Commission Delegated Regulation (EU) 2020/760Show full title

ANNEX I Model of declaration of independence referred to in Article 12

Instructions for completing the declaration

(1)

In block A, fill in the information on the tariff quota to which the declaration of independence applies.

(2)

In block B, tick the applicable box.

(3)

In block C, indicate the operator’s name, EORI number, date and place of signature, and include the signature of the operator’s competent managing (chief executive) officer.

A. Tariff quota concerned

a Only to fill in if the origin of the goods is a mandatory element in the licence application.
Tariff quota order number
CN code(s)
Origin of the product(s)a

B. Independence of operator

The applicant for the tariff quota order number listed above declares:

1. The applicant is not linked, as set out in Article 11 of Delegated Regulation (EU) 2020/760, with other legal or natural persons applying for the same tariff quota order number.

box to be ticked as appropriate.

2. The applicant is linked, as set out in Article 11 of Delegated Regulation (EU) 2020/760, with other legal or natural persons applying for the same tariff quota order number. The applicant regularly performs substantial economic activities towards third parties within the meaning of Article 11(3). The applicant has disclosed the natural or legal persons to which it is linked in the LORI electronic system in accordance with Article 11(4).

box to be ticked as appropriate.

C. Operator’s details

Name
EORI number
Date and place
Signature
Role in the company of the signatory

ANNEX II Information to be provided in relation to the prior compulsory registration referred to in Article 13

EORI of the economic operator

Economic operator identity

►	Name of the company
►	Address of headquarter: Street name
►	Address of headquarter: Street number
►	Address of headquarter: Postal code
►	Address of headquarter: City
►	Address of headquarter: Country
►	Address of Operational office: Street name
►	Address of Operational office: Street number
►	Address of Operational office: Postal code
►	Address of Operational office: City
►	Address of Operational office: Country
►	Phone number
►	Email address to be used for communication with Member States’ licence issuing authorities and customs authorities
►	Legal status
►	Principal economic activity of the operator

Proof of substantial economic activity of the economic operator

►	Attachment of an excerpt from the commercial register or equivalent document as per the applicable national legislation
►	Attachment of last audited annual accounts (if any)
►	Attachment of last balance sheet
►	Attachment of VAT certificate
►	Additional documents to be uploaded following requests for clarification received from the licence issuing authority

Declaration of independence pursuant to Article 12 of Delegated Regulation (EU) 2020/760

■	List of tariff quota order numbers and short description	Please select ‘yes’ if you apply for the tariff quota, or ‘no’ if you do not apply for the tariff quota.	Declaration of independenceto be attached if in the previous column you have selected ‘yes’
►	…

Reference quantity

Please declare the reference quantity for the following tariff quotas:

■	Tariff quota order number	Reference quantity (in kg)	TRQ period to which the reference quantity applies – Start of the period	TRQ period to which the reference quantity applies – End of the period
►

Persons of the company empowered to introduce a licence application on behalf of the operator

Operator must provide the list of persons of the company empowered to introduce a licence application on its behalf, for the tariff quotas listed above.

■	Surname(s)	Name(s)	Date of birth	Place of birth	ID document	ID Card/Passport Number	Supporting docs for the empowerment
►

Economic operator ownership structure

■

Type of ownership (the operator should choose the correct option)

If the owner(s) is a company:

■	Company EORI (if any)	Company name	Address of headquarter: Street name	Address of headquarter: Street number	Address of headquarter: Postal code	Address of headquarter: City	Address of headquarter: Country	Phone number	Email address	Role in the operator (e.g. sole owner, partner, main shareholder (above 25 % stock or controlling stock)…)	Commercial register
►

If the owner(s) is a natural person:

■	Surname(s)	Name(s)	Date of birth	Place of birth	ID document	ID Card/Passport Number	Role in the operator (e.g. sole owner, partner, main shareholder (above 25 % stock or controlling stock)…)
►

The operator must provide information on legal persons applying for the tariff quotas listed above, which are linked to that operator within the meaning of Article 11 of Delegated Regulation (EU) 2020/760

■	Company EORI	Company name	Address of headquarter: Street name	Address of headquarter: Street number	Address of headquarter: Postal code	Address of headquarter: City	Address of headquarter: Country	Phone number	Email address	Legal status	Link
►

The operator must provide information on natural persons applying for the tariff quotas listed above, which are linked to that operator within the meaning of Article 11 of Delegated Regulation (EU) 2020/760

■	Surname(s)	Name(s)	Date of birth	Place of birth	ID document	ID Card/Passport Number	Link
►

Management structure of the economic operator

Please list the persons holding office as member of board of directors/Chief Executive Officer/Chief Financial Officer (if applicable) or analogue roles in operator management structure. Please ensure that data in the table below is consistent with the information provided in the documents submitted as proof of substantial economic activity. In case the table below is filled with incorrect or incomplete information, the penalties provided for in Article 15 of Delegated Regulation (EU) 2020/760 apply.

■	Surname(s)	Name(s)	Date of birth	Place of birth	ID document	ID Card/Passport Number	Function in the company
►

In order to proceed with your application for registration, you must agree with the following statements:

(1) The information provided is correct, complete and up to date. I am aware that the penalties provided for in Article 15 of Delegated Regulation (EU) 2020/760, apply in case the information provided is incorrect, incomplete or not up to date.

(2) I agree to the disclosure of the information to the Commission, the customs authorities and the licence issuing authorities of the Member States.

(3) I commit to submit updated information in case of changes to the structure of the legal entity, in a timely manner and in accordance with Articles 12 and 13 of Delegated Regulation (EU) 2020/760.

■

Please confirm that you agree with the three statements above: