HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"L 302/16
EN
Official Journal of the European Union
19.11.2011
COMMISSION IMPLEMENTING REGULATION (EU) No 1189/2011
of 18 November 2011
laying down detailed rules in relation to certain provisions of Council Directive 2010/24/EU
concerning mutual assistance for the recovery of claims relating to taxes, duties and other measures
THE EUROPEAN COMMISSION,
(6)
In order to ensure legal certainty, it is appropriate to
state expressly the legal effect of the notifications made
by the requested Member State at the request of the
applicant Member State.
Having regard to the Treaty on the Functioning of the European
Union,
(7) In
order
to
ensure
legal
certainty,
it
is
also
appropriate
to
specify that the notification or communication of the
Having regard to Council Directive 2010/24/EU of 16 March
uniform instrument permitting enforcement in the
2010 concerning mutual assistance for the recovery of claims
requested Member State does not have any effect on
relating to taxes, duties and other measures (
the consequences of the notification of the initial

1 ), and in particular
Article 26 thereof,
instrument permitting enforcement, and that the revised
instrument permitting enforcement in the requested
Member State does not have any effect on the initial
claim or the initial instrument permitting enforcement.
Whereas:
(8) Commission
Regulation
(EC)
No
1179/2008 of
28 November 2008 laying down detailed rules for imple
(1)
Directive 2010/24/EU has substantially changed the rules
menting certain provisions of Council Directive
concerning mutual assistance for the recovery of claims
2008/55/EC on mutual assistance for the recovery of
relating to taxes, duties and other measures and newly
claims relating to certain levies, duties, taxes and other
determined the implementing powers of the
measures ( 3 ) should be repealed.
Commission, in relation to those laid down in Council
Directive 2008/55/EC ( 2 ). Therefore, it is appropriate to
replace the existing implementing rules adopted by the
Commission by a new implementing Regulation.
(9) The
measures
provided
for
in
this
Regulation
are
in
accordance with the opinion of the Recovery Committee,
(2) In
order
to
ensure
a
fast
communication
between
the HAS ADOPTED THIS REGULATION:
competent authorities, detailed rules should be adopted
with regard to the practical arrangements and the time
periods for communication between the requested and
the applicant authorities.
CHAPTER I
GENERAL PROVISIONS
Article 1
(3) In
order
to
ensure
legal
certainty,
it
is
appropriate
to
specify that the validity of documents is not affected
This Regulation lays down the detailed rules for implementing
by the fact that they are transmitted electronically.
Article 5(1), Articles 8, 10, 12(1), Article 13(2), (3), (4) and (5),
Articles 15, 16(1) and 21(1) of Directive 2010/24/EU, including
the detailed rules on conversion, transfer of sums recovered, as
well as the means by which communications between
(4) In
order
to
confirm
that
documents
transmitted
by
post authorities may be transmitted.
are sent by a competent authority, it is appropriate to
provide specific rules with regard to this way of
communication.
Article 2
1. All
requests
for
information,
notification,
recovery
or
precautionary measures pursuant to Articles 5(1), 8, 10 and
(5)
In order to ensure that appropriate data and information
16(1) of Directive 2010/24/EU (hereinafter ‘the requests for
are transmitted, models of the standard form accom
assistance’) and all accompanying instruments, forms and
panying the request for notification and of the
other documents, as well as any other information
instrument permitting enforcement in the requested
communicated with regard to these requests shall be sent by
Member State should be established.
the CCN network, unless this is impracticable for technical
reasons.
( 1 ) OJ L 84, 31.3.2010, p. 1.
( 2 ) OJ L 150, 10.6.2008, p. 28.
( 3 ) OJ L 319, 29.11.2008, p. 21.

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2. Documents
transmitted
in
electronic
form
or
print
outs
relating to these taxes, duties and other measures under the
thereof shall be deemed to have the same legal effect as
law in force in the Member State in which the applicant
documents transmitted by post.
authority is situated;
3. If a request cannot be transmitted by CCN network, it
(c) any third party holding assets belonging to or having debts
shall be transmitted by post. In that case the following rules
towards one of the persons referred to in points (a) or (b).
shall apply:
(a) the request shall be signed by an official of the applicant
Article 4
authority, duly authorised to make such a request;
Information and other particulars communicated by the
requested authority to the applicant authority pursuant to
(b) the standard form accompanying the notification request,
Articles 5(1), 8, 10 and 16(1) of Directive 2010/24/EU shall
referred to in the second subparagraph of Article 8(1) of
be conveyed in the official language or one of the official
Directive 2010/24/EU (hereafter ‘the uniform notification
languages of the Member State of the requested authority or
form’) or the uniform instrument permitting enforcement
in another language agreed between the applicant and requested
in the requested Member State referred to in Article 12 of
authorities.
that Directive shall be signed by a duly authorized official of
the applicant authority;
Article 5
(c) if the request is accompanied by a copy of a document
If the requested authority refuses to handle a request for
other than the uniform notification form or the uniform
assistance, it shall notify the applicant authority of the
instrument permitting enforcement in the requested
reasons for its refusal, specifying the provisions of Directive
Member State, the applicant authority shall certify the
2010/24/EU on which it relies. Such notification shall be
conformity of this copy with the original, by stating in
given by the requested authority as soon as it has taken its
this copy, in the official language or one of the official
decision and in any event within 1 month of the date of the
languages of the Member State in which it is situated, the
acknowledgement of the receipt of the request.
words ‘certified a true copy’, the name of the certifying
official and the date of that certification.
Article 6
For the purposes of point (b) of the first subparagraph, the
Each request for information or for recovery or precautionary
Member States shall use the uniform notification form estab
measures shall indicate whether a similar request has been
lished in accordance with the model set out in Annex I to this
addressed to any other authority.
Regulation and the uniform instrument permitting enforcement
in the requested Member State established in accordance with
the model set out in Annex II to this Regulation.
CHAPTER II
REQUESTS FOR INFORMATION
4. Where
the
uniform
notification
form
or
the
uniform
Article 7
instrument permitting enforcement in the requested Member
State are transmitted by electronic means, their structure and
The requested authority shall acknowledge receipt of the request
lay-out may be adapted to the requirements of the electronic
for information as soon as possible and in any event within
communication system in order to facilitate the communication
seven calendar days of such receipt.
between the competent authorities, provided that the set of data
and information therein is not substantially altered with regard
to the models set out in Annexes I and II.
Upon receipt of the request the requested authority shall, where
appropriate, ask the applicant authority to provide any addi
tional information necessary. The applicant authority shall
Article 3
provide all additional necessary information to which it
1. The
applicant
authority
may
make
a
request
for
assistance normally has access.
in respect of either a single claim or several claims where those
are recoverable from one and the same person.
Article 8
2. A request for information, recovery or precautionary
1. The
requested
authority
shall
transmit
each
item
of
measures may relate to any of the following persons:
requested information to the applicant authority as and when
it is obtained.
(a) the principal debtor or a co-debtor;
2. Where,
with
respect
to
the
particularity
of
a
case,
all
or
some of the requested information cannot be obtained within a
(b) a person other than a (co-)debtor, liable for settlement of
reasonable time the requested authority shall inform the
the taxes, duties and other measures, or for other claims
applicant authority thereof and state the reasons.

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In any event, at the end of 6 months from the date of acknowl
Article 12
edgement of receipt of the request, the requested authority shall
inform the applicant authority of the outcome of the investi
1. The
requested
authority
shall
acknowledge
receipt
of
the
gations which it has conducted in order to obtain the
request for notification as soon as possible and in any event
information requested.
within seven calendar days of such receipt.
Upon receipt of the request for notification, the requested
On the basis of the information received from the requested
authority shall take the necessary measures to effect notification
authority, the applicant authority may request the requested
in accordance with the law in force in the Member State in
authority to continue its investigation. That request shall be
which it is situated.
made within 2 months of the receipt of the notification of
the outcome of the investigations carried out by the requested
authority, and shall be treated by the requested authority in
accordance with the provisions applying to the initial request.
If necessary, without prejudice to the final date for notification
indicated in the request for notification, the requested authority
shall ask the applicant authority to provide additional
information.
Article 9
The applicant authority may, at any time, withdraw the request
for information which it has sent to the requested authority.
The applicant authority shall provide all additional information
The decision to withdraw shall be transmitted to the requested
to which it normally has access.
authority.
2. The
requested
authority
shall
inform
the
applicant
authority of the date of notification as soon as this has been
CHAPTER III
effected, by certifying the notification in the request form
REQUESTS FOR NOTIFICATION
returned to the applicant authority.
Article 10
1. Any
request
for
notification
shall
include
the
original
or
a
Article 13
certified copy of each document, notification of which is
1. A
notification
made
by
the
requested
Member
State
in
requested.
accordance with the national laws, regulations and adminis
trative practices in force in that State, shall be deemed to
have the same effect in the applicant Member State as if it
The uniform notification form accompanying the request
had been made by the applicant Member State itself in
pursuant to the second subparagraph of Article 8(1) of
accordance with the national laws, regulations and adminis
Directive 2010/24/EU shall be completed by or under the
trative practices in force in the applicant Member State.
responsibility of the applicant authority. It shall provide
information to the addressee with regard to the documents
for which notification assistance has been requested.
2. A
notification
of
a
document
relating
to
more
than
one
type of tax, duty or other measure, shall be deemed valid if it is
made by an authority of the requested Member State which is
competent for at least one of the taxes, duties or other measures
2. With
regard
to
the
information
mentioned
in
the
uniform mentioned in the notified document, provided that it is allowed
notification form, the following shall apply:
under the national law of the requested Member State.
(a) the amount of the claim shall be mentioned where already
Article 14
established;
For the purposes of notification, the requested Member State
may use the uniform notification form, referred to in
Article 10(1) in its official language or in one of its official
(b) the indication of the period within which notification is to
languages in accordance with its national law.
be effected may be done by an indication of the date before
which the applicant authority intends the notification to
take place.
CHAPTER IV
REQUESTS FOR RECOVERY OR FOR PRECAUTIONARY
MEASURES
Article 11
Article 15
The request for notification may relate to any person referred to
in Article 3(c) of Directive 2010/24/EU who, in accordance
Requests for recovery or for precautionary measures shall
with the law in force in the applicant Member State, is
include a declaration that the conditions laid down in
required to be informed of any document which concerns
Directive 2010/24/EU for initiating the mutual assistance
that person.
procedure have been fulfilled.

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Article 16
Article 19
1. The
uniform
instrument
permitting
enforcement
in
the
1. The requested authority shall, as soon as possible or in
requested Member State accompanying the request for
any event within seven calendar days of receipt of the request
recovery or for precautionary measures shall be completed by
for recovery or for precautionary measures, acknowledge the
or under the responsibility of the applicant authority, on the
receipt of the request.
basis of the initial instrument permitting enforcement in the
applicant Member State.
2. The
requested
authority
may
ask
the
applicant
authority
to
provide additional information or to complete the uniform
The administrative penalties, fines, fees and surcharges referred
instrument permitting enforcement in the requested Member
to in Article 2(2)(a) of Directive 2010/24/EU and the interest
State, if required. The applicant authority shall provide all addi
and costs referred to in Article 2(2)(c) of that Directive which,
tional necessary information to which it normally has access.
in accordance with the rules in force in the applicant Member
State, may be due from the date of the initial instrument
permitting enforcement until the date before the date on
which the recovery request is sent, may be added in the
Article 20
uniform instrument permitting enforcement in the requested
1. Where,
with
respect
to
the
particularity
of
a
case,
all
or
Member State.
part of the claim cannot be recovered or precautionary
measures cannot be taken within a reasonable time, the
requested authority shall inform the applicant authority
2. A
single
uniform
instrument
permitting
enforcement
in thereof and state the reasons.
the requested Member State may be issued in respect of
several claims and several persons, corresponding to the initial
instrument permitting enforcement in the applicant Member
State.
On the basis of the information received from the requested
authority, the applicant authority may request the latter to re-
open the procedure for recovery or for precautionary measures.
3. In
so
far
as
initial
instruments
permitting
enforcement
for That request shall be made within 2 months of the receipt of
several claims in the applicant Member State have already been
the notification of the outcome of that procedure, and shall be
replaced by a global instrument permitting enforcement for all
treated by the requested authority in accordance with the
these claims in that Member State, the uniform instrument
provisions applying to the initial request.
permitting enforcement in the requested Member State may
be based on the initial instruments permitting enforcement in
the applicant Member State or on that global instrument
2. No
later
than
at
the
end
of
each
six-month
period
regrouping those initial instruments in the applicant Member
following the date of acknowledgement of the receipt of the
State.
request, the requested authority shall inform the applicant
authority of the state of progress or the outcome of the
procedure for recovery or for precautionary measures.
4. In
order
to
enforce
the
claims
for
which
recovery
assistance is requested, the requested Member State may use
the uniform instrument permitting enforcement in that
Member State in its official language or in one of its official
Article 21
languages in accordance with its national law.
1. Any
action
contesting
the
claim
or
the
instrument
permitting its enforcement which is taken in the Member
State of the applicant authority shall be notified to the
Article 17
requested authority by the applicant authority immediately
The addressee of a request for recovery or precautionary
after the applicant authority has been informed of such action.
measures may not rely on the notification or communication
of the uniform instrument permitting enforcement in the
requested Member State to claim a prolongation or a re-
2. If
the
laws,
regulations
and
administrative
practices
in
opening of the time period to contest the claim or the initial
force in the requested Member State do not permit
instrument permitting enforcement if that has been validly
precautionary measures or the recovery requested under the
notified.
second and third subparagraphs of Article 14(4) of Directive
2010/24/EU, the requested authority shall notify the applicant
authority thereof as soon as possible and in any event within
Article 18
1 month of the receipt of the notification referred to in
1. If the currency of the requested Member State is different
paragraph 1.
from the currency of the applicant Member State, the applicant
authority shall express the amount of the claim to be recovered
in both currencies.
3. The
requested
authority
shall
notify
any
action
taken
in
the requested Member State for reimbursement of sums
recovered or for compensation in relation to recovery of
2. The
exchange
rate
to
be
used
for
the
purposes
of
the contested claims under the third subparagraph of
recovery assistance shall be the last exchange rate published
Article 14(4) of Directive 2010/24/EU to the applicant
in the Official Journal of the European Union before the date the
authority immediately after the requested authority has been
request is sent.
informed of such action.

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The requested authority shall as far as possible involve the
tional request with the initial request is not possible, the
applicant authority in the procedures for settling the amount
requested authority shall comply with the additional request
to be reimbursed and the compensation due. Upon a reasoned
only if it concerns an amount not less than that referred to
request from the requested authority, the applicant authority
in Article 18(3) of Directive 2010/24/EU.
shall transfer the sums reimbursed and the compensation paid
within 2 months of the receipt of that request.
6. In order to convert the amount of the claim resulting
from the adjustment referred to in paragraph 2 into the
Article 22
currency of the Member State of the requested authority, the
applicant authority shall use the exchange rate used in its initial
1. If the request for recovery or for precautionary measures
request.
becomes devoid of purpose as a result of payment of the claim
or of its cancellation or for any other reason, the applicant
authority shall immediately inform the requested authority so
Article 23
that the latter may stop any action which it has undertaken.
1. The amounts that have to be remitted to the applicant
authority, in accordance with Article 13(5) of Directive
2010/24/EU, shall be transferred to the applicant authority in
2.
Where the amount of the claim which is the subject of the
the currency of the requested Member State.
request for recovery or for precautionary measures is adjusted
by a decision of the competent body referred to in Article 14(1)
of Directive 2010/24/EU, the applicant authority shall inform
The transfer of the recovered amounts shall take place within 2
the requested authority of that decision and, if recovery is
months of the date on which recovery was effected.
requested, communicate a revised uniform instrument
permitting enforcement in the requested Member State. This
revised uniform instrument permitting enforcement in the
However, if recovery measures applied by the requested
requested Member State shall be made by or under the respon
authority are contested for a reason not falling within the
sibility of the applicant authority, on the basis of the decision
responsibility of the applicant Member State, the requested
adjusting the amount of the claim.
authority may wait to transfer any sums recovered in relation
to the applicant Member State’s claim, until the dispute is
settled, if the following conditions are simultaneously fulfilled:
3. A
revised
uniform
instrument
permitting
enforcement
in
the requested Member State does not have any consequences
with regard to the possibilities to contest the initial claim, the
(a) the requested authority finds it likely that the outcome of
initial instrument permitting enforcement in the applicant
this contestation will be favorable to the party concerned,
Member State or the decision referred to in the preceding
and
subparagraph.
(b) the applicant authority has not declared that it will
4. If
the
adjustment
referred
to
in
paragraph
2
entails
a
reimburse the sums already transferred if the outcome of
reduction in the amount of the claim, the requested authority
that contestation is favorable to the party concerned.
shall continue its action to take recovery or precautionary
measures, but that action shall be limited to the amount still
outstanding.
If the applicant authority has made a declaration to reimburse
in accordance with point (b) of the third subparagraph, it shall
return the recovered amounts already transferred by the
requested authority within 1 month of the receipt of the
If, at the time when the requested authority is informed of the
request for reimbursement. Any other compensation due shall,
reduction in the amount of the claim, an amount exceeding the
in that case, be borne solely by the requested authority.
amount still outstanding has already been recovered by it but
the transfer procedure referred to in Article 23 has not yet been
initiated, the requested authority shall repay the amount
2. The
competent
authorities
of
the
Member
States
may
overpaid to the person entitled thereto.
agree on different arrangements for the transfer of amounts
below the threshold applied in accordance with Article 18(3)
of Directive 2010/24/EU.
5. If
the
adjustment
referred
to
in
paragraph
2
entails
an
increase in the amount of the claim, the applicant authority
may address to the requested authority an additional request
Article 24
for recovery or for precautionary measures.
Regardless of any amounts collected by the requested authority
by way of the interest referred to in Article 13(4) of Directive
2010/24/EU, a claim shall be deemed recovered in proportion
That additional request shall, as far as possible, be dealt with by
to the recovery of the amount expressed in the national
the requested authority at the same time as the initial request
currency of the Member State of the requested authority, on
from the applicant authority. Where, in view of the state of
the basis of the exchange rate referred to in Article 18(2) of this
progress of the existing procedure, consolidation of the addi
Regulation.

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CHAPTER V
FINAL PROVISIONS
Article 25
Regulation (EC) No 1179/2008 is hereby repealed.
Article 26
This Regulation shall enter into force the 20th day following its publication in the Official Journal of the
European Union.
It shall apply from 1 January 2012.
This Regulation shall be binding in its entirety and directly applicable in all Member States.
Done at Brussels, 18 November 2011.
For the Commission
The President
José Manuel BARROSO

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ANNEX I
Uniform notification form providing information about notified document(s) (to be transmitted to the addressee
of the notification) ( 1 )
This document, accompanies document(s) hereby notified by the competent authority of [name of requested Member
State].
This notification concerns documents of the competent authorities of [name of applicant Member State], which asked for
notification assistance, in accordance with Article 8 of Council Directive 2010/24/EU of 16 March 2010.
A. IDENTIFICATION OF THE ADDRESSEE OF THE NOTIFICATION
1. Name:
2. Address:
3. Date of birth:
4. Place of birth:
B. PURPOSE OF THE NOTIFICATION
1. This notification is intended:
to inform the addressee, about the document(s) to which this information document is attached,
to interrupt the period of limitation with regard to the claim(s) mentioned in the notified document(s),
to confirm the addressee, about his/her obligation to pay the amounts mentioned under point C,
Please note that in case of non-payment, the authorities may take enforcement and/or precautionary measures to
ensure the recovery of the claim(s). This may cause extra costs charged to the addressee.
You are the addressee of this notification, as you are considered to be:
the principal debtor,
a co-debtor,
a person other than the (co-)debtor, liable for settlement of the taxes, duties and other measures, or for other
claims relating to these taxes, duties and other measures, under the laws in force in the applicant State,
a person other than the (co-)debtor, holding assets belonging to, or having debts towards, the (co-)debtor or to
any other person liable,
a third party which may become affected by enforcement measures concerning other persons,
(The following information will appear if the addressee of the notification is a person other than the (co-)debtor, holding assets
belonging to, or having debts towards, the (co-)debtor or to any other person liable, or a third party which may become affected by
enforcement measures concerning other persons: the notified documents concern claims relating to taxes and duties, for which the
following person(s) is (are) liable: [name and address (known or assumed)]).
2. The applicant authority of [name of the applicant Member State] invited the competent authorities of [name of the
requested Member State] to make this notification before [date]. Please note that this date is not specifically related to
any period of limitation.
C. DESCRIPTION OF THE NOTIFIED DOCUMENT(S)
1. Reference number:
Date of establishment:
( 1 ) The elements put in Italic are optional.

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2. Nature of the notified document:
Tax assessment,
Payment order,
Decision following an administrative appeal,
Other administrative document:
Judgment/order of:
Other judicial document,
3. Name of the claim concerned (in the language of the applicant Member State):
4. Nature of the claim:
a) customs duties,
b) value added tax,
c) excise duties,
d) tax on income or capital,
e) tax on insurance premiums,
f) inheritance and gift taxes,
g) national taxes and duties on immovable property, other than the above-mentioned ones,
h) national taxes and duties on the use or ownership of means of transport,
i) other taxes and duties levied by or on behalf of the applicant State,
j) taxes and duties levied by or on behalf of territorial or administrative subdivisions of the applicant State,
excluding taxes and duties levied by local authorities,
k) taxes and duties levied by or on behalf of local authorities,
l) other tax-based claim,
m) refunds, interventions and other measures forming part of the system of total or partial financing of the
European Agricultural Guarantee Fund (EAGF) and the European Agricultural Fund for Rural Development
(EAFRD), including sums to be collected in connection with these actions, and levies and other duties
provided for under the common organisation of the market for the sugar sector
5. Amount of the claim concerned, in the currency of [Name of the applicant Member State]:
Principal amount:
Administrative penalties and fines:
Interest up to [date]:
Costs up to [date]:
Fees for certificates and similar documents issued in connection with administrative procedures related to the claim mentioned
under point 3:
Total amount for this claim:
6. The amount mentioned under point 5 should be paid:
before:

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within [number] calendar days following the date of this notification,
without any further delay,
This payment should be made to:
Reference to be used for the payment:
7. You can reply to the document(s) that are hereby notified.
Last day for replying:
Time period for replying:
Name and address of the authority to whom a reply can be sent:
8. Contestation possibility
The period for contestation of the claim or the notified document(s) has already come to its end,
Last day for contestation:
Time period for contestation:
Name and address of the authority where a contestation has to be submitted:
Please note that disputes concerning the claim, the instrument permitting enforcement or any other document originating from the
authorities of [name of applicant Member State], fall within the competence of the competent bodies of [name of applicant
Member State], in accordance with Article 14 of Council Directive 2010/24/EU.
Any such dispute is governed by the procedural and language rules applying in [name of applicant Member State].
Please note that the recovery may begin before the end of the contestation period.
9. Office responsible with regard to the attached document(s)
Name,
Address,
Telephone,
E-mail,
Language in which this office can be contacted,
10. Further information about:
the notified document(s)
and/or the possibility to contest the obligations
can be obtained from:
the office responsible with regard to the attached document(s), mentioned under point C.9.
the following office:

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ANNEX II
Uniform instrument permitting enforcement in the requested Member State ( 1 )
UNIFORM INSTRUMENT PERMITTING ENFORCEMENT OF CLAIMS COVERED BY COUNCIL DIRECTIVE
2010/24/EU
Date of issue:
REVISED UNIFORM INSTRUMENT PERMITTING ENFORCEMENT OF CLAIMS COVERED BY COUNCIL DIRECTIVE
2010/24/EU
Date of issue of the original uniform instrument:
Date of revision:
Reason for the revision: judgment/order of [name of the Court] administrative decision of [date]
Reference number:
EU Member State where this document is issued:
Each EU Member State can request recovery assistance from other Member States for unpaid claims referred to in
Article 2 of Council Directive 2010/24/EU of 16 March 2010.
Recovery measures taken by the requested Member State are based on:
a uniform instrument permitting enforcement, in accordance with Article 12 of this Directive,
a revised uniform instrument permitting enforcement, in accordance with Article 15 of this Directive (to take account
of the decision of the competent body referred to in Article 14(1) of this Directive),
This document is the [revised] uniform instrument permitting enforcement. It concerns the claim(s) mentioned below,
which remain(s) unpaid in [name of applicant Member State].The initial instrument for the enforcement of this/these
claim(s) has been notified in so far as required under the national law of [name of applicant Member State].
Disputes concerning the claim(s) fall exclusively within the competence of the competent bodies of [name of applicant
Member State], in accordance with Article 14 of Directive 2010/24/EU. Any such action must be brought before them in
accordance with the procedural and language rules in force in [name of applicant Member State].
DESCRIPTION OF THE CLAIM(S) AND THE PERSON(S) CONCERNED
IDENTIFICATION OF THE CLAIM
1. Reference:
2. Nature of the claim:
a) customs duties,
b) value added tax,
c) excise duties,
d) tax on income or capital,
e) tax on insurance premiums,
( 1 ) The elements put in Italic are optional.

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f) inheritance and gift taxes,
g) national taxes and duties on immovable property, other than the above-mentioned ones,
h) national taxes and duties on the use or ownership of means of transport,
i) other taxes and duties levied by or on behalf of the (applicant) State,
j) taxes and duties levied by or on behalf of territorial or administrative subdivisions of the (applicant) State,
excluding taxes and duties levied by local authorities,
k) taxes and duties levied by or on behalf of local authorities,
l) other tax-based claim,
m) refunds, interventions and other measures forming part of the system of total or partial financing of the
European Agricultural Guarantee Fund (EAGF) and the European Agricultural Fund for Rural Development
(EAFRD), including sums to be collected in connection with these actions, and levies and other duties
provided for under the common organisation of the market for the sugar sector
3. Name of the tax/duty concerned:
4. Period or date concerned:
5. Date establishment of the claim:
6. Date on which enforcement becomes possible:
7. Amount of the claim (initially due – still due):
principal amount:
administrative penalties and fines:
interest till date before the day the request is sent:
costs till date before the day the request is sent:
fees for certificates and similar documents issued in connection with administrative procedures related to the
tax/duty concerned:
total amount of this claim:
8. Date of notification of the initial instrument permitting enforcement in [name of the applicant State]
9. Office responsible for the assessment of the claim: name, address and other contact details:
10. Further information concerning the claim or the possibilities for contesting the payment obligation can be obtained
from:
the office responsible for the assessment of the claim, mentioned under point 9,
the office responsible for the Uniform instrument permitting enforcement: name, address and other contact
details,

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IDENTIFICATION OF THE PERSON(S) CONCERNED IN THE NATIONAL INSTRUMENT(S) PERMITTING
ENFORCEMENT
1. Name
2. Address
3. Cause of liability:
principal debtor,
co-debtor,
a person other than the (co-)debtor, liable for settlement of the taxes, duties and other measures, or for other
claims relating to these taxes, duties and other measures,

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