{
  "url": "https://openlegislation.uk/eu-regulation-2011-1189/annex-III",
  "json_url": "https://openlegislation.uk/eu-regulation-2011-1189/annex-III.json",
  "legislation": "eur/2011/1189",
  "legislation_title": "Commission Implementing Regulation (EU) No 1189/2011 of 18 November 2011 laying down detailed rules in relation to certain provisions of Council Directive 2010/24/EU concerning mutual assistance for the recovery of claims relating to taxes, duties and other measures",
  "legislation_url": "https://openlegislation.uk/eu-regulation-2011-1189",
  "path": "annex/III",
  "kind": "annex",
  "number": "III",
  "heading": "Declaration specifying reasons and circumstances for a request for precautionary measures",
  "text": "The elements put in Italic are optional. It is suggested to remove subsections that are not selected.\nWhere this form is transmitted by electronic means, its structure and lay-out may be adapted to the requirements and possibilities of the electronic communication system, provided that the set of data and information contained therein is not substantially altered.\nName of the language(s) of this document\nDeclaration specifying reasons and circumstances for a request for precautionary measures\nbased on:\nArticle 16 of Directive 2010/24/EU\n…\nThis declaration is linked to the request for precautionary measures\nwith the following reference:\nRef. …\nsent by the following applicant State:\nto the following requested State:\nThe following information on specific reasons and circumstances for this request is provided:\n1.\nGeneral information\n1.1.\nThe claim(s) is (are) the subject of an instrument permitting enforcement in the applicant State which is contested.\n1.2.\nThe claim(s) is (are) the subject of an instrument permitting enforcement in the applicant State which is not contested.\n1.3.\nThe claim(s) is (are) not yet subject of an instrument permitting enforcement in the applicant State.\n1.4.\nThe claim(s) is (are) not contested.\n1.5.\nThe claim(s) may no longer be contested by and administrative appeal/by an appeal to the courts.\n1.6.\nThe claim(s) is (are) contested but the laws, regulations and administrative practices in force in the State of the applicant authority allow to take precautionary measures.\n2.\nJustifying documents and/or reasons\n2.1.\nThis request is accompanied by a uniform instrument permitting recovery in the requested State.\nNote: this uniform instrument permitting enforcement in the requested State also allows the requested State to take precautionary measures (for requests based on Directive 2010/24/EU: see the second subparagraph of Article 12(1) of that Directive).\n2.2.\nThis request is based on an administrative decision (attached) permitting precautionary measures in the applicant State, which contains the following evaluation:\n2.2.1.\nAdministrative evaluation of the need to take precautionary measures assessed by:\nname of the authority:\naddress of the authority:\ndate of this decision:\nDD/MM/YYYY\ndetails contact person:\n2.2.2.\nCircumstances\nThe instrument permitting enforcement is contested.\nThe claim(s) is (are) not yet the subject of an instrument permitting enforcement.\nThe contesting of the claim(s) by the debtor was already rejected in first instance, but this decision is not final.\n2.2.3.\nThis authority has allowed precautionary measures in the applicant State in accordance with its national law, on the following date:\nDD/MM/YYYY\n2.2.4.\nThe precautionary measures are considered to be justified for the following reasons, demonstrating the urgency and the risk that collection and recovery could be thwarted or seriously hindered:\nhigh (estimated) amount of the (expected) debt/significant debiting\nsuspicion of fraud\nPerson(s) concerned making themselves insolvent\nrestructuring of assets\nalienation of property\nattempt to hide/conceal/dissipate assets\ncareless business management\nfrequent change of residence\nrelocation of property abroad\ndebtor not respecting earlier payment agreements\nother elements/reasons: …\nShort explanation (recommended): …\n2.3.\nThis request is based on a judicial confirmation (attached) that precautionary measures are justified:\n2.3.1.\nJudicial evaluation of the need to take precautionary measures assessed by:\nname of the Court:\naddress of the Court:\ndate of the decision:\nDD/MM/YYYY\n(Details contact person:)\n2.3.2.\nThe Court decided:\nat the unilateral request of the tax authorities\nfollowing the contesting of the claim by the debtor, by another person liable or by another person subject to the precautionary measures\n2.3.3.\nThis Court has allowed precautionary measures in the applicant State in accordance with its national law, on the following date:\nDD/MM/YYYY\n2.4.\nThis request for precautionary measures is based on the reasons mentioned in the attached document(s).\n2.5.\nPrecautionary measures are justified for the following reasons, demonstrating the urgency and the risk that collection and recovery could be thwarted or seriously hindered:\nhigh (estimated) amount of the (expected) debt/significant levels of debt\nSuspicion of fraud\nPerson(s) concerned making themselves insolvent\nrestructuring of assets\nalienation of property\nattempt to hide/conceal/dissipate assets\ncareless business management\nfrequent change of residence\nrelocation of property abroad\ndebtor not respecting earlier payment agreements\nother elements/reasons: …\nShort explanation (recommended): …\n3.\nOther information\n3.1.\nThe authorities of the requested State are requested not to inform the debtor or other person concerned before the start of the precautionary measures.\n3.2.\nOther information: …",
  "extent": "E+W+S+N.I.",
  "status": null,
  "version": "current",
  "annotations": [
    {
      "type": "F",
      "label": "F1",
      "text": "Inserted by Commission Implementing Regulation (EU) 2017/1966 of 27 October 2017 amending Implementing Regulation (EU) No 1189/2011 as regards the communication of assistance requests and the follow-up to those requests."
    },
    {
      "type": "footnote",
      "label": "f1",
      "text": "The elements put in Italic are optional. It is suggested to remove subsections that are not selected."
    },
    {
      "type": "footnote",
      "label": "f2",
      "text": "Where this form is transmitted by electronic means, its structure and lay-out may be adapted to the requirements and possibilities of the electronic communication system, provided that the set of data and information contained therein is not substantially altered."
    }
  ],
  "outstanding_effects": [],
  "provenance": {
    "source": "legislation.gov.uk",
    "source_url": "https://www.legislation.gov.uk/eur/2011/1189/annex/III",
    "retrieved_at": "2026-11-01T14:49:45.205569+00:00"
  },
  "licence": "Open Government Licence v3.0",
  "licence_url": "https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/",
  "attribution": "Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives."
}