1 Start 2 Step 2 3 Step 3 4 Step 4 5 Step 5 6 Step 6 7 Complete ANNEX V CERTIFICATE CONCERNING DECISIONS GRANTING RIGHTS OF ACCESS (Point (a) of Article 42(1) and point (a) of Article 47(1) of Council Regulation (EU) 2019/1111)(1) (Point (a) of Article 42(1) and point (a) of Article 47(1) of Council Regulation (EU) 2019/1111) IMPORTANT To be issued, upon application by a party, by the court that has given the decision only if the conditions of Article 47(3) of the Regulation, as indicated in points 11 to 14, are met. If not, Annex III of the Regulation should be used. 1. MEMBER STATE OF ORIGIN * - Select -BelgiumBulgariaCzechiaGermanyEstoniaIrelandGreeceSpainFranceCroatiaItalyCyprusLatviaLithuaniaLuxembourgHungaryMaltaNetherlandsAustriaPolandPortugalRomaniaSloveniaSlovakiaFinlandSweden 1. MEMBER STATE OF ORIGIN (2) * List of options for 1. MEMBER STATE OF ORIGIN (<sup>2</sup>) Belgium Bulgaria Czechia Germany Estonia Ireland Greece Spain France Croatia Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Romania Slovenia Slovakia Finland Sweden 2. COURT WHICH GAVE THE DECISION AND IS ISSUING THE CERTIFICATE * 2.1. Name * 2.2. Address * 2.3. Tel./fax/e-mail* Tel. Fax E-mail 3. DECISION * 3.1. Date (dd/mm/yyyy) * 3.2. Reference number * Upload file Leave this field blank Download the blank form Save draft Load draft Next Page >