Annex A - Application for recognition or recognition and enforcement
| Published date | 21 March 2018 |
| Subject Matter | Family law forms |
Application for Recognition
or Recognition and Enforcement
( Article 10(1) a) Article 10(2) a) Article 30)
CONFIDENTIALITY AND PERSONAL DATA PROTECTION NOTICE
Personal data gathered or transmitted under the Convention shall be used only for the purposes for which it was gathered or transmitted. Any authority processing such information shall ensure its confidentiality, in accordance with the law of its State.
An authority shall not disclose or confirm information gathered or transmitted in application of this Convention if it determines that to do so could jeopardise the health, safety or liberty of a person in accordance with Article 40.
A determination of non-disclosure has been made by a Central Authority in accordance with Article 40. If this box is ticked, information under sections 2 d, e, f and g and 5 should only be provided in the Restricted Information on the Applicant page of this form.
1. Requesting Central Authority file reference number:________________________
2. Particulars of the applicant
The applicant is:
The person for whom maintenance is sought or payable
The representative of the person for whom maintenance is sought or payable
The debtor
The representative of the debtor
a. Family name(s): _________________________________________________
b. Given name(s): _________________________________________________
c. Date of birth: [1] _____________________________________ (dd/mm/yyyy)
or
a. Name of the public body: ____________________________________
b. Family name(s) of the contact person: ___________________________________
c. Given name(s) of the contact person: ____________________________________
and
d. Address: _________________________________________________
_________________________________________________
e. Telephone numbers: _________________________________________________
_________________________________________________
f. Fax number: _________________________________________________
g. E-mail: _________________________________________________
3. Particulars of the person(s) for whom maintenance is sought or payable
3.1 Maintenance is sought or payable for the applicant named above
Maintenance basis:
parentage in loco parentis or equivalent relationship
marriage analogous relationship to marriage
affinity (please identify): _________________________________
grandparent sibling grandchild
other: ________________________________________________
3.2 Maintenance is sought or payable for the following child(ren)
a. Family name(s): _____________________________________
Given name(s): _____________________________________
Date of birth _____________________________________ (dd/mm/yyyy)
Maintenance basis:
parentage in loco parentis or equivalent relationship
b. Family name(s): _____________________________________
Given name(s): _____________________________________
Date of birth _____________________________________ (dd/mm/yyyy)
Maintenance basis:
parentage in loco parentis or equivalent relationship
c. Family name(s): _____________________________________
Given name(s): _____________________________________
Date of birth _____________________________________ (dd/mm/yyyy)
Maintenance basis:
parentage in loco parentis or equivalent relationship
3.3 Maintenance is sought or payable for the following person
Family name(s): _____________________________________
Given name(s): _____________________________________
Date of birth _____________________________________ (dd/mm/yyyy)
Maintenance basis:
marriage analogous relationship to marriage
affinity (please identify): _________________________________
grandparent sibling grandchild
other: ________________________________________________
3.4 Maintenance is sought or payable for additional children or persons, additional
particulars are attached
4.1 Particulars (if known) of the debtor
The person is the same as the applicant named above
a. Family name(s): ____________________________________
b. Given name(s): ____________________________________
c. Date of birth: ________________________________ (dd/mm/yyyy)
d. Residential address: ____________________________________
____________________________________
e. Postal address: ____________________________________
____________________________________
4.2 If the debtor is the applicant, particulars (if known and applicable) of the representative of the person(s) for whom maintenance is sought or payable
a. Family name(s): ____________________________________________
b. Given name(s): ____________________________________________
c. Address: ____________________________________________
____________________________________________
d. Telephone numbers: ____________________________________________
____________________________________________
e. Fax number: ____________________________________________
f. E-mail: ____________________________________________
4.3 Information that may assist with the location of the respondent
a. Personal identification number: ____________________________________ (include name of country or territorial unit that issued the number)
b. Any other information that may assist with the location of the respondent
_____________________________________________________________________
5. Payments
a. Details for electronic transfer of payments (if applicable)
Name of the bank: ________________________________
NBIC:[2] ________________________________
SWIFT-address: ________________________________
IBAN:[3] ________________________________
Account number: ________________________________
Name of account holder: ________________________________
Reference: [4] ________________________________
b. Details for payments by cheques (if applicable)
Cheque payable to: ________________________________
Cheque to be sent to: ________________________________
(address) ________________________________
________________________________
Reference:[5] ________________________________
6. This is an application for recognition only; do not initiate enforcement measures
7. Bases for recognition and enforcement (Article 20) (please tick all relevant boxes)
Date of decision: ___________ (dd/mm/yyyy) State of origin: __________________
The respondent was habitually resident in the State of origin at the time
proceedings were instituted;
The respondent has submitted to the jurisdiction either expressly or by
defending on the merits of the case without objecting to the jurisdiction at the
first available opportunity;
The creditor was habitually resident in the State of origin at the time
proceedings were instituted;
The child for whom the maintenance was ordered was habitually resident in
the State of origin at the time proceedings were instituted, provided that the
respondent has lived with the child in that State or has resided in that State
and provided support for the child there;
There has been agreement to the jurisdiction by the parties in writing or
evidenced by writing (except in disputes relating to maintenance obligations
in respect of children);
The maintenance decision was made by an authority exercising jurisdiction on
a matter of personal status or parental responsibility and that jurisdiction was
not based solely on the nationality of one of the parties; or
In a case where the State addressed has made a reservation in accordance
with Article 20(2), there are factual circumstances in...
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