Образец запроса и подтверждения о вручении за границей судебных или внесудебных документов в форме свидетельства________________________________________________________________________________Annex to the Convention
FORMS------------------------------------------------------------------¦ REQUEST ¦¦ FOR SERVICE ABROAD OF JUDICIAL OR EXTRAJUDICIAL DOCUMENTS ¦¦ --------------------------------------------------------- ¦¦ Convention on the Service Abroad of Judicial and Extrajudicial¦¦ Documents in Civil or Commercial Matters, ¦¦ signed at The Hague, ____________ 196 . ¦¦ ¦¦-------------------------------- -------------------------------¦¦¦ Identity and address ¦ ¦ Address of receiving ¦¦¦¦ of the applicant ¦ ¦ authority ¦¦¦¦ ¦ ¦ ¦¦¦¦ ¦ ¦ ¦¦¦¦ ¦ ¦ ¦¦¦¦ ¦ ¦ ¦¦¦-------------------------------- -------------------------------¦¦ ¦¦The undersigned applicant has the honour to transmit - in¦¦duplicate - the documents listed below and, in conformity with¦¦Article 5 of the above-mentioned Convention, requests prompt¦¦service of one copy thereof on the addressee, i.e, ¦¦ (identity and address) _____________________________________¦¦ ____________________________________________________________¦¦a) in accordance with the provisions of sub-paragraph (a) of the¦¦ first paragraph of Article 5 of the Convention <*>. ¦¦b) in accordance with the following particular method¦¦ (sub-paragraph (b) of the first paragraph of Article 5) <*>: ¦¦ _____________________________________________________________¦¦ _____________________________________________________________¦¦ _____________________________________________________________¦¦c) by delivery to the addressee, if he accepts it voluntarily¦¦ (second paragraph of Article 5) <*>. ¦¦ ¦¦The authority is requested to return or to have returned to the¦¦applicant a copy of the documents - and of the annexes <*> -¦¦with a certificate as provided on the reverse side. ¦¦ ¦¦List of documents. ¦¦_____________________________________ ¦¦_____________________________________ ¦¦_____________________________________ ¦¦_____________________________________ ¦¦_____________________________________ ¦¦_____________________________________ ¦¦_____________________________________ Done at_______, the______¦¦_____________________________________ Signature and/or stamp. ¦¦ ¦¦ ¦¦<*> Delete if inappropriate. ¦----------------------------------------------------------------- Reverse of the request-----------------------------------------------------------------¦ CERTIFICATE ¦¦ ----------- ¦¦The undersigned authority has the honour to certify, in ¦¦conformity with Article 6 of the Convention, ¦¦1) that the document has been served <*> ¦¦ - the (date________________________________________________ ¦¦ - at (place, street, number)________________________________¦¦ ______________________________________________________¦¦ - in one of the following methods authorised by Article 5: ¦¦ a) in accordance with the provisions of sub-paragraph (a) of¦¦ the first paragraph of Article 5 of the Convention <*>. ¦¦ b) in accordance with the following particular method <*>:__¦¦ ______________________________________________________¦¦ c) by delivery to the addressee, who accepted it¦¦ voluntarily <*>. ¦¦ The documents referred to in the request have been delivered¦¦ to: ¦¦ - (identity and description of person)______________________¦¦ ______________________________________________________¦¦ - relationship to the addressee (family, business or other):¦¦ ______________________________________________________¦¦ ¦¦2) that the document has not been served, by reason of the ¦¦ following facts <*>: ¦¦ ______________________________________________________¦¦ ______________________________________________________¦¦ ______________________________________________________¦¦ ¦¦In conformity with the second paragraph of Article 12 of the¦¦Convention, the applicant is requested to pay or reimburse the¦¦expenses detailed in the attached statement <*>. ¦¦ ¦¦Annexes ¦¦ ¦¦Documents returned:_________________ ¦¦____________________________________ ¦¦____________________________________ ¦¦ Done at_______, the______¦¦In appropriate cases, documents ¦¦establishing the service: ¦¦____________________________________ Signature and/or stamp. ¦¦____________________________________ ¦¦____________________________________ ¦¦ ¦¦ ¦¦<*> Delete if inappropriate. ¦----------------------------------------------------------------------------------------------------------------------------------¦ SUMMARY OF THE DOCUMENT TO BE SERVED ¦¦ ------------------------------------ ¦¦ Convention on the service abroad of judicial and extrajudicial ¦¦ documents in civil or commercial matters, signed at ¦¦ The Hague, the _______________ 196 . ¦¦ ¦¦ (article 5, fourth paragraph) ¦¦ ¦¦Name and address of the requesting authority:__________________ ¦¦ __________________ ¦¦ __________________ ¦¦ ¦¦Particulars of the parties <*>:________________________________ ¦¦ ________________________________ ¦¦ ________________________________ ¦¦ ¦¦ ¦¦ JUDICIAL DOCUMENT <**> ¦¦ ¦¦Nature and purpose of the document:____________________________ ¦¦ _________________________________________ ¦¦ _________________________________________ ¦¦Nature and purpose of the proceedings and, where appropriate, ¦¦the amount in dispute:_________________________________________ ¦¦ _________________________________________ ¦¦ _________________________________________ ¦¦Date and place for entering appearance <**>:___________________ ¦¦ _________________________________________ ¦¦Court which has given judgment <**>:___________________________ ¦¦ _________________________________________ ¦¦Date of judgment <**>:_________________________________________ ¦¦Time-limits stated in the document <**>:_______________________ ¦¦ _________________________________________ ¦¦ ¦¦ EXTRAJUDICIAL DOCUMENT <**> ¦¦ ¦¦Nature and purpose of the document:____________________________ ¦¦ _________________________________________ ¦¦ _________________________________________ ¦¦Time-limits stated in the document <**>:_______________________ ¦¦ _________________________________________ ¦¦ _________________________________________ ¦¦ ¦¦ ¦¦<*> If appropriate, identity and address of the person ¦¦ interested in the transmission of the document. ¦¦<**> Delete if inappropriate. ¦-----------------------------------------------------------------
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