EUROPEAN ENFORCEMENT ORDER CERTIFICATE — JUDGMENT

1. Member State of origin: Belgium Czech Republic Germany Estonia Greece Spain France Ireland Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands

Austria Poland Portugal Slovakia Slovenia Finland

Sweden United Kingdom

2. Court/Tribunal issuing the certificate:

2.1. Name:

2.2. Address:

2.3. Tel./fax/e-mail:

3. If different, Court/Tribunal giving the judgment:

3.1. Name:

3.2. Address:

3.3. Tel./fax/e-mail:

4. Judgment:

4.1. Date:

4.2. Reference number:

4.3. The parties:

4.3.1. Name and address of creditor(s):

4.3.2. Name and address of debtor(s):

5. Monetary claim as certified:

5.1. Principal amount:

5.1.1. Currency:

Euro

Pound sterling

Maltese lira

Slovenian tolar other (explain)

Cyprus pound

Hungarian forint

Polish zloty

Czech koruna

Lithuanian litas

Swedish kronor

Estonian kroon

Latvian lats

Slovak koruna

5.1.2. If the claim is for periodical payments

5.1.2.1. Amount of each instalment:

5.1.2.2. Due date of first instalment:

5.1.2.3. Due dates of following instalments

weekly monthly other (explain)

5.1.2.4. Period of the claim

5.1.2.4.1. Currently indefinite or

5.1.2.4.2. Due date of last instalment:

5.2. Interest

5.2.1. Interest rate

5.2.1.1. … % or

5.2.1.2. … % above the base rate of the ECB (1)

5.2.1.3. Other (explain)

5.2.2. Interest to be collected as from:

5.3. Amount of reimbursable costs if specified in the judgment:

6. Judgment is enforceable in the Member State of origin

7. Judgment is still subject to the possibility of a challenge

Yes No

8. Judgment is on an uncontested claim under Article 3(1)

9. Judgment is in compliance with Article 6(1)(b)

10. The judgment concerns matters relating to consumer contracts

Yes No

10.1. If yes:

The debtor is the consumer

Yes No

10.2. If yes:

The debtor is domiciled in the Member State of origin (within the meaning of Article 59 of Regulation (EC) No 44/2001)

11. Service of the document instituting the proceedings under Chapter III, where applicable

Yes No

11.1. Service was effected in compliance with Article 13

or service was effected in compliance with Article 14

or it is proved in accordance with Article 18(2) that the debtor has received the document

11.2. Due information

The debtor was informed in compliance with Articles 16 and 17

12. Service of summons, where applicable

Yes No

(1) Interest rate applied by the European Central Bank to its main refinancing operations.

12.1. Service was effected in compliance with Article 13

or service was effected in compliance with Article 14

or it is proved in accordance with Article 18(2) that the debtor has received the summons

12.2. Due information

The debtor was informed in compliance with Article 17

13. Cure of non-compliance with procedural minimum standards pursuant to Article 18(1)

13.1. Service of the judgment was effected in compliance with Article 13

or service of the judgment was effected in compliance with Article 14

or it is proved in accordance with Article 18(2) that the debtor has received the judgment

13.2. Due information

The debtor was informed in compliance with Article 18(1)(b)

13.3. It was possible for the debtor to challenge the judgment

Yes No

13.4. The debtor failed to challenge the judgment in compliance with the relevant procedural requirements

Yes No Done at Date

Signature and/or stamp

EUROPEAN ENFORCEMENT ORDER CERTIFICATE — COURT SETTLEMENT

1. Member State of origin: Belgium Czech Republic Germany Estonia Greece Spain France Ireland Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands

Austria Poland Portugal Slovakia Slovenia Finland

Sweden United Kingdom

2. Court issuing the certificate

2.1. Name:

2.2. Address:

2.3. Tel./fax/e-mail:

3. If different, Court approving the settlement or before which it was concluded

3.1. Name:

3.2. Address:

3.3. Tel./fax/e-mail:

4. Court settlement

4.1. Date:

4.2. Reference number:

4.3. The parties

4.3.1. Name and address of creditor(s):

4.3.2. Name and address of debtor(s):

5. Monetary claim as certified

5.1. Principal Amount:

5.1.1. Currency:

Euro

Pound sterling

Maltese lira

Slovenian tolar other (explain)

Cyprus pound

Hungarian forint

Polish zloty

Czech koruna

Lithuanian litas

Swedish kronor

Estonian kroon

Latvian lats

Slovak koruna

5.1.2. If the claim is for periodical payments

5.1.2.1. Amount of each instalment:

5.1.2.2. Due date of first instalment:

5.1.2.3. Due dates of following instalments

weekly monthly other (explain)

5.1.2.4. Period of the claim

5.1.2.4.1. Currently indefinite or

5.1.2.4.2. Due date of last instalment:

5.2. Interest

5.2.1. Interest rate

5.2.1.1. … % or

5.2.1.2. … % above the base rate of the ECB (1)

5.2.1.3. Other (explain)

5.2.2. Interest to be collected as from:

5.3. Amount of reimbursable costs if specified in the court settlement:

6. The court settlement is enforceable in the Member State of origin Done at Date

Signature and/or stamp

(1) Interest rate applied by the European Central Bank to its main refinancing operations.

EUROPEAN ENFORCEMENT ORDER CERTIFICATE — AUTHENTIC INSTRUMENT

1. Member State of origin: Belgium Czech Republic Germany Estonia Greece Spain France Ireland Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands

Austria Poland Portugal Slovakia Slovenia Finland

Sweden United Kingdom

2. Court/Authority issuing the certificate

2.1. Name:

2.2. Address:

2.3. Tel./fax/e-mail:

3. If different, Court/Authority drawing up or registering the authentic instrument

3.1. Name:

3.2. Address:

3.3. Tel./fax/e-mail:

4. Authentic instrument

4.1. Date:

4.2. Reference number:

4.3. The parties

4.3.1. Name and address of creditor(s):

4.3.2. Name and address of debtor(s):

5. Monetary claim as certified

5.1. Principal Amount:

5.1.1. Currency:

Euro

Pound sterling

Maltese lira

Slovenian tolar other (explain)

Cyprus pound

Hungarian forint

Polish zloty

Czech koruna

Lithuanian litas

Swedish kronor

Estonian kroon

Latvian lats

Slovak koruna

5.1.2. If the claim is for periodical payments

5.1.2.1. Amount of each instalment:

5.1.2.2. Due date of first instalment:

5.1.2.3. Due dates of following instalments

weekly monthly other (explain)

5.1.2.4. Period of the claim

5.1.2.4.1. Currently indefinite or

5.1.2.4.2. Due date of last instalment:

5.2. Interest

5.2.1. Interest rate

5.2.1.1. … % or

5.2.1.2. … % above the base rate of the ECB (1)

5.2.1.3. Other (explain)

5.2.2. Interest to be collected as from:

5.3. Amount of reimbursable costs if specified in the authentic instrument:

6. The authentic instrument is enforceable in the Member State of origin Done at Date

Signature and/or stamp

(1) Interest rate applied by the European Central Bank to its main refinancing operations.

CERTIFICATE OF LACK OR LIMITATION OF ENFORCEABILITY

(Article 6(2))

1. Member State of origin: Belgium Czech Republic Germany Estonia Greece Spain France Ireland Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands

Austria Poland Portugal Slovakia Slovenia Finland

Sweden United Kingdom

2. Court/Authority issuing the certificate

2.1. Name:

2.2. Address

2.3. Tel./fax/e-mail:

3. If different, Court/Authority issuing the judgment/Court settlement/Authentic instrument (*)

3.1. Name:

3.2. Address:

3.3. Tel./fax/e-mail:

4. Judgment/Court settlement/ Authentic instrument (*)

4.1. Date:

4.2. Reference number:

4.3. The parties

4.3.1. Name and address of creditor(s):

4.3.2. Name and address of debtor(s):

5. This judgment/Court settlement/Authentic instrument (*) was certified as a European Enforcement Order but

5.1. the judgment/Court settlement/Authentic instrument (*) is no longer enforceable

5.2. Enforcement is temporarily

5.2.1. stayed

5.2.2. limited to protective measures

5.2.3. conditional upon the provision of a security which is still outstanding

5.2.3.1. Amount of the security:

5.2.3.2. Currency:

Euro

Pound sterling

Maltese lira

Slovenian tolar other (explain)

Cyprus pound

Hungarian forint

Polish zloty

Czech koruna

Lithuanian litas

Swedish kronor

Estonian kroon

Latvian lats

Slovak koruna

5.2.4. Other (explain) Done at Date

Signature and/or stamp

(*) Delete as appropriate.

EUROPEAN ENFORCEMENT ORDER REPLACEMENT CERTIFICATE FOLLOWING A CHALLENGE

(Article 6(3))

A. The following judgment/court settlement/authentic instrument (*) certified as a European Enforcement Order was challenged

1. Member State of origin: Belgium Czech Republic Germany Estonia Greece Spain France Ireland Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands

Austria Poland Portugal Slovakia Slovenia Finland

Sweden United Kingdom

2. Court/Authority issuing the certificate

2.1. Name:

2.2. Address:

2.3. Tel./fax/e-mail:

3. If different, Court/Authority issuing the judgment/Court settlement/Authentic Instrument (*)

3.1. Name:

3.2. Address:

3.3. Tel./fax/e-mail:

4. Judgment/Court settlement/Authentic Instrument (*)

4.1. Date:

4.2. Reference number:

4.3. The parties

4.3.1. Name and address of creditor(s):

4.3.2. Name and address of debtor(s):

B. Upon that challenge the following decision has been handed down and is hereby certified as a European Enforcement Order replacing the original European Enforcement Order.

1. Court

1.1. Name:

1.2. Address:

1.3. Tel./fax/e-mail:

2. Decision

2.1. Date:

2.2. Reference number:

3. Monetary claim as certified

3.1. Principal amount

(*) Delete as appropriate.

3.1.1. Currency:

Euro

Pound sterling

Maltese lira

Slovenian tolar other (explain)

Cyprus pound

Hungarian forint

Polish zloty

Czech koruna

Lithuanian litas

Swedish kronor

Estonian kroon

Latvian lats

Slovak koruna

3.1.2. If the claim is for periodic payments

3.1.2.1. Amount of each instalment:

3.1.2.2. Due date of first instalment:

3.1.2.3. Due dates of following instalments

weekly monthly other (explain)

3.1.2.4. Period of the claim

3.1.2.4.1. Currently indefinite or

3.1.2.4.2. Due date of last instalment:

3.2. Interest

3.2.1. Interest rate

3.2.1.1. … % or

3.2.1.2. … % above the base rate of the ECB

3.2.1.3. Other (explain)

3.2.2. Interest to be collected as from:

3.3. Amount of reimbursable costs if specified in the decision:

4. Decision is enforceable in the Member State of origin

5. Decision is still subject to the possibility of a further appeal

Yes No

6. Decision is in compliance with Article 6(1)(b)

7. The decision concerns matters relating to consumer contracts

Yes No

7.1. If yes:

The debtor is the consumer

Yes No

7.2. If yes:

The debtor is domiciled in the Member State of origin in the meaning of Article 59 of Regulation (EC) No 44/2001

8. At the time of the decision following the challenge, the claim is uncontested within the meaning of Article 3(1)(b) or (c)

Yes No

If yes:

8.1. Service of the document instituting the challenge.

Did the creditor lodge the challenge?

Yes No

If yes:

8.1.1. Service was effected in compliance with Article 13

or service was effected in compliance with Article 14

or it is proved in accordance with Article 18(2) that the debtor has received the document

8.1.2. Due information

The debtor was informed in compliance with Articles 16 and 17

8.2. Service of summons, where applicable

Yes No

If yes:

8.2.1. Service was effected in compliance with Article 13

or service was effected in compliance with Article 14

or it is proved in accordance with Article 18(2) that the debtor has received the summons

8.2.2. Due information

The debtor was informed in compliance with Article 17

8.3. Cure of non-compliance with procedural minimum standards pursuant to Article 18(1)

8.3.1. Service of the decision was effected in compliance with Article 13

or Service of the decision was effected in compliance with Article 14

or it is proved in accordance with Article 18(2) that the debtor has received the decision

8.3.2. Due information

The debtor was informed in compliance with Article 18(1)(b) Done at Date

Signature and/or stamp

APPLICATION FOR RECTIFICATION OR WITHDRAWAL OF THE EUROPEAN ENFORCEMENT ORDER CERTIFICATE

(Article 10(3))

THE FOLLOWING EUROPEAN ENFORCEMENT ORDER CERTIFICATE

1. Member State of origin: Belgium Czech Republic Germany Estonia Greece Spain France Ireland Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands

Austria Poland Portugal Slovakia Slovenia Finland

Sweden United Kingdom

2. Court/Authority issuing the certificate

2.1. Name:

2.2. Address:

2.3. Tel./fax/e-mail:

3. If different, Court/Authority issuing the judgment/Court settlement/Authentic Instrument (*)

3.1. Name:

3.2. Address:

3.3. Tel./fax/e-mail:

4. Judgment/Court settlement/Authentic Instrument

4.1. Date:

4.2. Reference number:

4.3. The parties

4.3.1. Name and address of creditor(s):

4.3.2. Name and address of debtor(s):

HAS TO BE

5. RECTIFIED as due to a material error there is the following discrepancy between the European Enforcement Order certificate and the underlying judgment/court settlement/authentic instrument (explain)

6. WITHDRAWN because:

6.1. the certified judgment was related to a consumer contract but was given in a Member State where the consumer is not domiciled within the meaning of Article 59 of Regulation (EC) No 44/2001

6.2. the European Enforcement Order certificate was clearly wrongly granted for another reason (explain) Done at Date

Signature and/or stamp

(*) Delete as appropriate.