Certificate Issued in Accordance with Article 5

Date01 November 2022
FORM I
Certificado expedido de conformidad con el artículo 5 del Reglamento (UE) no 606/2013 del Parlamento Europeo y del
Consejo, relativo al reconocimiento mutuo de medidas de protección en materia civil (1)
1. Fecha en que se dictó la medida de protección (dd/mm/aaaa):
2. La medida de protección es ejecutoria desde (en caso de que la fecha sea diferente) [optativo] (dd/mm/aaaa):
3. Número de referencia de la medida de protección [optativo]:
4. Autoridad que dictó la medida de protección si es diferente de la autoridad que expide el certificado [optativo]
4.1. Denominación oficial:
4.2. Dirección completa
4.2.1. Calle y número/apartado de correos:
4.2.2. Ciudad:
4.2.3. Código postal:
4.2.4. Estado miembro:
BE BGCZDEEEELES FRHR IT
CYIELVLTLUHU MTNLATPL
PTRO SISKFISE UK
Otro:
4.3. Teléfono:
4.4. Fax [optativo]:
4.5. Dirección electrónica [optativo]:
4.6. Persona de contacto [optativo]
4.6.1. Nombre y apellido(s):
5. Fecha de expedición del certificado (dd/mm/aaaa):
6. Número de referencia del certificado:
7. Autoridad que expide el certificado
7.1. Denominación oficial
7.2. Dirección completa
7.2.1. Calle y número/apartado de correos:
7.2.2. Ciudad:
7.2.3. Código postal:
1 6Generated by the European e-Justice Portal

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