Anexo III - Extracto de un Documento Público con Fuerza Ejecutiva en Materia de Obligación de Alimentos No Sometido a un Procedimiento de Reconocimiento y Declaración de Exequátur

Date19 October 2016
ANNEX III
EXTRACT FROM AN AUTHENTIC INSTRUMENT IN MATTERS RELATING TO MAINTENANCE OBLIGATIONS NOT SUBJECT TO
PROCEEDINGS FOR RECOGNITION OR A DECLARATION OF ENFORCEABILITY
(Article 48 of Council Regulation (EC) No 4/2009 of 18 December 2008 on jurisdiction, applicable law, recognition and enforcement of
decisions and cooperation in matters relating to maintenance obligations (1))
IMPORTANT
To be issued by the competent authority in the Member State of origin
To be issued only if the authentic instrument is enforceable in the Member State of origin
Mention only information which is given in the authentic instrument or of which the competent authority has been made aware
1. Date and reference number of the authentic instrument:
The authentic instrument is recognised and enforceable in another Member State without any possibility of opposing its recognition
and without the need for a declaration of enforceability (Article 48 of Regulation (EC) No 4/2009).
2. Nature of the authentic instrument
2.1. Instrument formally drawn up or registered on:
(dd/mm/yyyy)
Agreement concluded or authenticated on:
(dd/mm/yyyy)
2.2. Competent authority:
2.2.1. Name:
2.2.2. Address:
2.2.2.1. Street and number/PO box:
2.2.2.2. Place and postal code:
2.2.2.3. Member State
Belgium Bulgaria Czechia
Germany Estonia Ireland
Greece Spain France
Croatia Italy Cyprus
Latvia Lithuania Luxembourg
Hungary Malta Netherlands
Austria Poland Portugal
Romania Slovenia Slovakia
Finland Sweden
2.2.3. Telephone/Fax/E-mail:
3. Creditor(s) (*)
3.1. Person A
3.1.1. Surname and given name(s):
3.1.2. Date (dd/mm/yyyy) and place of birth:
1 9Generated by the European e-Justice Portal
(1) OJ L 7, 10.1.2009, p. 1.
(*) If the authentic instrument concerns more than three creditors or three debtors, attach an additional sheet.

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