FORM 40A
CERTIFICATE CONCERNING A JUDGEMENT IN CIVIL AND COMMERCIAL MATTERS
Article 53 of Regulation (EU) No 1215/2012 of the European Parliament and of the Council on jurisdiction and the recognition and enforcement of judgments in civil and commercial matters
1. COURT OF ORIGIN
1.1 Name:
1.2 Address:
1.2.1 Street and number/PO box:
1.2.2 Place and postal code:
1.2.3 Member State:
AT .... BE .... BG .... CY .... CZ .... DK .... DE .... EE .... EL .... ES .... FI .... FR .... HR .... HU ....IE .... IT .... LT .... LU .... LV .... MT .... NL .... PL .... PT .... RO .... SE .... SI .... SK .... UK ....
1.3 Telephone:
1.4 Fax:
1.5 E-mail (if available):
2 CLAIMANT(S) (1)
2.1 Surname and given name(s)/name of company or organisation:
2.2 Identification number (if applicable and if available):
2.3 Date (dd/mm/yyyy) and place of birth or, if legal person, of incorporation/formation/ registration (if relevant and if available):
2.4 Address:
2.4.1 Street and number/PO box:
2.4.2 Place and postal code:
2.4.3 Country:
AT ... BE .... BG .... CY .... CZ .... DK .... DE .... EE .... EL .... ES .... FI .... FR .... HR .... HU ....
IE .... IT .... LT .... LU .... LV .... MT .... NL .... PL .... PT .... RO .... SE .... SI .... SK .... UK ....
Other (Please specify (ISO-code)) ....
2.5 E-mail (if available):
3. DEFENDANT(S) (2)
3.1 Surname and given name(s)/name of company or organisation:
3.2 Identification number (if applicable and if available):
3.3 Date (dd/mm/yyyy) and place of birth or, if legal person, of incorporation/formation/registration (if relevant and if available):
3.4 Address:
3.4.1 Street and number/PO box:
3.4.2 Place and postal code:
3.4.3 Country:
AT .... BE .... BG .... CY .... CZ .... DK .... DE .... EE .... EL .... ES .... FI .... FR .... HR .... HU ....
IE .... IT .... LT .... LU .... LV .... MT .... NL .... PL .... PT .... RO .... SE .... SI .... SK .... UK ....
Other (Please specify (ISO-code)) ....
3.5 E-mail (if available):
4. THE JUDGEMENT
4.1 Date (dd/mm/yyyy) of the judgment:
4.2 Reference number of the judgment:
4.3 The judgment was given in default of appearance
4.3.1 .... No
4.3.2 ....Yes (please indicate the date (dd/mm/yyyy) on which the document instituting the proceedings or an equivalent document was served on the defendant):
4.4 The judgment is enforceable in the Member State of origin without any further conditions having to be met.
4.4.1 .... Yes (please indicate the date (dd/mm/yyyy) on which the judgment was declared enforceable, if applicable):
4.4.2 .... Yes, but only against the following person(s) (please specify):
4.4.3 .... Yes, but limited to part(s) of the judgment (please specify):
4.4.4 The judgment does not contain an enforceable obligation
4.5 As of the date of issue of the certificate, the judgment has been served on the defendant(s):
4.5.1 .... Yes, (please indicate the date of service (dd/mm/yyyy) if known):
4.5.1.1 The judgment was served in the following language(s):
BG .... ES .... CS .... DK .... DE .... ET .... EL .... EN .... FR .... HR .... GA .... IT ....
LV .... LT .... HU .... MT .... NL .... PL .... PT .... RO .... SK .... SL .... FI .... SV ....
Other (Please specify (ISO-code)) ....
4.5.2 .... Not to the knowledge of the Court
4.6 Terms of the judgment and interest:
4.6.1 Judgment on a monetary claim (3)
4.6.1.1 Short description of the subject matter of the case:
4.6.1.2 The court has ordered:
............ (surname and given name(s)/name of company or organisation) (4)
to make a payment to
........... (surname and given name(s)/name of company or organisation)
4.6.1.2.1 If more than one person has been liable for one and the same claim, the whole amount may be collected from any one of them:
4.6.1.2.1.1 .... Yes
4.6.1.2.1.2 .... No
4.6.1.3 Currency:
.... euro (EUR) .... Bulgarian lev (BGN) .... Czech koruna (CZK) .... Danish krone (DKK)
.... kuna (HRK) .... Hungarian forint (HUF) .... Polish zloty (PLN) .... pound sterling (GBP)
.... Romanian leu (RON) .... Swedish krona (SEK) .... Other (please specify ISO code)):
4.6.1.4 Principal Amount:
4.6.1.4.1 Amount to be paid in one sum
4.6.1.4.2 Amount to be paid in instalments (5)
Due date (dd/mm/yyyy) |
Amount |
... |
... |
... |
... |
4.6.1.4.3 .... Amount to be paid regularly
4.6.1.4.3.1 .... per day
4.6.1.4.3.2 .... per week
4.6.1.4.3.3 .... other (state frequency):
4.6.1.4.3.4 From date (dd/mm/yyyy) or event:
4.6.1.4.3.5 If applicable, until (date (dd/mm/yyyy) or event):
4.6.1.5 Interest, if applicable:
4.6.1.5.1 Interest:
4.6.1.5.1.1 .... Not specified in the judgment
4.6.1.5.1.2 .... Yes, specified in the judgment as follows:
4.6.1.5.1.2.1 Amount:
or:
4.6.1.5.1.2.2 Rate ... %
4.6.1.5.1.2.3 Interest due from .......... (date (dd/mm/yyyy) or event) to ......... (date (dd/mm/yyyy) or event) (6)
4.6.1.5.2 .... Statutory Interest (if applicable) to be calculated in accordance with (please specify relevant statute):
4.6.1.5.2.1 Interest due from ............... (date (dd/mm/yyyy) or event) to ............... (date (dd/mm/yyyy) or event) (6)
4.6.1.5.3 .... Capitalisation of interest (if applicable, please specify):
4.6.2 Judgment ordering a provisional, including a protective, measure:
4.6.2.1 Short description of the subject matter of the case and the measure ordered:
4.6.2.2 The measure was ordered by a court having jurisdiction as to the substance of the matter:
4.6.2.2.1 .... Yes
4.6.3 Other type of judgment:
4.6.3.1 Short description of the subject matter of the case and the ruling by the court:
4.7 Costs (7):
4.7.1 Currency:
.... euro (EUR) .... Bulgarian lev (BGN) .... Czech koruna (CZK) .... Danish krone (DKK)
.... kuna (HRK) .... Hungarian forint (HUF) .... Polish zloty (PLN) .... pound sterling (GBP)
.... Romanian leu (RON) .... Swedish krona (SEK) .... Other (please specify ISO code)):
4.7.2 The following persons(s) against whom enforcement is sought has/have been ordered to bear the costs:
4.7.2.1 Surname and given name(s)/name of company or organisation:(8)
4.7.2.2 If more than one person has been ordered to bear the cost, the whole amount may be collected from any one of them:
4.7.2.2.1 .... Yes
4.7.2.2.2 .... No
4.7.3 The costs of which recovery is sought are as follows: (9)
4.7.3.1 .... The costs have been fixed in the judgment by way of a total amount (please specify amount):
4.7.3.2 .... The costs have been fixed in the judgment by way of a percentage of total costs (please specify percentage of total):
4.7.3.3 .... Liability for the costs has been determined in the judgment and the exact amounts are as follows:
4.7.3.3.1 .... Court fees:
4.7.3.3.2 .... Lawyers’ fees:
4.7.3.3.3 .... Cost of service of documents:
4.7.3.3.4 .... Other:
4.7.3.4 .... Other (please specify):
4.7.4 Interest on costs:
4.7.4.1 .... Not applicable
4.7.4.2 .... Interest specified in the judgment
4.7.4.2.1 .... Amount: or
4.7.4.2.2 .... Rate...%
4.7.4.2.2.1 Interest due from ............... (date (dd/mm/yyyy) or event) to ........... (date (dd/mm/yyyy) or event) (6)
4.7.4.3 .... Statutory Interest (if applicable) to be calculated in accordance with (please specify relevant statute):
4.7.4.3.1 Interest due from ............... (date (dd/mm/yyyy) or event) to ............... (date (dd/mm/yyyy) or event) (6)
4.7.4.4 .... Capitalisation of interest (if applicable, please specify):
Done at: ...
Signature and/or stamp of the court of origin
--------------------------------------------
(1) Insert information for all claimants if the judgment concerns more than one.
(2) Insert information for all defendants if the judgment concerns more than one.
(3) If the judgment only concerns costs relating to a claim which has been decided in an earlier judgment, leave point 4.6.1. blank and go to point 4.7.
(4) If more than one person has been ordered to make a payment, insert information for all persons.
(5) Insert information for each instalment.
(6) Insert information for all periods if more than one.
(7) This point also covers situations where the costs are awarded in a separate judgment.
(8) Insert information for all persons if more than one.
(9) In the event that the costs may be recovered from several persons, insert the breakdown for each person separately.
Form 40A originally inserted by SI 882 of 2004 effective 23 December 2004, substituted by SI 597 of 2014, effective 19 December 2014 and re-substituted by S.I. 618 of 2015, effective 30 December 2015.