FORM FOR THE TRANSMISSION OF AN APPLICATION FOR COMPENSATION IN CROSS-BORDER SITUATIONS | eJustice Portal

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ANNEX I

FORM FOR THE TRANSMISSION OF AN APPLICATION FOR COMPENSATION IN CROSS-BORDER SITUATIONS
(Article 6(2) of Directive 2004/80/EC)

FORM FOR THE TRANSMISSION OF AN APPLICATION FOR COMPENSATION IN CROSS-BORDER SITUATIONS
(Article 6(2) of Directive 2004/80/EC)

1. Case reference:

2. Language of the application and any supporting documentation (Article 6 (3) of Directive 2004/80/EC):

Other (please specify):

2. Language of the application and any supporting documentation (Article 6 (3) of Directive 2004/80/EC):

3. Application transmitted by

Details of the assisting authority (transmitting authority)

Member State:

Name of the authority:

Member State:

Contact person or the department responsible for handling the matter:

Address:

Telephone (including code):

Fax:

E-mail:

4.To

Details of the deciding authority (receiving authority)

Member State

Find a competent court/authority

Country:

Instrument: Compensation to Crime victims

Competence type: Deciding Authorities

Name of the authority:

Member State:

Address:

Telephone (including code):

Fax:

E-mail:

Advanced settings

Add-more values

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