Annex IV - Certificate concerning Decisions Ordering the Return of a Child to Another Member State Pursuant to the 1980 Hague Convention (1) and Any Provisional, Including Protective, Measures Taken in Accordance with Article 27(5) of the Regulation Accompanying Them

• Date: 26 December 2022

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ANNEX IV

CERTIFICATE CONCERNING DECISIONS ORDERING THE RETURN OF A CHILD TO ANOTHER MEMBER STATE PURSUANT TO THE

1980 HAGUE CONVENTION(1) AND ANY PROVISIONAL, INCLUDING PROTECTIVE, MEASURES TAKEN IN ACCORDANCE WITH

ARTICLE 27(5) OF THE REGULATION ACCOMPANYING THEM

(Point (c) of Article 36(1) of Council Regulation (EU) 2019/1111(2))

IMPORTANT

To be issued, upon application by a party, by the court of a Member State of origin of a return decision as communicated to

the Commission pursuant to Article 103 of the Regulation, where the return decision needs to be enforced in another

Member State due to a further abduction of the child(ren) after return was ordered, or where the return decision contains a

provisional, including a protective, measure based on Article 27(5) of the Regulation to protect the child from the grave risk

referred to in point (b) of Article 13(1) of the 1980 Hague Convention.

1. MEMBER STATE OF ORIGIN OF THE DECISION ORDERING THE RETURN OF THE CHILD(REN(3)

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

United Kingdom

2. COURT ISSUING THE CERTIFICATE*

2.1.Name

2.2. Address

2.3. Tel./fax/e-mail*

Tel.

Fax

...