EN    EN  
 EUROPEAN  
COMMISSION 
Brussels, XXX   
[…](2015) XXX  draft 
ANNEXES 1 to 4 
  
ANNEXES 
I to IV 
to the 
COMMISSION DELEGATED REGULATION (EU) No …/.  of XXX 
supplementing Regulation (EC) No 273/2004 of the European Parliament and of the 
Council on drug precursors and Council Regulation (EC) No 111/2005 laying down rules 
for the monitoring of trade between the Union and third countries in drug precursors, 
and repealing Commission Regulation (EC) No 1277/2005 
  
EN 2   EN ANNEXES 
I to IV 
to the 
COMMISSION DELEGATED REGULATI ON (EU) No …/.  of XXX 
supplementing Regulation (EC) No 273/2004 of  the European Parliament and of the 
Council on drug precursors and Council Regula tion (EC) No 111/2005 laying down rules 
for the monitoring of trade between the Unio n and third countries in drug precursors, 
and repealing Commission Regulation (EC) No 1277/2005 
 
ANNEX I  
Substance Quantity 
Acetone1 50 kg 
Ethyl ether1 20 kg 
Methylethylketone1 50 kg 
Toluene1 50 kg 
Sulphuric acid 100 kg 
Hydrochloric acid 100 kg 
1) The salts of these substances whenever the existence of such salts is possible . 
  
EN 3   EN ANNEX II  
 
                                    European Union 
Declaration of the operator  
on the entry of the scheduled substances  
into the customs territory of the Union  
(Article 8 of Regulation (EC) No.  111/2005)  
  Article 12 of the United Nations' C onvention against illicit traffic in 
narcotic drugs and psychotropic substances  
1.Operator 
 (name, address, phone, fax, email)  2.a. Country of export 
2.b.Transit country/countries 
2.c. Country of final destination  
3a. Exporter in the country of export 
(name, address, phone, fax, email)  3b. Competent authority in country of export (name, address, phone, fax, email) 
4a. Importer in the country of destination  
(name, address, phone, fax, email) 4b. Competent authority in the country import 
(name, address, phone, fax, email) 
5a. CN-Code 
5a. Net weight  O R I G I N A L 5a.Scheduled Substance 
5a. % of mixture 
5b. CN-Code 
5b. Net weight 5b.Scheduled Substance 
5b. % of mixture  
6a. Bill of lading/Airway bill/or other transport 
document number of country of export  6b. Reference number of the export authorisation of the 
exporter in the third country of export (optional)   
7. Declaration by the operator: 
Name: ________________       Representing :_______________________ (operator) 
I hereby declare that  - to my knowledge - the scheduled substances have left  the country of export in accordance with the provisions in fo rce adopted pursuant to Article 12  of the United Nations' Convention 
against illicit traffic in narcotic drugs and psychotro pic substances. The following supporting evidence is 
attached (optional) : 
□        copy of export authorisation                   □  copy of licence/registration 
Signature : ________________ ______            Place:______________           Date: _______________ 
  
EN 4   EN Notes 
1. The layout of the model is not binding. 
2. The order numbers and the text of the model are binding.  
EN 5   EN ANNEX III 
I. List of countries of destin ation for export of scheduled subs tances of Category 2 referred to 
in Article 10: 
Substance Destination 
Acetic anhydride   
Phenylacetic Acid Potassium permanganate  Any third country  
 
Anthranilic acid   Afghanistan 
Australia 
Antigua and Barbuda 
Benin 
Bolivia Brazil 
Canada 
Cayman Islands Chile 
Colombia  
Costa Rica Dominican Republic 
Ecuador  
Ethiopia Ghana 
Haiti 
India  Indonesia 
Jordan 
Kazakhstan Lebanon 
Madagascar Malaysia 
Maldives 
Mexico  
Nigeria 
Oman Paraguay 
Peru  
Philippines Republic of Moldova 
Russian Federation 
Saudi Arabia South Africa 
Tajikistan 
Turkey  United Arab Emirates 
United Republic of Tanzania  
Venezuela   
EN 6   EN Piperidine  Afghanistan 
Australia 
Antigua and Barbuda 
Benin Bolivia 
Brazil  
Canada Cayman Islands 
Chile  
Colombia  Costa Rica 
Dominican Republic 
Ecuador  
Ethiopia 
Ghana Haiti 
India  
Indonesia Jordan 
Kazakhstan 
Lebanon Madagascar  Malaysia 
Maldives 
Mexico  
Nigeria Oman 
Paraguay 
Peru  Philippines 
Republic of Moldova 
Russian Federation Saudi Arabia 
Tajikistan 
Turkey  
United Arab Emirates 
United Republic of Tanzania  United States of America 
Venezuela 
  
EN 7   EN II. List of countries of destin ation for export of scheduled substances of Category 3 referred to 
in Article 10: 
Substance Destination 
Methylethyl ketone (MEK) 
Toluene  Acetone 
Ethyl ether  Afghanistan 
Australia Antigua and Barbuda 
Argentina 
Benin Bolivia 
Brazil 
Canada 
Cayman Islands 
Chile  Colombia 
Costa Rica 
Dominican Republic Ecuador 
Egypt 
El Salvador Ethiopía 
Ghana 
Guatemala Haiti  
Honduras 
India Jordan 
Kazakhastan Lebanon 
Madagascar Malaysia 
Maldives 
Mexico Nigeria 
Oman 
Pakistan 
Paraguay 
Peru Philippines 
Republic of Moldova 
Republic of Korea Russian Federation 
Saudia Arabia 
Tajikistan Turkey 
United Arab Emirates 
United Republic of Tanzania Uruguay 
Venezuela 
Hydrochloric acid  
Sulphuric acid Bolivia  
Chile Colombia  
Ecuador Peru 
Turkey Venezuela 
This includes the salts of these substances whenever the existence of such salts is possible .  
EN 8   EN ANNEX IV 
    MULTILATERAL CHEMICAL REPORTING NOTIFICATION  
1. ACTION ADDRESSEE  
2. Additional addressee  
3. Additional addressee  
4. Name  5. Agency (name and address)  6. Country  
7. Telephone  8. Fax  9. E-Mail  
10. Signature and date   
 
11. This shipment  □  WILL/  □  WILL NOT  proceed if a reply is not received within … days.  
12. Does your office have any objection to this shipment? □Yes   □No   □ Further inquiries required                                
 If YES, please provide details and reasons 
PART A  
This multilateral chemical report ing notification covers:    
    one export operation , or    
    several export operations to be carried out within a specific time frame (Beginning:………….End:……………).  
13. Name of scheduled substance  14. Quantity and weight  15. CN code  
16. Exporting country  17. Point of exit 18. Departure date 
19. Importing country  20. Point of entry 21. Estimated arrival date 
22. Transhipment route (including Free Zones, and Final Destination) 23. Means of transport: 
24. Importer (name, address, telephone and fax)  
25. Import/export authorisation number 
26. Ultimate consignee  (name, address, telephone and fax) 
27. Other remarks 
PART B  
28. Exporter, manufacturer or supplier (name, address, telephone and fax)  
29. Intermediaries (name, address, telephone and fax)  
30. Transit companies (name, address, telephone and fax)  
31. Transportation details (Flight no./vessel, etc.)  
Notes  
EN 9   EN 1. The layout of the model is not binding. 
2. The order numbers and the text of the model are binding. The completion of the boxes marked in bold 
is mandatory. 
3. Further details of the boxes:  Box "Part A": Indicate whether the MCRN covers on e or several export operations. Where it covers 
several operations, indicate the intended time frame. 
Box 14 (quantity and weight): In the case of a MCRN to cover several export operations, indicate the 
maximum quantity and weight.  
 Item 18 (Departure date): In the case of a MCRN to  cover several export operations, this box must be 
filled out indicating the final estimated departure date.