Annex B - Application for enforcement of a decision made or recognised in the requested state
| Published date | 21 March 2018 |
| Subject Matter | Family law forms |
Application for Enforcement of a Decision Made or Recognised in the Requested State
(Article 10(1) b))
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
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. Particulars (if known) of the debtor (respondent)
a. Family name(s): ____________________________________
b. Given name(s): ____________________________________
c. Date of birth: ____________________________________ (dd/mm/yyyy)
d. Personal identification number: _______________________
(include name of country or territorial unit that issued the number)
e. Residential address: ____________________________________
____________________________________
f. Postal address: ____________________________________
____________________________________
g. Any other information that may assist with the location of the debtor
________________________________________________________
________________________________________________________
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:3 ________________________________
6. The decision made in the requested State
6.1 Type of authority: judicial authority or administrative authority
6.2 Name and place of authority: _________________________________________________
6.3 (address if applicable) _________________________________________________
_________________________________________________
6.4 Date of the decision: ______________________________ (dd/mm/yyyy)
6.5 Date of effect of the decision: ______________________________ (dd/mm/yyyy)
6.6 Reference number of the decision: ___________________________________________
6.7 Names of the parties: ___________________________________________
___________________________________________
___________________________________________
___________________________________________
7. The following are attached to this application:
Decision made in the requested State
Decision (or registration) made in the requested State to recognise a decision of another State
Decision of the State of origin (other State)
Statement of arrears
Financial Circumstances Form
8. Where the application is for the recovery of maintenance other than maintenance obligations arising from a parent-child relationship towards a person under the age of 21 years, the applicant (creditor) has benefited from legal assistance in the State of origin (Articles 17 and 25(1) f))
9. Other information: __________________________________________________________
___________________________________________________________________________
10. Attestations
This application was completed by the applicant and reviewed by the requesting Central Authority
This application complies with the requirement of the Convention (Article...
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