name, town/city and postal code, country) …
Legal entity (only in case of a representative professional organisation) …
Nationality …
Tel, fax, e-mail …
Traditional term under Article 54(1)(a) of Regulation (EC) No 479/2008 (*)
Traditional term under Article 54(1)(b) of Regulation (EC) No 479/2008 (*)
[(*) to cross out the useless indication]
Article 31(a) (*)
Article 31(b) (*)
[(*) delete as appropriate]
List of protected designations of origin or geographical indications concerned …
Grapevine products categories …
Definition …
Copy of the rules
[to be attached]
Name of the signatory …
Signature …