[AD.1.]

Trade and Cooperation Agreement between the European Union and the European Atomic Energy Community, on the one part, and the United Kingdom of Great Britain and Northern Ireland, on the other part, (‘the Trade and Cooperation Agreement (TCA)’) and in particular its Protocol on administrative cooperation and combating fraud in the field of value added tax and on mutual assistance for recovery of claims (‘the Protocol’) (OJ L 149, 30.04.2021, p. 10)

[AD.2.]

Decision No  of the Trade Specialised Committee on Administrative cooperation in VAT and recovery of taxes and duties established by the Trade and Cooperation Agreement between the European Union and the European Atomic Energy Community, on the one part, and the United Kingdom of Great Britain and Northern Ireland,  on the other part, and in particular its Protocol on administrative cooperation and combating fraud in the field of value added tax and on mutual assistance for recovery of claims (‘the Protocol’), of … [date] on standard forms for the communication of information and statistical data, the transmission of information via the CCN network and the practical arrangements for the organisation of contacts between central liaison offices and liaison departments

[AD.3.]

Decision No° of the Trade Specialised Committee on Administrative cooperation in VAT and recovery of taxes and duties established by the Trade and Cooperation Agreement between the European Union and the European Atomic Energy Community, on the one part, and the United Kingdom of Great Britain and Northern Ireland, on the other part of … [date] laying down implementing rules for provisions relating to recovery assistance of the Protocol on administrative cooperation and combating fraud in the field of value added tax and on mutual assistance for recovery of claims

[RD.1.]

CCN/CSI General Security Policy (ITSM Web Portal)

[RD.2.]

CCN/CSI Baseline Security Checklist (ITSM Web Portal)

[RD.3.]

https security recommendations of CCN /Mail III Webmail access – Ref. CCN /Mail III User Guide for NAs

[RD.3.]

Security recommendations of CCN /Mail III Webmail access – Ref. CCN Intranet – Local Network Administrator Guide

ACRONYM

DEFINITION

CCN

Common Communication Network

CET

Central European Time

CIRCABC

Communication and Information Resource Centre Administrator

DG

Directorate General

EoF

Exchange of Forms

ITIL 2

Information Technology Infrastructure Library

ITSM

Information Technology Service Management

VAT

Value Added Tax

EXPRESSION

DEFINITION

CET

Central European Time, GMT+1 and during summertime GMT+2 hours

Party

Within the scope of this SLA, 'Party' shall mean either the United Kingdom or the Commission.

Working days and hours (ITSM service desk)

7:00 to 20:00 (CET), 5 days a week (Monday to Friday including holidays)

PRIORITY

ACKNOWLEDGEMENT TIME

RESOLUTION TIME

P1: Critical

30 m

4 h

P2: High

30 m

13 h (1 day)

P3: Medium

30 m

39 h (3 days)

P4: Low

30 m

65 h (5 days)

CCN/Mail mailbox

Form

VIESCLO

Exchange of Information under Articles PVAT.7, 8, 10, 11, 12 and 16 of the Protocol

General exchanges

VIESCLO

Exchange of Information under Articles PVAT.7, 8, 10, 11, 12 and 16 of the Protocol

Request for notification

TAXFRAUD

Exchange of Information under Articles PVAT.7, 8, 10, 11, 12 and 16 of the Protocol

Anti-fraud exchanges

TAXAUTO

Automatic exchanges

REC-A-CUST;
REC-B-VAT;
REC-C-EXCISE;
REC-D-INCOME-CAP;
REC-E-INSUR;
REC-F-INHERIT-GIFT;
REC-G-NAT-IMMOV;
REC-H-NAT-TRANSP;
REC-I-NAT-OTHER;
REC-J-REGIONAL;
REC-K-LOCAL;
REC-L-OTHER;
REC-M-AGRI

Request for information under Article PVAT.20 of the Protocol

Request for notification under Article PVAT.23 of the Protocol

Request for recovery under Article PVAT.25 of the Protocol

Request for precautionary measures under Article PVAT.31 of the Protocol

A) BASIC INFORMATION

A1

Requesting State:

Requested State:

Requesting authority:

Requested authority:

A2

Official dealing with the request/exchange in the requesting authority:

Official dealing with the reply to the request/exchange in the requested authority:

Name:

Name:

Email:

Email:

Telephone:

Telephone:

Language:

Language:

A3

Requesting authority national reference:

Requested authority national reference:

Space reserved for the requesting authority:

Space reserved for the requested authority:

A4

Date of transmission of the request/exchange:

Date of transmission of the reply:

A5

No of attachments to the request/exchange:

No of attachments to the reply:

A6

A7

○    General request/exchange

□    I, requested authority, will not be able to reply within the following deadlines:

○    Request for information

○    3 months

○    Spontaneous exchange of information

○    1 month for information that is already in my possession

□    Feedback on spontaneous exchange of information is requested

Reason for delay:

○    Anti-fraud request/exchange

○    Request for information

○    Missing Trader Fraud - Registration control/Business activity

○    Spontaneous supply of information

□    Feedback on spontaneous information is requested

□    Expected time of reply:

□    The requested authority of the State authorises the transmission of the information to another State (Article PVAT.6(6) of the Protocol on administrative cooperation and combating fraud in the field of Value Added Tax and on mutual assistance for the recovery of claims relating to taxes and duties)

□    Feedback on the reply is requested

Pursuant to Article PVAT.6(4) of the Protocol on administrative cooperation and combating fraud in the field of Value Added Tax and on mutual assistance for the recovery of claims relating to taxes and duties, the State providing the information shall, on the basis of a reasoned request, permit the use of the information received for purposes other than those referred to in Article PVAT.2(1) of that Protocol.

B) REQUEST FOR GENERAL INFORMATION

Requesting authority

Requested authority

Requested authority 12

B1 VAT identification number (if not, tax identification number)

B1 VAT identification number (if not, tax identification number)

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

VAT number:

VAT number:

VAT number:

□    VAT number not available

□    VAT number not available

□    VAT number not available

Tax identification number:

Tax identification number:

Tax identification number:

B2 Name

B2 Name

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

Name:

B3 Trading name

B3 Trading name

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

Trading name:

B4 Address

B4 Address

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

Address:

B5 The following dates in the format (YYYY/MM/DD):

B5 The following dates in the format (YYYY/MM/DD):

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

(a)    issue of the VAT/tax identification number

(a)    issue of the VAT/tax identification number

(a)    issue of the VAT/tax identification number

(b)    cancellation of the VAT/tax identification number

(b)    cancellation of the VAT/tax identification number

(b)    cancellation of the VAT/tax identification number

(c)    Incorporation

(c)    Incorporation

(c)    Incorporation

B6 Date of commencement of activity

B6 Date of commencement of activity

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

Date of commencement of activity

Date of commencement of activity

B7 Date of cessation of activity

B7 Date of cessation of activity

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

Date of cessation of activity

Date of cessation of activity

B8 Names of the managers/directors

B8 Names of the managers/directors

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

B9 Names of the owners, proprietors, associates, partners, agents, stakeholders or persons having other rights in the business

B9 Names of the owners, proprietors, associates, partners, agents, stakeholders or persons having other rights in the business

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

B10 Nature of the activity

B10 Nature of the activity

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

(a)    Legal status of the business

(a)    Legal status of the business

(a)    Legal status of the business

(b)    Actual principal activity 13

(b)    Actual principal activity

(b)    Actual principal activity

B11 Nature of the transaction

Nature of the transaction

B11 Goods/services involved

○    Please fill in

Nature of the transaction

B11 Goods/services involved

○    Please confirm

○    I confirm    ○    I do not confirm

Period and amount to which the request/exchange relates

B12 Supply of goods from one country to another

From

Period

Period

To

Amount

Amount

Sources:

□    VAT information exchange system (VIES)

□    Other

B13 Supply of services from one country to another

From

Period

Period

To

Amount

Amount

Sources:

□    VIES

□    Other

C) ADDITIONAL INFORMATION

Registration

□    C1 The taxable person in the requested State (□) / the taxable person in the requesting State (□) is currently not identified for VAT purposes.

According to the VIES or other sources, supplies have been made after the date of cessation of the activity. Please explain.

□    C2 The taxable person in the requested State (□) / the taxable person in the requesting State (□) is not identified for VAT purposes.

According to the VIES or other sources, supplies have been made before the date of registration. Please explain.

Transactions of goods/services

Goods

□    C3 According to the VIES or other sources, the taxable person in the requested State made supplies of goods but the taxable person in the requesting State either:

○    did not declare a purchase of the goods;

○    denies receipt of the goods;

○    declared a purchase for a different amount and the declared amount is:

Please investigate and explain.

□    I attach copies of documents in my possession.

□    C4 The purchase declared by the taxable person in the requesting State does not correspond with the information from VIES or other sources. Please investigate and explain.

□    C5 Please provide the addresses where the goods were delivered.

Addresses:

□    C6 The taxable person in the requesting State claims to have made supply to a person in the requested State. Please confirm that the goods were received and whether they were:

□    accounted for:    ○ Yes    ○ No

□    declared/paid by a taxable person in the requested State    ○ Yes    ○ No

Name and/or VAT identification number of the taxable person in the requested State.

Prior/onward movement of the goods

□    C7 From whom were the goods purchased? Please provide names, trading names and VAT numbers in box C41.

□    C8 To whom were the goods sold on? Please provide names, trading names and VAT numbers in box C41.

Services

□    C9 According to the VIES or other sources, the taxable person in the requested State made supplies of services taxable in the requesting State but the taxable person in the requesting State either:

○    did not declare the service;

○    denies having received the service;

○    declared having received the service for a different amount and the declared amount is:

Please investigate and explain.

□    I attach copies of documents in my possession.

□    C10 The purchase declared by the taxable person in the requesting State does not correspond with the information from the VIES or other sources. Please investigate and explain.

□    C11 Please provide the addresses where the services were provided.

Addresses:

□    C12 The taxable person in the requesting State claims to have made supply to a person in the requested State. Please confirm that the services were provided and whether they were:

□    accounted for:    ○ Yes    ○ No

□    declared/paid by a taxable person in the requested State    ○ Yes    ○ No

Name and/or VAT identification number of the taxable person in the requested State.

Transport of goods

□    C13 Please provide the name/VAT identification number and the address of the transporter.

Name and/or VAT identification number and address:

□    C14 Who ordered and paid the transportation of the goods?

Name and/or VAT identification number and address:

□    C15 Who is the owner of the means of transport used?

Name and/or VAT identification number and address:

Invoices

□    C16 Please provide the amount invoiced and currency.

Payment

□    C17 Please provide the amount paid and currency.

□    C18 Please provide the name of the bank account holder and the number of the account from which and/or to which the payment was made.

From:

Name of the account holder:

IBAN number or account number:

Bank:

To:

Name of the account holder:

IBAN number or account number:

Bank:

□    C19 Please provide the following details where the payment was made in cash:

□    Who handed over the money, to whom, where and when?

□    What document (cash receipt, etc.) was issued confirming the payment?

□    C20 Is there any evidence of third party payments? If yes, please provide additional information in box C41    ○ Yes    ○ No

Placing of an order

□    C21 Please furnish all available details of the person placing the order, how the order was placed and how the contact was established between the supplier and the customer.

Goods covered by special schemes/particular procedures

Please tick the appropriate box and enter your question in box C40

□    C22 Triangular transactions.

□    C23 Margin scheme.

□    C24 Distance sales of goods

□    covered by the Union scheme

□    covered by the Import scheme

□    C25 New means of transport sold to non-taxable persons.

□    C26 Exemption under Customs Procedure 42XX / 63XX.

□    C27 Gas and electricity.

□    C28 Call-off stock arrangements.

□    C29 Others:

Services covered by particular provisions

Please tick the appropriate box and enter your question in box C40

□    C30 Supply of services provided by an intermediary.

□    C31 Supply of services connected to immovable property.

□    C32 Supplies of passenger transport.

□    C33 Supplies of transport of goods.

□    C34 Supply of cultural, artistic, sporting, scientific, educational, entertainment and similar services, ancillary transport services and valuations of and work on movable tangible property.

□    C35 Supply of restaurant and catering services other than as provided for at C37.

□    C36 Supply of transport hire.

□    C37 Supply of restaurant and catering services for consumption on board of ships, aircraft or trains.

□    C38 Supply of services

□    covered by the non-Union scheme

□    covered by the Union scheme

□    C39 Services for which effective use and enjoyment rules are applied.

□    C40 Background information and further questions

C41 Free text reply box

D) REQUEST FOR DOCUMENTS

Please provide copies of the following documents (where applicable see amount and period in part B12 and B13)

□    D1 Invoices

○    Provided

○    Not available

□    D2 Contracts

○    Provided

○    Not available

□    D3 Orders

○    Provided

○    Not available

□    D4 Evidence of payments

○    Provided

○    Not available

□    D5 Transport documentation

○    Provided

○    Not available

□    D6 Creditor's ledger for the taxable person in the requested State

○    Provided

○    Not available

□    D7 Debtor's ledger for the taxable person in the requested State

○    Provided

○    Not available

□    D8 Call-off stock registers

From    To

○    Provided

○    Not available

□    D9 One-stop-shop/import one-stop-shop records

From    To

○    Provided

○    Not available

□    D10 Bank account statements

From    To

○    Provided

○    Not available

□    D11 Others

○    Provided

○    Not available

E) SPONTANEOUS SUPPLY OF INFORMATION (GENERAL)

□    E1 Based on the records of the taxable person in the sending State, it appears that they should be registered in the receiving State.

□    E2 According to the records of the taxable person in the sending State, □ goods / □ services were supplied to them by a taxable person in the receiving State, but no information is available via the VIES/Customs or other sources data.

□    E3 According to the records of the taxable person in the sending State, VAT is to be paid on goods supplied to the receiving State, but no data was entered into VIES/Customs or other sources data.

□    E4 According to the VIES/Customs or other sources data, the taxable person in the receiving State made supplies to a taxable person in the sending State but the latter taxable person either:

□    did not declare a purchase of □ goods / receipt of □ services;

□    denies the purchase of the □ goods / receipt of □ services.

□    E5 According to the records of the taxable person in the sending State, VAT is to be paid on services supplied in the receiving State.

□    E6 Background and additional information:

□    E7 I attach copies of invoices in my possession.

F) MISSING TRADER FRAUD: REGISTRATION CONTROL / BUSINESS ACTIVITY

(A) Identification of the business

Requesting authority

Requested authority

Requested authority 14

F1 VAT identification number (if not, tax identification number)

F1 VAT identification number (if not, tax identification number)

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

VAT number:

VAT number:

VAT number:

□    VAT number not available

□    VAT number not available

□    VAT number not available

Tax identification number:

Tax identification number:

Tax identification number:

F2 Name

F2 Name

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

Name:

F3 Address

F3 Address

○    Please fill in

○    Please confirm

○ I confirm    ○ I do not confirm

Address:

F4 The following dates in the format (YYYY/MM/DD):

F4 The following dates in the format (YYYY/MM/DD):

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

(a)    issue of the VAT/tax identification number

(a)    issue of the VAT/tax identification number

(a)    issue of the VAT/tax identification number

(b)    cancellation of the VAT/tax identification number

(b)    cancellation of the VAT/tax identification number

(b)    cancellation of the VAT/tax identification number

(c)    Incorporation

(c)    Incorporation

(c)    Incorporation

F5 Owners, proprietors, associates, partners, agents, stakeholders or persons having other rights in the business

F5 Owners, proprietors, associates, partners, agents, stakeholders or persons having other rights in the business

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

(a)    Name

(a)    Name

(a)    Name

(b)    Address

(b)    Address

(b)    Address

(c)    Date of birth

(c)    Date of birth

(c)    Date of birth

(d)    Nationality

(d)    Nationality

(d)    Nationality

F6 Managers/directors

F6 Managers/directors

○    Please fill in

○    Please confirm

○    I confirm    ○    I do not confirm

(a)    Name

(a)    Name

(a)    Name

(b)    Address

(b)    Address

(b)    Address

(c)    Date of birth

(c)    Date of birth

(c)    Date of birth

(d)    Nationality

(d)    Nationality

(d)    Nationality

(B) Information requested

□    F7 Are the persons referred to in F5 and F6 (with date of birth if known) contained in any of your databases?

○    Yes    ○    No

□    F8 Do those persons referred to in F5 and F6 have a financial criminal record?

□    The information cannot be given for legal reasons.

○    Yes    ○    No

□    F9 Do those persons referred to in F5 and F6 have a history of involvement in missing trader fraud or other type of fraud?

□    The information cannot be given for legal reasons.

○    Yes    ○    No

□    F10 Are those persons referred to in F5 and F6 either resident at or connected with the address given?

○    Yes    ○    No

□    F11 Is the stated address residential/business/temporary accommodation/accountant/other?

○    Yes

○    No

□    F12 What is the business activity?

□    F13 Is the business's tax compliance suspect?

○    Yes    ○    No

□    F14 What is the reason for the cancellation of the VAT number?

□    F15 Please advise of any associated business 15 including their VAT identification numbers and any views as to their credibility.

□    F16 Please provide details of known bank accounts of the business in the requested State and any associated businesses.

□    F17 Please provide information from recapitulative statements or from Customs declarations on the supplies/purchases of goods/services for the year(s):

□    F18 Please provide information from VAT declarations/about payments for the year(s):

□    F19 Any additional comments:

G) SPONTANEOUS SUPPLY OF INFORMATION (MISSING TRADER FRAUD)

Sending authority

Receiving authority

Identification of the business

G1 VAT identification number (if not, tax identification number)

Identification of the business

G1 VAT identification number (if not, tax identification number)

VAT number:

VAT number:

□    VAT number not available

□    VAT number not available

Tax identification number:

Tax identification number:

G2 Name

G2 Name

G3 Address

G3 Address

G4 The following dates in the format (YYYY/MM/DD):

G4 The following dates in the format (YYYY/MM/DD):

(a)    issue of the VAT/tax identification number

(a)    issue of the VAT/tax identification number

(b)    cancellation of the VAT/tax identification number

(b)    cancellation of the VAT/tax identification number

(c)    Incorporation

(c)    Incorporation

G5 Owners, proprietors, associates, partners, agents, stakeholders or persons having other rights in the business

G5 Owners, proprietors, associates, partners, agents, stakeholders or persons having other rights in the business

(a)    Name

(a)    Name

(b)    Address

(b)    Address

(c)    Date of birth

(c)    Date of birth

(d)    Nationality

(d)    Nationality

G6 Managers, directors

G6 Managers, directors

(a)    Name

(a)    Name

(b)    Address

(b)    Address

(c)    Date of birth

(c)    Date of birth

(d)    Nationality

(d)    Nationality

Any additional comments

H) FEEDBACK 16

Results related to the information provided:

1)    The information provided:

□    Resulted in an additional assessment of VAT or of other taxes. Please provide details on the type and amount of tax assessed:

Type of tax:

Additional assessment:

Penalty:

□    Resulted in VAT registration.

□    Resulted in VAT deregistration.

□    Resulted in the cancellation of a VAT number from VIES or from VAT registered taxpayer's database.

□    Resulted in the correction of VAT declarations.

□    Led to a desk enquiry.

□    Led to a new audit procedure or was used as part of an on-going audit.

□    Led to a fraud investigation.

□    Resulted in a request for information.

□    Led to a presence in administrative office or to participation in administrative enquiry.

□    Led to Multilateral control (MLC).

□    Resulted in other actions:

□    Did not result in any substantial action.

2)    Other comments:

Date of transmission:

Request for notification (Article PVAT. 12
Reference:
N_SS_RR _ 20YYMMDD-000000-000000

O) Envelope

(O1) Applicant State:

Requested State:

Applicant authority:

Requested authority:

(O2) Official dealing with the exchange in the applicant authority:

Official dealing with the exchange in the requested authority:

Name:

Name:

Email:

Email:

Telephone:

Telephone:

Fax:

Fax:

(O3) Applicant authority reference:

Requested authority reference:

Space reserved for the applicant authority:

Space reserved for the requested authority:

(O4) Date of transmission of the request:

Date of transmission of the reply:

(O5) Requester name:

Requester official capacity:

Information relating to the person to be notified

○ For natural persons: ○ For legal entities: 

First name:

Family name:

Maiden name:

Date and place of birth:

Date:

Place:

Country:

Address:

Street:

Building identifier: Suite identifier:

City: Post code:

Country:

 E-mail:    

Information relating to the instrument (or decision)

Nature and subject of the instrument (or decision) to be notified:

Final date for notification:    

Other information:    

Reference:
N_SS_RR _ 20YYMMDD-000000-000000

O) Envelope

(O1) Applicant State:

Requested State:

Applicant authority:

Requested authority:

(O2) Official dealing with the exchange in the applicant authority:

Official dealing with the exchange in the requested authority:

Name:

Name:

Email:

Email:

Telephone:

Telephone:

Fax:

Fax:

(O3) Applicant authority reference:

Requested authority reference:

Space reserved for the applicant authority:

Space reserved for the requested authority:

(O4) Date of transmission of the request:

Date of transmission of the reply:

–

Name

–

Address (known or assumed)

–

Other data relevant to the identification of the addressee

□

to inform the addressee about the document(s) to which this document is attached.

□

to interrupt the period of limitation with regard to the claim(s) mentioned in the notified document(s).

□

to confirm to the addressee his/her obligation to pay the amounts mentioned under point D.

□

the principal debtor

□

a co-debtor

□

a person other than the (co-)debtor, liable for settlement of the taxes, duties and other measures, or for other claims relating to these taxes, duties and other measures, under the laws in force in the applicant State

□

a person other than the (co-)debtor, holding assets belonging to, or having debts towards, the (co-)debtor or to any other person liable

□

a third party which may become affected by enforcement measures concerning other persons

□

the principal debtor: [name and address (known or assumed)]

□

a co-debtor: [name and address (known or assumed)]

□

a person other than the (co-)debtor, liable for settlement of the taxes, duties and other measures, or for other claims relating to these taxes, duties and other measures, under the laws in force in the applicant State: [name and address (known or assumed)]).

–

Name:

–

Address:

–

Other contact details:

–

Language(s) in which this office can be contacted:

□

at the abovementioned office responsible with regard to the attached document(s), and/or

□

from the following office:

–

Name:

–

Address:

–

Other contact details:

–

Language(s) in which this office can be contacted:

–

Reference number:

–

Date of establishment:

–

Nature of the notified document:

□

Tax assessment

□

Payment order

□

Decision following an administrative appeal

□

Other administrative document:

□

Judgment or order of:

□

Other judicial document:

–

Name of the claim(s) concerned (in the language of the applicant State):

–

Nature of the claim(s) concerned:

–

Amount of the claim(s) concerned:

□

Principal amount:

□

Administrative penalties and fines:

□

Interest up to [date]:

□

Costs up to [date]:

□

Fees for certificates and similar documents issued in connection with administrative procedures related to the claim mentioned under point [x]:

□

Total amount for this (these) claim(s):

–

The amount mentioned under point [x] should be paid:

□

before:

□

within [number] days following the date of this notification

□

without any further delay

–

This payment should be made to:

–

Holder of the bank account:

–

International Bank Account Number (IBAN):

–

Bank Identification Code (BIC):

–

Name of the bank:

–

Reference to be used for the payment:

–

The addressee can reply to the document(s) that is (are) hereby notified.

□

Last day for replying:

□

Time period for replying:

–

Name and address of the authority to whom a reply can be sent:

–

Possibility of contesting:

□

The period to contest the claim or the notified document(s) has already come to its end.

□

Last day for contesting the claim:

□

Time period to contest the claim: [number of days/weeks/months] following

□

the date of this notification.

□

the establishment of the notified document(s)

□

another date:

–

Name and address of the authority where a contestation has to be submitted:

□

Please note that the recovery may begin before the end of the period within which the claim may be contested.

–

Other information:

–

Date of issue:

–

Reference number:

–

Date of issue of the original uniform instrument:

–

Date of revision:

–

Reason for the revision:

□

judgment or order of [name of the Court] of [date]

□

administrative decision of [date]

–

Reference number:

□

a uniform instrument permitting enforcement, in accordance with Article PVAT.27 of the above Protocol.

□

a revised uniform instrument permitting enforcement, in accordance with Article PVAT.30 of the above Protocol (to take account of the decision of the competent body referred to in Article PVAT.29(1) of that Protocol).

1.

Reference:

2.

Nature of the claim(s) concerned:

□    a) customs duties

□    b) value added tax

□    c) excise duties

□    d) tax on income or capital

□    e) tax on insurance premiums

□    f) inheritance and gift taxes

□    g) national taxes and duties on immovable property, other than the above-mentioned ones

□    h) national taxes and duties on the use or ownership of means of transport

□    i) other taxes and duties levied by or on behalf of the applicant State

□    j) taxes and duties levied by or on behalf of territorial or administrative subdivisions of the applicant State, excluding taxes and duties levied by local authorities

□    k) taxes and duties levied by or on behalf of local authorities

□    l) other tax-based claim

□    m) refunds, interventions and other measures forming part of the system of total or partial financing of the European Agricultural Guarantee Fund (EAGF) and the European Agricultural Fund for Rural Development (EAFRD), including sums to be collected in connection with these actions, and levies and other duties provided for under the common organisation of the market for the sugar sector

3.

Name of the tax/duty concerned:

4.

Period or date concerned:

5.

Date of establishment of the claim:

6.

Date on which enforcement becomes possible:

7.

Amount of the claim still due:

□

principal amount:

□

administrative penalties and fines:

□

interest till date before the day the request is sent:

□

costs till date before the day the request is sent:

□

total amount of this claim:

□

Date:

□

No date available

–

Name:

–

Address:

–

Other contact details:

–

Language(s) in which this office can be contacted:

□

the office indicated above

□

the following office responsible for the Uniform instrument permitting enforcement:

–

Name:

–

Address:

–

Other contact details:

–

Language(s) in which this office can be contacted:

□

natural person

□

other

–

Name

–

Address (known or assumed)

–

Other data relevant to the identification of the addressee

□

Legal representative

–

Name

–

Address (known or assumed)

–

Other data relevant to the identification of the addressee

□

principal debtor

□

a co-debtor

□

a person other than the (co-)debtor, liable for settlement of the taxes, duties and other measures, or for other claims relating to these taxes, duties and other measures under the laws in force in the applicant State

□

natural person

□

other

–

Name:

–

Address (known or assumed):

–

Other data relevant to the identification of the addressee:

□

Legal representative

–

Name:

–

Address (known or assumed):

–

Other data relevant to the identification of the addressee:

□

principal debtor

□

a co-debtor

□

a person other than the (co-)debtor, liable for settlement of the taxes, duties and other measures, or for other claims relating to these taxes, duties and other measures under the laws in force in the applicant State

–

in the currency of the applicant State:

–

in the currency of the requested State:

-in EUR:

1.    STATE OF THE APPLICANT AUTHORITY

A.    Applicant authority

Country:

Name:

Telephone:

Reference of the file:

Name of the official dealing with the request:

Language skills

B.    Office initiating the request

Name:

Address:

Postcode:

Town:

Telephone:

E-mail:

Reference of the file:

Name of the official dealing with the request:

2.    STATE OF THE REQUESTED AUTHORITY

A.    Requested authority

Country:

Name:

Telephone:

Reference of the file:

Name of the official dealing with the request:

Language skills

B.    Office handling the request

Name:

Address:

Postcode:

Town:

Telephone:

E-mail:

Reference of the file:

Name of the official dealing with the request:

3.    INFORMATION RELATING TO THE REQUEST

□ This request includes claims which are more than 5 years old, dating from the due date of the claims to the date of the initial request for assistance (for contested claims or instruments permitting enforcement: from the moment at which the claim or the instrument permitting enforcement may no longer be contested).

For this (these) claim(s), the request is based on the following circumstances:

□ This request is connected to another request of 20YY/MM/DD, which was processed by the requested authority under reference number: [optional]

□ Other:

□ A similar request is sent to the following competent authority(ies) within the State of the requested authority:

□ A similar request is sent to the following competent authority(ies) within the following State(s):

□    I, applicant authority, ask the requested authority not to inform the person(s) concerned about this request.

□    I, applicant authority, confirm that the information to be received will be subject to the secrecy provisions defined in the legal basis quoted above.

4.    INFORMATION RELATING TO THE PERSON CONCERNED

A.    Information is requested with regard to:

□    For natural persons:

First name(s):

Surname:

Maiden name (name at birth):

Date of birth:

Place of birth:

VAT number:

Tax Identification Number:

Other identification data:

Address of this person: □ known — □ assumed

–    Street and number:

–    Details of address:

–    Postcode and town:

–    Country:

□    Or for legal entities:

Company name:

Legal status:

VAT number:

Tax Identification Number:

Other identification data:

Address of this legal entity: □ known — □ assumed

–    Street and number:

–    Details of address:

–    Postcode and town:

–    Country:

□    Legal representative

Name:

Address of this legal representative: □ known — □ assumed

–    Street and number:

–    Details of address:

–    Postcode and town:

–    Country:

B.    Liability: the person concerned is:

□    the principal debtor

□    a co-debtor

□    a person other than the (co-)debtor, liable for settlement of the taxes, duties and other measures, or for other claims relating to these taxes, duties and other measures under the laws in force in the applicant State;

□    a person other than the (co-)debtor, holding assets belonging to, or having debts towards, the (co-)debtor or to any other person liable.

□    a third party which may become affected by enforcement measures concerning other persons.

C.    Other relevant information concerning the above persons:

□    Bank account number(s)

–    Bank account number (IBAN):

–    Bank identification code (BIC):

–    Name of the bank:

□    Car information on 20YY/MM/DD

–    car plate number:

–    car brand:

–    colour of the car:

□    Estimated or provisional or □ precise amount of the claim(s):

□    Other:

5.    INFORMATION REQUESTED

□    Information about the identity of the person concerned (for natural persons: full name, date and place of birth; for legal entities: company name and legal status)

□    Information about the address

□    Information about the income and assets for recovery

□    Information about the heirs and/or legal successors

□    Other:

6.    FOLLOW-UP OF THE REQUEST FOR INFORMATION

Date

Nr

Message

Applicant authority

Requested authority

date

1

□

I, requested authority, acknowledge receipt of the request.

date

□    To be combined with acknowledgment

2

□

I, requested authority, invite the applicant authority to complete the request with the following additional information:

date

3

□

I, requested authority, have not yet received the additional information required and will close your request if I do not receive this information before 20YY/MM/DD.

date

4

I, applicant authority,

□

a

provide on request the following additional information:

□

b

am not able to provide the requested additional information

(because:)

date

5

□

I, requested authority, acknowledge receipt of the additional information and am now in a position to proceed.

date

6

I, requested authority, do not provide assistance and close the case because:

□

a

I do not have competence for any of the claims to which the request relates.

□

b

the claim is older than foreseen in the Protocol.

□

c

I am not able to obtain this information for the purpose of recovering similar national claims.

□

d

this would disclose a commercial, industrial or professional secret.

□

e

the disclosure of this information would be liable to prejudice the security or be contrary to the public policy of the State.

□

f

the applicant authority did not provide all the required additional information

□

g

other reason:

date

7
□

I, applicant authority, ask to be informed about the present status of my request.

date

8

I, requested authority, cannot provide the information now because:

□    I have asked for information from other public bodies.

□    I have asked for information from a third party.

□    I am arranging a personal call.

□    other reason:

date

9

The requested information cannot be obtained because:

□

a

the person concerned is not known.

□

b

insufficient data for identification of person concerned.

□

c

the person concerned has moved away, address unknown.

□

d

the requested information is not available.

□

e

other reason:

date

10

□

I, requested authority, transmit the following part of the requested information:

date

11

I, requested authority, transmit all (or the final part of) the requested information:

□

a

Identity confirmed

□

b

Address confirmed

□

c

The following data about the identity of the person concerned have changed (or are added):

For natural persons:

□    First name(s):

□    Surname:

□    Maiden name:

□    Date of birth:

□    Place of birth:

For legal entities:

□    Legal Status:

□    Company name:

□

d

The following address data have changed (or are added):

□    Street and no.:

□    Details of address:

□    Postcode and town:

□    Country:

□    Telephone:

□    Fax:

□    E-mail:

□

e

Financial situation:

□    Bank account(s) known:

Bank account number (IBAN): …

Bank identification code (BIC): …

Name of the bank: …

□    Employment details: □ Employee —□ Self-employed — □ Unemployed

□    It seems that the person concerned has no means to settle the debt/no assets to cover recovery

□    The person concerned is bankrupt/insolvent:

–    Date of order:

–    Date of release:

–    Liquidator’s details:

Name:

Street and no:

Details of address:

Postcode and town:

Country:

□    It seems that the person concerned has:

□    limited means to partially settle the debt

□    sufficient means/assets for recovery

□    Comments:

□

f

Debt disputed

□    person concerned has been advised to contest the claim in the State of the applicant authority

□    references of the dispute, if available:

□    further details attached

□

g

Debtor deceased on YYYY/MM/DD

□

h

Name and address of heirs/will executor:

□

i

Other comments:

□

j

I recommend proceeding with recovery procedures

□

k

I recommend not proceeding with recovery procedures

date

12
□

I, applicant authority, withdraw my request for information.

date

13
□

Other: comment from  applicant authority or  requested authority: