ANNEX IIICERTIFICATE REFERRED TO IN ARTICLE 41(1) CONCERNING JUDGMENTS ON RIGHTS OF ACCESS7
1.
Member State of origin
2.Court or authority issuing the certificate
2.1.
Name
2.2.
Address
2.3.
Tel./fax/e-mail
3.Person(s) with rights of access
3.1.
Full name
3.2.
Address
3.3.
Date and place of birth (where available)
4.Holders of parental responsibility other than those mentioned under 389
4.1.
4.1.1.
Full name
4.1.2.
Address
4.1.3.
Date and place of birth (where available)
4.2.
4.2.1.
Full name
4.2.2.
Address
4.2.3.
Date and place of birth (where available)
4.3.Other
4.3.1.
Full name
4.3.2.
Address
4.3.3.
Date and place of birth (where available)
5.Court which delivered the judgment
5.1.
Name of Court
5.2.
Place of Court
6.Judgment
6.1.
Date
6.2.
Reference number
7.Children who are covered by the judgment10
7.1.
Full name and date of birth
7.2.
Full name and date of birth
7.3.
Full name and date of birth
7.4.
Full name and date of birth
8.Is the judgment enforceable in the Member State of origin?
8.1.
Yes
8.2.
No
9.
Where the judgment was given in default of appearance, the person defaulting was served with the document which instituted the proceedings or with an equivalent document in sufficient time and in such a way as to enable that person to arrange for his or her defence, or the person has been served with the document but not in compliance with these conditions, it is nevertheless established that he or she accepted the decision unequivocally
10.
All parties concerned were given an opportunity to be heard
11.
The children were given an opportunity to be heard, unless a hearing was considered inappropriate having regard to their age or degree of maturity
12.Practical arrangements for exercise of rights of access (to the extent stated in the judgment)
12.1.
Date and time
12.1.1.
Start
12.1.2.
End
12.2.
Place
12.3.
Specific obligations on holders of parental responsibility
12.4.
Specific obligations on the person with right of access
12.5.
Any restrictions attached to the exercise of rights of access
13.
Names of parties to whom legal aid has been granted
Done at …, date …
Signature and/or stamp