Circuit Court Forms

FORM 19A

O. 35A, r. 3(1)

[Title as in the proceedings]

I, AB, ……………… of …………………. , the (plaintiff or state other capacity) in the above-entitled proceedings, aged eighteen years and upwards MAKE OATH and say as follows:

1. [State deponent’s authority]. I make this affidavit from facts within my own knowledge save where otherwise appears and where so otherwise appears, I believe the same to be true.

2. I beg to refer to the proceedings had herein and to the [judgment given/order made] on the ….. day of ………….. 20….. where [judgment was given for the plaintiff / the defendant was ordered to pay the plaintiff] the sum of € ….. . I say that the said [judgment/order] amounts to a judgment on an uncontested claim, within the meaning of Regulation (EC) No 805/2004

3. The claim herein was for payment of a specific sum of money which had fallen due and that the claim was uncontested within the meaning of Article 3 of Regulation (EC) No 805/2004 because:

[state which of the circumstances set out in Article 3 applies]

4. The [judgment / order] may be certified as a European Enforcement Order under Article 6 of Regulation (EC) No 805/2004 because:

*each of the conditions set out in paragraphs (a), (b), (c) and (where appropriate) (d) of paragraph 1 of Article 6 of the said Regulation is met in respect of the [judgment / order] or

*(where any of the procedural requirements set out in any one or more of Articles 13 to 17 inclusive of Regulation (EC) No 805/2004 is not met) *each of the conditions set out in paragraphs (a), (b) and (where appropriate) (d) of paragraph 1 of Article 6 of the said Regulation is met in respect of the [judgment / order] and, [state the basis upon which under Article 18(1) or Article 18(2) of the Regulation any non-compliance was cured]

5. I beg to refer to a completed draft European Enforcement Order certificate in the form in Annex I to Regulation No. 805/2004 upon which marked “A” I have signed my name prior to the swearing hereof and I say that the contents of the said draft certificate as completed are true. I accordingly pray that the [judgment / order] be certified as a European Enforcement Order in accordance with Article 6 of the said Regulation No. 805/2004 in the form of the draft exhibited hereto.

SWORN etc