[en] FORM K. CERTIFICATE OF SERVICE OR NON-SERVICE OF DOCUMENTS

FORM K

FORM K - CERTIFICATE OF SERVICE OR NON-SERVICE OF DOCUMENTS
(Articles 11(2), 12(4) and 14 of Regulation (EU) 2020/1784 of the European Parliament and of the Council of 25 November 2020 on the service in the Member States of judicial and extrajudicial documents in civil or commercial matters (service of documents)(¹))

Articles 11(2), 12(4) and 14 of Regulation (EU) 2020/1784 of the European Parliament and of the Council of 25 November 2020 on the service in the Member States of judicial and extrajudicial documents in civil or commercial matters (service of documents)

Service shall be effected as soon as possible. If it has not been possible to effect service within one month of receipt, the receiving agency shall inform the transmitting agency (Article 11(2) of Regulation (EU) 2020/1784)

Reference No of the transmitting agency:

Reference No of the receiving agency:

Addressee:

Please choose one of the below options

COMPLETION OF SERVICE

NON-SERVICE OF DOCUMENTS

1. COMPLETION OF SERVICE (Article 14)

1.1. Date and address of service

1.2. The document was

1.2.1. served in accordance with the law of the Member State addressed, namely

1.2.1.1. handed to

1.2.1.1.1. the addressee in person

1.2.1.1.2. another person

1.2.1.1.2.1. Name:

1.2.1.1.2.2. Address:

1.2.1.1.2.2.1. Street and number/PO box:

1.2.1.1.2.2.2. Place and postcode:

1.2.1.1.2.2.3. Country:

1.2.1.1.2.3. Nature of relationship with the addressee:

family

employee

other

1.2.1.1.3. the addressee’s address

1.2.1.1.4. another address (please specify) (²)

Please specify

1.2.1.2. served by postal services

1.2.1.2.1. without acknowledgement of receipt

1.2.1.2.2. with the enclosed acknowledgement of receipt

1.2.1.2.2.1. from the addressee

1.2.1.2.2.2. from another person

1.2.1.2.2.2.1. Name:

1.2.1.2.2.2.2. Address:

1.2.1.2.2.2.2.1. Street and number/PO box:

1.2.1.2.2.2.2.2. Place and postcode:

1.2.1.2.2.2.2.3. Country:

1.2.1.2.2.2.3. Nature of relationship with the addressee:

family

employee

other

1.2.1.3. served electronically (please state how):

1.2.1.4. served by another method (please state how):

1.2.2. served by the following particular method (please state how):

1.3. The addressee of the document was informed, in accordance with Article 12(2) of Regulation (EU) 2020/1784, in writing that the addressee may refuse to accept the document if it is not written in or accompanied by a translation into either a language which he or she understands or the official language or one of the official languages of the place of service.

At least one of the options in points 2, 3 or 4 should be checked. Multiple choices are also possible.

2. INFORMATION IN ACCORDANCE WITH ARTICLE 11(2) OF REGULATION (EU) 2020/1784

It was not possible to effect service within one month of receipt

3. REFUSAL OF DOCUMENT (Article 12(4) of Regulation (EU) 2020/1784)

3.1. The addressee refused to accept the document due to the language used

3.1.1. Date of attempt of service:

3.1.2. Date of refusal, if available:

3.2. The document is annexed to this certificate.

3.2.1. Yes

3.2.2. No

4. REASON FOR NON-SERVICE OF DOCUMENT

4.1. Address unknown:

4.1.1. Steps to establish the address were undertaken (³):

4.1.1. Steps to establish the address were undertaken

Yes

4.2. Addressee cannot be located

4.3. Document could not be served before the date or time limit stated in item 6.2 in the request for service of documents (Form A)

4.4. Other (please specify)

4.5. The document is annexed to this certificate

Yes

Done at:

Date:

Please remember to sign and stamp (if available) this form once it has been printed.

Signature and/or stamp or electronic signature and/or electronic seal:

PDF form

Please select the language in which you wish to generate the pdf form

(¹)OJ L 405, 2.12.2020, p. 40

(²)Address established by the receiving agency in accordance with Article 7(2)(c) of Regulation (EU) 2020/1784.

(³) This item applies only to the MS which provide the assistance in accordance with Article 7(2)(c) of Regulation (EU) 2020/1784.

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