ORGANISATION MONDIALE 
DU COMMERCE 
Conseil des aspects des droits de propriété 
intellectuelle qui touchent au commerce IP/N/1/EEC/E/3 
23 janvier 2007 
(07-0321) 
Original: anglais/ 
français/ 
espagnol 
PRINCIPALES LOIS ET RÉGLEMENTATIONS CONSACRÉES 
À LA PROPRIÉTÉ INTELLECTUELLE NOTIFIÉES 
AU TITRE DE L'ARTICLE 63:2 DE L'ACCORD 
COMMUNAUTÉS EUROPÉENNES 
Le présent document contient le texte du Règlement (CE) N° 1891/2004 de la Commission 
du 21 octobre 2004 arrêtant les dispositions d'application du règlement (CE) n° 1383/2003 du Conseil 
concernant l'intervention des autorités douanières à l'égard de marchandises soupçonnées de porter 
atteinte à certains droits de propriété intellectuelle ainsi que les mesures à prendre à l'égard de 
marchandises portant atteinte à certains droits de propriété intellectuelle, notifié par les Communautés 
européennes au titre de l'article 63:2 de l'Accord (voir le document IP/N/lEEC/2). IP/N/lIEEC/E/3 
Page 2 
COMMISSION REGULATION (EC) No 1891/2004 
of 21 October 2004 
laying down proV1S1ons for the implementation of Council Regulation (EC) No 1383/2003 
concerning customs action against goods suspected of infringing certain intellectual property 
rights and the measures to be taken against goods found to have infringed such rights 
THE COMMISSION OF THE EUROPEAN COMMUNmES. 
Having regard to the Treaty establishing the European 
Community. 
Having regard to Council Regulation (EO No 1383/2003 of 22 
July 2003 concerning customs action against goods suspected 
of infringing certain intellectual property rights and the 
measures to be taken against goods found to have infringed 
such rights (1). and in particular Article 20 thereof. 
Whereas: 
(1) Regulation (EO No 1383/2003 introduced common 
rules with a view to prohibiting the entry. release for 
free circulation. exit. export. re-export or entry for a 
suspensive procedure of counterfeit and pirated goods. 
and to dealing effectively with the illegal marketing of 
such goods without impeding the freedom of legitimate 
trade. 
(2) Since Regulation (EO No 1383/2003 replaced Council 
Regulation (EO No 3295/94 of 22 December 1994 
laying down measures concerning the entry into the 
Community and the export and re-export from the 
Community of goods infringing certain intellectual 
property rights (2). it is also necessary to replace 
Commission Regulation (EO No 1367/95 e). which 
laid down provisions for the implementation of Regu­
lation (EO No 3295/94. 
(3) For the different types of intellectual property rights. it is 
necessary to define the natural and legal persons who 
may represent the holder of a right or any other 
person authorised to use the right. 
(4) It is necessary to specify the nature of the proof of 
ownership of intellectual property reqUired under the 
(I) OJ L 196. 2.8.2003. p. 7. 
(2) 01 L 341. 30.12.1994. p. 8. Regulation as last amended by Regu­
lation (EC) No 806/2003 (OJ L 122. 16.5.2003. p. 1). 
e) 01 L 133.17.6.1995. p. 2. Regulation as last amended by the 2003 
Act of Accession. second subparagraph of Article 5(5) of Regulation (EO 
No 1383/2003. 
(5) In order to harmonise and standardise the content and 
format of applications for action under Article 5(1) and 
(4) of Regulation (EO No 1383/2003 and the infor­
mation to be entered on the application form. a stan­
dardised version of the form should be established. The 
language requirements for applications for action under 
Article 5(4) of the Regulation should also be laid down. 
(6) The type of information to be included in applications 
for action should be specified in order to enable the 
customs authorities to recognise more readily goods 
that may infringe an intellectual property right. 
(7) It is necessary to define the type of right-holder liability 
declaration which must accompany the application for 
action. 
(8) In the interests of legal certainty. it is necessary to specify 
when the time periods laid down in Article 13 of Regu­
lation (EC) No 1383/2003 commence. 
(9) Procedures should be laid down for the exchange of 
information between Member States and the 
Commission. so that it is possible. on the one hand. 
for the Commission to monitor the effective application 
of the procedure laid down by Regulation (EC) No 
1383/2003. to draw up in due course the report 
referred to in Article 23 thereof and to try to quantify 
and describe patterns of fraud. and. on the other hand. 
for the Member States to introduce appropriate risk 
analysis. 
(10) This Regulation should apply from the same date as 
Regulation (EO No 1383/2003. 
(11) The measures provided for in this Regulation are in 
accordance with the opinion of the Customs Code 
Committee. HAS ADOPTED TJ-IIS REGULATION: 
Article 1 
For the purposes of Article 2(2)(b) of Regulation (Eq No 
1383/2003. hereinafter 'the basic Regulation'. the right-holder 
or any other person authorised to use the right may be repre­
sented by natural or legal persons. 
The persons referred to in the fIrst paragraph shall include 
collecting societies which have as their sole or principal 
purpose the management or administration of copyrights or 
related rights; groups or representatives who have lodged a 
registration application for a protected designation of origin 
or a protected geographical indication; and plant breeders. 
Article 2 
1. If an application for action within the meaning of Article 
5(1) of the basic Regulation is lodged by the right-holder 
himself. the proof reqUired under the second sub paragraph of 
Article 5(5) shall be as follows: 
(a) in the case of a right that is registered or for which an 
application has been lodged, proof of registration with the 
relevant office or proof that the application has been 
lodged; 
(b) in the case of a copyright. related right or design right 
which is not registered or for which an application has 
not been lodged. any evidence of authorship or of the 
applicant's status as original holder. 
A copy of registration from the database of a national or inter­
national office may be considered to be proof for the purposes 
of point (a) of the first subparagraph. 
For protected designations of origin and protected geographical 
indications, the proof referred to in point (a) of the fIrst subpar­
agraph shall. in addition. consist in proof that the right-holder is 
the producer or group and proof that the designation or indi­
cation has been registered. This subparagraph shall apply mutatis 
mutandis to wines and spirits. 
2. Where the application for action is lodged by any other 
person authorised to use one of the rights referred to in Article 
2(1) of the basic Regulation. proof shall. in addition to the 
proof reqUired under paragraph 1 of this Article. consist in 
the document by virtue of which the person is authorised to 
use the right in question. 
3. Where the application for action is lodged by a represen­
tative of the right-holder or of any other person authorised to 
use one of the rights referred to in Article 2(2) of the basic 
Regulation. proof shall. in addition to the proof referred to in 
paragraph 1 of this Article. consist in his authorisation to act. IP/N/llEEClE13 
Page 3 
A representative. as referred to in the fIrst subparagraph. must 
produce the declaration required pursuant to Article 6 of the 
basic Regulation. signed by the persons referred to in para­
graphs 1 and 2 of this Article. or a document authOrising 
him to bear any costs arising from customs action on their 
behalf in accordance with Article 6 of the basic Regulation. 
Article 3 
1. The documents on which applications for action are made 
pursuant to Article 5(1) and (4) of the basic Regulation. the 
decisions referred to in Article 5(7) and (8) and the declaration 
required pursuant to Article 6 of the basic Regulation must 
conform with the forms set out in the Annexes to this Regu­
lation. 
The forms shall be completed by electronic or mechanical 
means. or legibly by hand. Handwritten forms shall be 
completed in ink and in block capitals. Whatever method is 
used. forms shall contain no erasures. overwritten words or 
other alterations. Where the form is fllled in electronically. it 
shall be made available to the applicant in digital form on one 
or more public sites that are directly accessible by computer. It 
may subsequently be reproduced on private printing equipment. 
Where additional sheets are attached. as referred to in boxes 8. 
9. 10 and 11 of the form on which the application for action 
prOvided for in Article 5(1) is to be made out, or in boxes 7. 8. 
9 and 10 of the form on which the request for action prOvided 
for in Article 5(4) is to be made out. they shall be deemed to be 
an integral part of the form. 
2. Forms for applications for action under Article 5(4) of the 
basic Regulation shall be printed and completed in one of the 
official languages of the Community deSignated by the 
competent authorities of the Member State in which the appli­
cation for action has to be submitted. together with any trans­
lations that may be reqUired. 
3. The form shall be made up of two copies: 
(a) the copy for the Member State in which the application is 
lodged. marked '1'; 
(b) the copy for the right-holder. marked '2'. 
The application forms, duly completed and Signed. accompanied 
by one extract of the form for each Member State indicated in 
box 6 of the form. as well as the documentary proof referred to 
in boxes 8, 9 and 10. shall be presented to the competent 
customs departtnent. which. after accepting the form, shall 
retain it for at least one year longer than its legal period of 
validity. IPINI1 IEEC/E/3 
Page 4 
If the extract of a decision granting an application for action is 
addressed to one or more Member States pursuant to Article 
5(4) of the basic Regulation, the Member State which receives 
the extract shall complete without delay the 'acknowledgement 
Cif receipt' section of the form by indicating the date of receipt 
and shall return a copy of the extract to the competent 
authority indicated in box 2 of the form. 
So long as his application for Community action remains valid. 
the right-holder may, in the Member State where the application 
was originally lodged. enter a request for action to be taken in 
another Member State not previously mentioned. In such cases. 
the period of validity of the new application shall be -the period 
remaining under the original application. and it may be renewed 
in accordance with the conditions applying to the original appli­
cation. 
ATticle4 
For the purposes of Article 5(6) of the basic Regulation. the 
place of manufacture or production. the distribution network or 
names of licensees and other information may be requested by 
the department responsible for receiving and processing appli­
cations for action in order to facilitate the technical analysis of 
the products concerned. 
Article 5 
If an application for action is lodged in accordance with Article 
4(1) of the basic Regulation before expiry of the time limit of 
three working days and accepted by the customs service 
deSignated for that purpose, the time limits referred to in 
Articles 11 and 13 of that Regulation shall be counted only 
from the day after the application is received. 
If the customs service informs the declarant or holder of goods 
that the goods are suspected of infringing an intellectual 
property right and that. pursuant to Article 4(1) of the basic 
Regulation. they have been detained, or their release suspended. 
the time limit of three working days shall be counted only from 
the time the right-holder is notified. 
Article 6 
In the case of perishable goods, the procedure for suspension of 
release or for detention of the goods shall be initiated primarily 
in respect of products for which an application for action has 
already been lodged. 
Article 7 
1. Where Article 11 (2) of the basic Regulation applies, the 
right-holder shall notify the customs authOrity that proceedings 
have been initiated to determine whether. under national law. 
an intellectual property right has been infringed. Except in the case of perishable goods, if insufficient time remains to apply 
for such proceedings before the expiry of the time-limit laid 
down in the fIrst subparagraph of Article 13(1) of the basic 
Regulation. the situation may be deemed an appropriate case 
within the meaning of the second subparagraph of that 
provision. 
2. If an extension of ten working days has already been 
granted under Article 11 of the basic Regulation. no further 
extension may be granted under Article 13 thereof. 
Article 8 
1. Each Member State shall inform the Commission as soon 
as possible of the competent customs department. referred to in 
Article 5(2) of the basic Regulation, responsible for receiving 
and processing applications for action from right-holders. 
2. At the end of each calendar year, each Member State shall 
send the Commission a list of all the written applications for 
action under Article 5(1) and (4) of the basic Regulation. giving 
the name and details of each right-holder. the type of right for 
which each application was submitted. and a summary 
desCription of each product concerned. The applications that 
have not been granted shall be included in that list. 
3. In the month following the end of each quarter, each 
Member State shall send the Commission a list. by product 
type. giving detailed information on the cases in which the 
release of goods has been suspended or goods have been 
detained. The information shall include the follOwing details: 
(a) the name of the right-holder; a description of the goods; if 
known, the origin, provenance and destination of the goods; 
the name of the intellectual property right infringed; 
(b) for each item, the quantity of goods whose release was 
suspended or which were detained; their customs status; 
the type of intellectual property right infringed; the means 
of transport used; 
(c) whether commercial or passenger traffic was involved and 
whether the procedure was initiated ex officio or as the result 
of an application for action. 
4. The Member States may send the Commission infor­
mation concerning the real or estimated value of the goods 
for which release has been suspended or which have ·been 
detained. 
5. At the end of every year, the Commission shall. in an 
appropriate manner. communicate to all Member States such 
information as it receives pursuant to paragraphs 1 to 4. 6. The Commission shall publish the list of departments 
within the customs authority. as referred to in Article 5(2) of 
the basic Regulation. in the C series of the Official Journal of the 
European Union. 
Article 9 
Applications for action lodged before 1 July 2004 shall remain 
valid until their legal expiry date and shall not be renewed. 
However. they must be accompanied by the declaration 
required under Article 6 of the basic Regulation. the model 
for which is set out in the Annexes to this Regulation. The 
declaration shall release any deposit and fee payable in the 
Member States. 
Where proceedings brought before the competent authority on 
a matter of substance before 1 July 2004 are still under way on IP/N/llEEClE13 
Page 5 
that date. the deposit shall not be released before the close of 
those proceedings. 
Article 10 
Regulation (EC) No 1367/95 is repealed. References to the 
repealed Regulation shall be construed as references to this 
Regulation. 
Article I I 
This Regulation shall enter into force on the day of its publi­
cation in the Official Journal of the European Union. 
It shall apply from 1 July 2004. 
This Regulation shall be binding in its entirety and directly applicable in all Member States. 
Done at Brussels. 21 October 2004. 
For the Commission 
Frederik BOLKESTEIN 
Member of the Commission IP INIlIEEC/E/3 
Page 6 
ANNEX I 
I NATIONAL APPLICATION FOR ACTION 
1. Date of receipt of the application for action by the designated 
customs department (within the meaning of Article 5(2) of Regu­
lation (EC) No 138312003) 
DDlMMlYY: . J. J .. 
3. Details of applicant (J.e. right-holder within the meaning of Article 
2(2) of Regulation (i!C) No 138312003 
NAME: ..................................................................................................... .. 
FUNCTION: ............................................................................................. .. I 
INTELLECTUAL PROPERTY RIGHTS 
APPLICATION FOR ACTION BY CUSTOMS AUTHORITIES 
pursuant to Article 5(1) of Regulation (EC) No 138312003 
ADDRESS: ................................................................................................ 1---------------------.., 
TOWN: .................................... ........ .................... .................... ........ .......... 2. Name and address of competent authority to which application Is 
made (see Annex I-C for detalla): 
POSTCODE: ........................................................................................... . 
COUNTRY: ............................................................................................. .. 
VAT NO: .................................................................................................. . 
TEL ......................................................................................................... .. 
MOBILE: ................................................................................................. .. 
FAX ......................................................................................................... .. 
E-MAIL: ................................................................................................... .. 
INTERNET ADDRESS: .......................................................................... . 
4. Status of applicant (within meaning of Artlcla 2(2) of the Regulation(EC) No 138312003 (I)}: 
o Right-holder (*) o Right-holder's representative (*) 
o Authorised user of the right (*) o Representative 01 authorised user (*) 
5. Type of right to which application refers (1): 
o Trademark o Design right o Copyright or related right o Patent 
o Supplementery protectfon certificate o Protected designation of origin 0 Protected geographical indication 
o Plant variety right 
o Geographical designations lor spirit drinks (2) 
6. Name and addre .. of contact person (administrative matters): 7. Name and address of contact person (technical matters): 
TEL. .......................................................................................................... TEL ........................................................................................................ . 
FAX .......................................................................................................... FAX ....................................................................................................... .. 
E-MAIL: .............. ............................................................................... ......... E-MAIL: .................................................................................................. . 
MOBILE: ................................................................................................... MOBILE: ................................................................................................ . 
INTERNET ADDRESS: ........................................................................... INTERNET ADDRESS: ......................................................................... . B. I attach essential data on the authentic goods: 
Number of documents attached (3): 0 Number of photos attached (3): 0 
9. I attach specific Information concerning the type or pattern of fraud: 
Number of documents attached (3): 0 Number of photos attached (3): 0 IP /NI 1 IEEClE13 
Page 7 
10. I attach document(s) attesting to the fact that the applicant holds the right for the goods In question within the meaning of Article 2(2) of 
Regulation (EC) No 138312003 (**): 
Number of documents attached (3): 0 
11. I attach the undertaking laid down In Article 6 of Regulation (EC) No 138312003, assuming liability In tha situations outlined in that 
Article (**): 
Undertaking attached: 0 
12. Any other Information In the right-holder's possession, e.g.: 
-Country or countries of production: 
-Routes used by traffickers: 
-Technical differences between the authentic and the 
suspect goods: 
-eN tariff heading: 
-Other useful information: 
13. Date of filing application: 
~ate on which drawn up 
DDIMMNY: . J. J .. Place Number of documents attached (4): 0 
Number of documents attached (4): 0 
Number of documents attached (4): 0 
Number of documents attached (4): 0 
Appllcanfs signature and stamp n IPINIllEEClE13 
Page 8 
14. Decision by customs authorities (within the meaning of Article 5(7) and (8) of Regulation (Ee) No 138312003) 
o The application Is approved for action Registration number of application for action: ................ .. 
Date Place Signature and stamp 
DDIMMIYY: . J. J .. 
o The application is valid until: .. .t .. .t .... Any request for extension of the validity period should be sent to the competent authority of box 2, 
at the latest 30 working days before the validity of the application expires. 
o The application has been refused 
A reasoned decision stating the grounds for refusal and information concerning the appeal procedure are attached. 
Date Place 
DDIMMIYY: . J. J .. 
(.) See box 10 (Ior further Information see 'Notes on ccmpletion', Annex I-A). 
("") For further Information see 'Notes on ocmpletion', Annex I-A, Signature and stamp 
(-) If the applicant is a representative 01 the right-holder, he must provide proof that he Is empowered to represent the right-holder. 
(1) TIck the appropriate box(es). 
(2) Council RegulaUon (EEC) No 157&'89 (OJ L 160, 12.6.1989, p. 1). 
(") Insert the relevant number, If none are attached, Insert O. 
(~) Insert the relevant number, If none are attached, Insert O. ANNEX I-A 
NOTES ON COMPLETION 
I. OBUGATORY INFORMATION ON RIGHTS AND ABILITY TO ACT 
(a) Where the holder of the right makes the application himself: IPINIlIEEC/E/3 
Page 9 
-in the case of a right that is registered or for which an application has been lodged. proof of registration with 
the relevant office or lodging of the application. 
-in the case of a copyright. related right or design right which is not registered or for which an application has 
not been lodged. any evidence of authorship or of his status as original holder. 
(b) Where the application is made by any other person referred to in Article 2(2)(b) authorised to use one of the 
rights referred to in Article 2(1)(a). (b) and (c) of the basic Regulation. in addition to the proof reqUired under 
point (a) of this Article. the document by virtue of which the person is authorised to use the right in question. 
(c) Where a representative of the holder or of any other person referred to in Article 2(2)(a) and (b) authorised to 
use one of the rights referred to in Article 2(1)(a). (b) and (c) of the basic Regulation applies. in addition to the 
proof reqUired under points (a) and (b) of this Article. proof of authorisation to act. 
The natural or legal person who fills in box 3 of the Application for action must, in an cases, be the one 
who will provide the documents foreseen in box 11 of the Application for action. 
(d) Box 5 contains all geographical indications. Protected designation of origin (PDO) and protected geographical 
indication (PGI) means the official indications according to Council Regulation (EEC) No 2081/92 (OJ L 208. 
24.7.1992. p. 1). Commission Regulations (EC) No 1107/96 (OJ L 148. 21.6.1996. p. 1) and (EC) No 2400/96 
(OJ L 327. 18.12.1996. p. 11). 'Geographical designations for spirituous beverages' means the official desig­
nations according to Regulation (EEC) No 1576/89. Individual producers as well as groups or their represen­
tatives are entitled to make an application. 
(e) Registration and specifications are required when an application is made: for protected deSignation of origin and 
protected geographical indication. 
n. WHAT MUST THE APPUCATlON FOR ACTION CONTAIN? 
An application for action can be used by the right-holder. free of charge. either as a preventive measure or where he 
'has reason to think that his intellectual property right or rights have been or are likely to be infringed. The 
application must contain all the information needed to make the goods in question readily recognisable by the 
customs authorities, and in particular: 
-an accurate and detailed technical description of the goods. 
-any specific information the right-holder may have concerning the type or pattern of fraud. 
-the name and address of the contact person appointed by the right-holder. 
-the undertaking reqUired of the applicant by Article 6 of the basic Regulation and proof that the applicant holds 
the right for the goods in question. 
-The right-holders must imperatively return the proof of receipt of the notification which was addressed to them 
by the Customs Service. according to Articles 4 (ex officio) and 9. It must be done immediately after having 
received this notification. The legal deadlines (three to 10 working days) start from the moment of receipt of the 
notification. It is imperative that the right-holder. as soon as he is contacted by the customs authorities. 
immediately confirms the receipt of the notification. IPINIllEEClE13 
Page 10 
-Within the meaning of the basic Regulation 'working day' (Council Regulation (EEC, Euratom) No 1182/71 (OJ L 
124.8.6.1971. p. 1)) is considered every day other than public holidays, Saturdays and Sundays. Moreover, the 
calculation of working days as included in Articles 4 and 13. has to be carried out taking into account the fact 
that the day of receipt of the notification is not included. The deadlines to be taken into account within the 
meaning of the basic Regulation commence therefore as from the day after the receipt of the notification. 
The application for action can be submitted electronically if an electronic data exchange system is available. In all 
other cases. the form is to be completed by mechanical means or in legible handwriting and must not contain 
erasures or overwriting. 
Ill. HOW TO FILE AN APPLICATION FOR ACTION 
The right-holder must submit his application for action to the relevant office referred to in box 2 of the fonn. On 
receipt of the application. the competent customs office will process it and inform the applicant of its decision by 
writing within 30 working days. If the office refuses the application by reasoned decision. the applicant has the right 
of appeal. The period during which the customs authorities will take action is set at one year. renewable annually. 
N. EXPLANATIONS OF THE MAIN BOXES TO BE FILLED IN BY THE APPLICANT 
Box 3: Name. address and capacity of the applicant. Within the meaning of Article 2(2). the applicant may be the 
right-holder himself. a person authorised to use the intellectual property right or a designated representative. 
Box 4: Status of the applicant. Tick the appropriate box. 
Box 5: Type of right concerned by the application for action. Tick the appropriate box. 
Boxes 6 and 7: Contact details for the applicant's contact person dealing with administrative matters should be 
entered in Box 6. Box 7 is for the contact details of the person who would be responsible for meeting the customs 
authorities to discuss technical details of the goods detained. The person concerned must be easily contactable at 
short notice. 
Boxes 8. 9 and 12: Box 8 is for specific and accurate information which would enable the customs authorities to 
identify the authentic goods correctly and for any information the right -holder may possess concerning the type or 
pattern of fraud (documents. photos etc.). 
The information should be as detailed as possible to allow the customs authorities to identify suspect consignments 
Simply and effectively using risk analysis principles. 
Various types of information should be entered in these boxes to help improve customs intelligence on products and 
patterns of fraud. Additional supporting details can be prOvided such as: the pre-tax value of the legal goods. the 
location of the goods or their intended destination, particulars identifying the consignment or packages. the 
scheduled arrival or departure date of the goods. the means of transport used. the identity of the importer. 
exporter or holder. 
Box 11: The natural or legal person who fills in box 3 of the Application for action must. in all cases. be the one 
who will provide the documents foreseen in box 11 of the Application for action. 
Box 13: By signing this box, the right-holder certifies that he accepts the terms of the Regulation and his obligations. ANNEX I-B IPINIlIEEC/E/3 
Page 11 
DECLARATION IN ACCORDANCE wrrn ARTICLE 6 OF COUNCR REGULATION (EC) No 1383/2003 
I, the undersigned ................................ . 
right-holder, within the meaning of Anicle 2(2) of Regulation (Eq No 1383/2003 (hereinafter 'the basic Regulation', of 
the intellectual property rights certified by the attached documents, hereby undertake in accordance with Article 6 of the 
Regulation to assume liability towards the persons involved in a situation referred to in Article 1(1) in the event that a 
procedure initiated pursuant to present Regulation is discontinued owing to an act or omission on my part or in the 
event that the goods in question are subsequently found not to infringe an intellectual property right. 
- 1 hereby undenake to pay all costs incurred under the basic Regulation by keeping goods under customs control 
pursuant to Article 9, and where applicable Article 11. including costs occasioned by the destruction of goods 
infringing an intellectual property right pursuant Article 17. 
- 1 confirm that I have taken note of Article 12 of the basic Regulation and undertake to notify the department 
indicated in Article 5(2) of any alteration to or loss of my intellectual property rights. 
Done at ........................... on ... / ........ /20 .. 
(Signature) IP/N/1IEECIEI3 
Page 12 
ANNEX l-C 
NAMES AND ADDRESSES FOR TIlE SUBMISSION OF ABIUlY TO ACT 
BELGIUM 
Monsieur le Directeur general des douanes et accises 
Service 'Gestion des Groupes cibles' -Regimes divers -Direction 1 (Contrefa~on-Piraterie) 
Boite 37 Boulevard du Jardin Botanique 50 
B-lOlO Bruxelles 
Telephone (32-2) 2103138 
Telecopieur (32-2) 2103213 
Courrier eIectronique: org.contr.reg.div@minfin.fed.be 
De heer Directeur-generaal van de Administratie der Douane en Accijnzen Dienst 
Diverse regelingen 
Directie 1 'Namaak en Piraterij' 
Rijksadministratief Centrum 
Finandetoren bus 37 Kruidtuinlaan 50 
B-1 0 10 Brussel 
Tel. (32-2) 21031 38 
Fax (32-2) 2103213 
E-mail: org.contr.reg.diV@minfin.fed.be 
DENMARK 
Central Customs and Tax Administration 
Customs Control 
0stbanegade 123 
DK-2100 Copenhagen 
Tel. +4572379000 
Fax: +4572372917 
E-mail: toldskat®toldskat.dk 
Internet: www.erhverv.toldskat.dk 
GERMANY 
Oberfinanzdirektion Nurnberg Zentralstelle Gewerblicher Rechtsschutz 
Sophienstra&e 6 
0-80333 Munchen 
Tel.:. (49-89) 5995 (2349) 
Fax: (49-89) 59952317 
E-mail: zgr®ofdm.bfinv.de 
Internet: www.zoll.de/eO_downloadsfbO_vordrucke/eO_vub/index.html 
SPAIN 
Departamento de Aduanas e Impuestos Especiales 
Subdireccion General de Gestion Aduanera 
Avenida del L1ano Castellano 17 
E-28071 Madrid 
Tel.: (34) 917289854 
Fax: (34) 917291200 
FRANCE 
Direction generale des douanes 
Bureau E4 -Section de la propriete intellectuelle 
8 rue de la Tour des dames 
F-75436 Paris Cedex 09 
Telephone (33-1) 55074860 
Telecopieur (33-1) 55074866 IRELAND 
Office of the Revenue Commissioners 
Customs Branch 
Unit 2 
Government Offices 
Nenagh 
Co Tipperary 
Ireland 
Tel. (3536763238) 
Fax (3536732381) 
E-mail: tariff@revenue.ie 
Internet: www.revenue.ie 
ITALY 
Agenzia Delle Dogane 
Ufficio Antifrode 
Via Mario Carucci, 71 
1-00144 Roma 
Tel.: (39-6) 50242081 -50246596 
Fax: (39-6) 509573 00 -50242021 
E-mail: dogane.antifrode@agenziadogane.it 
LUXEMBOURG 
Direction des douanes et accises 
Division 'Attributions Securitaires' 
Boite postale 1605 
L-I016 Luxembourg 
Telephone (352) 290191 
Telecopieur (352) 498790 
NETHERLANDS 
Douane-Noord/kantoor Groningen, afdeling IER 
P.O. Box 380 
9700 AJ Groningen 
Nederland 
Tel. +31505232175 
Fax: +31 505232176 
E-mail: Douane.hier@tiscalirnail.nl 
Internet: www.douane.nl 
AUSTRIA 
Zollamt Villach 
Competence Center Gewerblicher Rechtsschutz 
Ackerweg 19 
A-9500 Villach 
Tel.: (43) 42423028-(39, 41 0 52) 
Fax: (43) 4242 30 28-71 oder 73 
E-mail: post.425-pdp.zaktn@bm(gv.at 
PORTUGAL 
Ministerio das Finan'?S 
Direc,.ao-Geral das Alfandegas e dos lmpostos 
Especiais sobre 0 Consumo 
Direc,.ao de Servicos de Regula,.ao Aduaneira 
Rua da Alfandega, n.o 5 R/C 
P-1149-006 Lisboa 
Tel.: +35121881 3890 
Fax: +351218813984 
E-mail: dsra@dgaiec.min-financas.pt 
Internet: www.dgaiec.min-flOancas.pt IP/NI1 IEEClE13 
Page 13 IP /NI 1 IEEClE13 
Page 14 
FINLAND 
Tullihallitus 
Valvontaosasto 
PL 512 
FI -001 01 Helsinki 
Tel.: (358) 204922748 
Fax: (358) 20492 2669 
Enforcement Department 
National Board of Customs 
Box 512 
FI-00101 Helsinki 
SWEDEN 
Tullverke~ huvudkontor 
Handelsenheten 
Box 12854 
S-112 98 Stockholm 
Tel.: (46) 771 520520 
Fax: (46-8) 4050550 
From July 2004 the address will be: 
Tullverket 
Kc Ombud 
S pecialistenheten 
Box 850 
S-201 80 Malmo 
Tel.: (46) 771 520520 
Fax: (46-40) 6613013 
Internet: www.tulIverket.se 
UNITED KINGDOM 
HM Customs & Excise 
errops 1'1 Floor West 
Alexander House 
21 Victoria Avenue 
Southend-on-Sea 
Essex SS99 !AA 
United Kingdom 
Tel.: (441702)36 72 21 
Fax: (44 1702) 36 68 25 
Internet: www.hmce.gov.uk 
GREECE 
A TTlKA CUSTOMS DISTRICT 
PI. Ag. Nikolaou 
GR-1851O Pireas 
Tel.: (+30210) 4282461, 4515587 
Fax: (+30210) 4511009 
Internet: www.e-oikonomia.gr 
SLOVAK REPUBliC 
Customs Directorate of the Slovak Republic 
Mierova 23 
SK-815 11 Bratislava 
Tel.: +421248273101 
Fax: +421243336448 
Internet: www.colnasprava.sk ESTONIA 
Maksu-ja Tolliamet 
Narva mnt 9j 
EE-15176 Tallinn 
Te!.: +372 683 5700 
Fax: +372 6835709 
E-mail: tolI@customs.ee 
LITHUANIA 
Customs Department under the Ministry of Finance of the Republic of Lithuania 
A. Jaksto 1/25 
LT-2600 Vilnius 
Te!.: +37052666111 
Fax: +37052666005 
CZECH REPUBliC 
CUSTOMS DIRECTORATE HRADEC KRALOVE 
ul. Bohuslava Martinu 1672/8a 
P.O.BOX 88 
CZ-501 01 HRADEC KRALOVE 
Tel: 00420495756111. 00420495756214. 00420495756267 
Fax: 00420495756200 
E-mail: posta0601@cs.mfcr.cz 
Internet: www.cs.mfcr.cz 
MALTA 
Director General of Customs 
Customs House 
Lascaris Wharf ValIetta. 
Te!': +356 25685101 
Fax: +356 25685243 
E-mail: carmel.v.portelli@gov.mt 
Internet: www.customs.business-Une.com/ 
SLOVENIA 
Customs Administration of Republic of Slovenia 
General Customs Directorate 
Smartinska 55 
SLO-1 523 Ljubljana 
Te!.: +386 1 478 3800 
Fax: + 386 1 478 3904 
E-mail: ipr.curs@gov.si 
CYPRUS 
Customs Headquarters 
Address: M. Karaoli 
1096 Nicosia 
Cyprus 
Postal address: 
Customs Headquarters 
1440 Nicosia 
Cyprus 
Tel.: 00357-22-601652, 00357-22-601858 
Fax: 00357-22-602769 
E-mail: headquarters@customs.mof.gov.cy IPINIIIEEClE13 
Page 15 IP/N/IIEEClE13 
Page 16 
REPUBLIC OF LATVIA 
Intellectual Property Rights Subdivision 
Enforcement Division 
National Customs Board 
State Revenue Service 
Republic of Latvia 
Kr. Valdemara Street 1 a 
LV-1841 Riga 
Tel.: +371 7047442. +371 7047400 
Fax: +371 7047440 
E-mail: customs@dep.vid.gov.lv 
Internet: www.vid.gov.lv 
HUNGARY 
17. sz. W.mhivatal (Customs Office no. 17) 
Direccion: H-1143. Budapest 
Hungaria krt. 112-114. 
Direccion postal: 
H-1591 Budapest 
pf. 310. 
Tel.: +361 470-42-60 +361 470-42-61 
Fax: +361 470-42-78 +361 470-42-79 
E-mail: vhI7000@mail.vpop.hu 
POLAND 
The Customs Chamber in Warsaw 
Str. Modlinska 4 
PL-03 216 Warsaw 
Tel.: +48 22 5104611 
Fax: +48 22 8115745 IP/N/l/EEC/E/3 
Page 17 
ANNEX 11 
I COMMUNITY APPLICATION FOR ACTION 
1. Date of receipt of the application for action by the designated 
customs department (within the meaning of Article 5(2) of 
Regulation (EC) No 1383/2003) 
DDIMMIYY: .1.1 .. 
3. Details of applicant (I.e. rlght-holder within the meaning of 
Article 2(2) of Regulation (EC) No 1383/2003 (i) 
NAME: .............................................................................................. . 
FUNCTION: .................................................................................... .. 
ADDRESS: ...................................................................................... . 
TOWN: ............................................................................................. . 
POSTCODE: .................................................................................... . 
COUNTRY: ...................................................................................... . 
VAT NO: .......................................................................................... . 
TEL. ................................................................................................. . 
MOBILE: .......................................................................................... . 
FAX .................................................................................................. . 
E-MAIL: ............................................................................................ . 
INTERNET ADDRESS: .................................................................. . I 
INTELLECTUAL PROPERTY RIGHTS 
APPLICATION FOR ACTION 
BY CUSTOMS AUTHORITIES 
under Article 5(4) of Regulation (EC) No 138312003 
2. Name and addr ... of comJ)818nt authority to which applica­
tion Is made (see Annex II-C for details): 
4. Status of applicant (within the meaning of Article 2(2) of Regulation (EC) No 138312003 (1»: 
o Right-holder (*) o Right-holder's representative (*) 
o Authorised user of the right (*) o Representative of authorised user (0) 
5. Type of right to which application refers: 
o Community trademark (2) o Community design f} right 
o Supplementary protection certificate (4) 
o Designation of Origin protected by the Community (S) 
o Geographical indication (protected by the Community (S) 
o Community protected plant variety right~) 
o Geographical designations for spirit drinks (1) 
6. Member State(s) in which action by customs authorities Is requested 
OAT o DK o FR o FI o LU 
o BE DEL DIE o SE o NL 
o DE o ES o IT o UK OPT 
o CY o HU o MT o CZ o EE 
o LV o LT o PL 051 o 5K 
7. I attach essential technical data on the authentic goods: 
o Number of documents attached (8) o Number of photos attached (8) 
8. I attach specific Information concerning the type or pattern of fraud: 
o Number of documents attached (8) o Number of photos attached (8) IPINI1 IEEClE13 
Page 18 
9. I attach document(s) attesting to the fact that the applicant holds the right for the goods In question within the meaning of Article 2(2) of 
Regulation (EC) No 138312003 (*) 
o Number of documents attached (8) 
10. I attach the undertaking laid down In Article 6 of Regulation (EC) No 1383/2003, assuming liability In the situations outlined In that 
Article (*): 
Undertaking attached: 0 
11. Right-holder's contact person In the other Member Statea where action Is requested (1) 
ADMINISTRATIVE QUESTIONS (lawyer, for example) 
OBE o DK ODE DEL 
Name: Name: Name: Name: 
Address: Address: Address: Address: 
Tel. Tel. Tel. Tel. 
Mobile: Mobile: Mobile: Mobile: 
Fax Fax Fax Fax 
E-mail: E-mail: E-mail: E-mail: 
o See attached list o See attached list o See attached list o See attached list 
DES o FI o FR DIE 
Name: Name: Name: Name: 
Address: Address: Address: Address: 
Tel. Tel. Tel. Tel. 
Mobile: Mobile: Mobile: Mobile: 
Fax Fax Fax Fax 
E-mail: E-mail: E-mail: E-mail: 
o See attached list o See attached list o See attached list o See attached list 
OIT o LU OAT o NL 
Name: Name: Name: Name: 
Address: Address: Address: Address: 
Tel. Tel. Tel. Tel. 
Mobile: Mobile: Mobile: Mobile: 
Fax Fax Fax Fax 
E-mail: E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list o See attached list 
OPT o SE o UK o CV 
Name: Name: Name: Name: 
Address: Address: Address: Address: 
Tel. Tel. Tel. Tel. 
Mobile: Mobile: Mobile: Mobile: 
Fax Fax Fax Fax 
E-mail: E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list o See attached list 
o HU o MT o SK o CZ 
. Name: Name: Name: Name: 
Address: Address: Address: Address: 
Tel. Tel. Tel. Tel. 
Mobile: Mobile: Mobile: Mobile: 
Fax Fax Fax Fax 
E-mail: E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list o See attached list o EE o LV o LT 
Name: Name: Name: 
Address: Address: Address: 
Tel. Tel. Tel. 
Mobile: Mobile: Mobile: 
Fax Fax Fax 
E-mail: E-mail: E-mail: 
o See attached list o See attached list o See attached list 
o SI 
Name: 
Address: 
Tei. 
Mobile: 
Fax 
E-mail: o See attached list 
12. Rlght-holder's contact person In the other Member States where action Is requested n 
TECHNICAL QUESTIONS (expert, for example) 
OBE o OK ODE 
Name: Name: Name: 
Address: Address: Address: 
Tel. Tel. Tel. 
Mobile: Mobile: Mobile: 
Fax Fax Fax 
E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list 
o ES o FI o FR 
Name: Name: Name: 
Address: Address: Address: 
Tel. Tel. Tel. 
Mobile: Mobile: Mobile: 
Fax Fax Fax 
E-mail: E-mail: E-mail: 
o See attached list o See attached list o See attached list 
OIT o LU OAT 
Name: Name: Name: 
Address: Address: Address: 
Tel. Tel. Tel. 
Mobile: Mobile: Mobile: 
Fax Fax Fax 
E-mall: E-mail: E-mail: o See attached list o See attached list o See attached list o PL 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: IP /N/11EEC1E13 
Page 19 
o See attached list 
o EL 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
o lE 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: 
o See attached list 
o NL 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list IPINI1 IEEClE13 
Page 20 
OPT 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
o HU 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: 
o See attached list 
o EE 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
o SI 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list o SE 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
o MT 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: 
o See attached list 
o LV 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
13_ Any other Information In the rlght-holcler's possession, e.g.: 
-Country or countries of production 
-Routes used by traffickers o UK o CV 
Name: Name: 
Address: Address: 
Tel. Tel. 
Mobile: Mobile: 
Fax Fax 
E-mail: E-mail: o See attached list o See attached list 
o SK o CZ 
Name: Name: 
Address: Address: 
Tel. 'Tel. 
Mobile: Mobile: 
Fax Fax 
E-mail: E-mail: 
o See attached list o See attached list 
o LT o PL 
Name: Name: 
Address: Address: 
Tel. Tel. 
Mobile: Mobile: 
Fax Fax 
E-mail: E-mail: o See attached list o See attached list 
Number of documents attached (9) 0 
Number of documents attached (i) 0 
-Technical differences between the authentic and the suspect goods: Number of documents attached (i) 0 
-eN tariff heading: 
-Other useful information Number of documents attached (i) 0 
14. Date of filing application: 
Date on which drawn up Place Appllcanfs Signature (**) 
DDIMMIYY: . .!. J .. . ............................................................................ . ................................................................................ 15. Decision by customs authorities (within the meaning of Article 5(7) and (8) of Regulation (Ee) No 1383nOO3) IPINI1 IEEClE/3 
Page 21 
o The application is approved Registration number of application for action: .................................... .. 
Date Place Signature and stamp 
DDIMMlYV: .. J .. .1 .•. 
o The application is valid until: . J. J ... Any request for extension of the validity period should be sent to the competent authority of box 2, at the latest 
30 working days before the validity of the application expires. 
o The application has been refused 
A reasoned decision stating the grounds for refusal and Information concemlng the appeal procedure are attached. 
Date Place Signature and stamp 
DDIMMlYV: .. J .. .1 ... 
16. Acknowledgement of receipt 
Conceming application made by ................................................................................................................................................ (name of the applicant) 
OAT o OK o FR o FI o LU NAME: 
OBE o EL DIE o SE o NL 
DOE o ES o IT o UK OPT 
o CV o HU o MT o SK o CZ PLACE AND DATE OF RECEIPT: o EE o LV o LT o PL 
o SI 
SIGNATURE AND STAMP: 
(.) See box 9 (Ior further Inlormatlon 8ee 'Notes on completion', Annex 11 • A). 
("') If the applicant Is a representallve 01 the righloholder, he must provide prool that he Is empowered to 
represent 1I1e right-holder. 
(1) TIck the appropriate box(es). 
(2) Council Regulation (EC) No 40/94 (OJ L t 1, 14. t t .1994, p. 1). 
(3) Council Regulation (EC) No 612002 (OJ L 3, 5.1.2002, p. 1). 
(4) Council Regulation (EEC) No 1768192 or Regulalion (EC) No 1610196 01 the European Parilament and 01 the Council (OJ L 196, 8.8.1996, p. 30). 
(5) Council Regulation (EEC) No 2081192 and (EC) No 1493199 (OJ L 179, 14.7.1999, p. 1). 
(&) Council Regulation (EC) No 2100194 (OJ LW, 1.9.1994, p. 1). 
(1) Regulation (EEC) No 1576/89 (OJ L 160, 12.6.1989. p. 1). 
(11) Insert the relevant number, ff none are attached, Insert O. 
(11) Insert the relevant number, H none are attached, Insert O. IP INIllEEClE13 
Page 22 
I COMMUNITY APPLICATION FOR AcnON 
1. ~ate of receipt of the application for action by the designated 
customs department (within the meaning of Article 5(2) of 
Regulation (EC) No 138312003) 
DDIMMIYY: .1.1 .. 
3. Details of applicant (I.e. riQ!lt-holder within the meaning of 
Article 2(2) of Regulation (I:C) No 138312003 (*» 
NAME: .............................................................................................. . 
FUNCTION: ..................................................................................... . 
ADDRESS: ...................................................................................... . 
TOWN: ............................................................................................. . 
POSTCODE: .................................................................................... . 
COUNTRY: ...................................................................................... . 
VAT NO: ......................................................................................... .. 
TEL. ................................................................................................. . 
MOBILE: .......................................................................................... . 
FAX .................................................................................................. . 
E-MAIL: ............................................................................................ . 
INTERNET ADDRESS: ................................................................. .. I 
INTELLECTUAL PROPERTY RIGHTS 
APPLICAnON FOR ACTION 
BY CUSTOMS AUTHORITIES 
under Article 5(4) of Regulation (EC) No 138312003 
2. Name and address of competent authority to which applica­
tion Is made (see Annex lIoC for details): 
4. Status of applicant (within the meaning of Article 2(2) of Reguletlon (EC) No 138312003 (,»: 
o Right-holder (*) o Right-holder's representative (*) 
o Authorised user of the right (*) o Representative of authorised user (*) 
5. Type of right to which application refers: 
o Community trademark f) o Community design (3) right 
o Supplementary protection certificate (4) 
o Designation of origin protected by the Community (5) 
o Geographical indication (protected by the Community(5) 
o Community protected plant variety right (6) 
o Geographical designations for spirit drinks e> 
6. Member State(s) in which action by customs authorities is requested 
OAT o OK o FR o FI o LU 
OBE o EL DIE o SE o NL 
o DE DES o IT o UK OPT 
o CY o HU o MT o CZ o EE 
o LV o LT o PL o SI o SK 
7. I attach essential technical data on the authentic goods: 
o Number of documents attached (11) o Number of photos attached (8) 
8. I attach specific Information concerning the type or pattern of fraud: 
o Number of documents attached (8) 0 Number of photos attached (8) IP /N/lIEECIE/3 
Page 23 
9. I attach document(s) attesting to the tact that the applicant holds the right tor the goods In question within the meaning ot Article 2(2) of 
Regulation (EC) No 1383fZOO3(*) 
o Number of documents attached (8) 
10. I attach the undertaking laid down In Article 6 of Regulation (EC) No 138312003, assuming liability In the situations outlined In that 
Article (*): 
Undertaking attached: 0 
11. Rlght-holder's contact person In the other Member States where action Is requested (1) 
ADMINISTRATIVE QUESTIONS (lawyer. for example) 
o BE o DK o DE DEL 
Name: Name: Name: Name: 
Address: Address: Address: Address: 
Tel. Tel. Tel. Tel. 
Mobile: Mobile: Mobile: Mobile: 
Fax Fax Fax Fax 
E-mail: E-mail: E-mail: E-mail: 
o See attached list o See attached list o See attached list o See attached list 
o ES o FI o FR o lE 
Name: Name: Name: Name: 
Address: Address: Address: Address: 
Tel. Tel. Tel. Tel. 
Mobile: Mobile: Mobile: Mobile: 
Fax Fax Fax Fax 
E-mail: E-mail: E-mail: E-mail: 
o See attached list o See attached list o See attached list o See attached list 
DIT o LU OAT o NL 
Name: Name: Name: Name: 
Address: Address: Address: Address: 
Tel. Tel. Tel. Tel. 
Mobile: Mobile: Mobile: Mobile: 
Fax Fax Fax Fax 
E-mail: E-mail: E-mail: E-mail: 
o See attached list o See attached list o See attached list o See attached list 
OPT o SE o UK o CV 
Name: Name: Name: Name: 
Address: Address: Address: Address: 
Tel. Tel. Tel. Tel. 
Mobile: Mobile: Mobile: Mobile: 
Fax Fax Fax Fax 
E-mail: E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list o See attached list 
o HU o MT o SK o CZ 
. Name: Name: Name: Name: 
Address: Address: Address: Address: 
Tel. Tel. Tel. Tel. 
Mobile: Mobile: Mobile: Mobile: 
Fax Fax Fax Fax 
E-mail: E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list o See attached list JP /NI l1EEC/E/3 
Page 24 
o EE 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
o SI 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list o LV o LT 
Name: Name: 
Address: Address: 
Tel. Tel. 
Mobile: Mobile: 
Fax Fax 
E-mail: E-mail: o See attached list o See attached list 
12. Right-holder's contact person in the other Member Statas where action Is requested(1) 
TECHNICAL QUESTIONS (expert, for example) 
OBE o OK o DE 
Name: Name: Name: 
Address: Address: Address: 
Tel. Tel. Tel. 
Mobile: Mobile: Mobile: 
Fax Fax Fax 
E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list 
o ES o FI o FR 
Name: Name: Name: 
Address: Address: Address: 
Tel. Tel. Tel. 
Mobile: Mobile: Mobile: 
Fax Fax Fax 
E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list 
OIT o LU OAT 
Name: Name: Name: 
Address: Address: Address: 
Tel. Tel. Tel. 
Mobile: Mobile: Mobile: 
Fax Fax Fax 
E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list o PL 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
o EL 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
DIE 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: 
o See attached list 
o NL 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list OPT o SE o UK 
Name: Name: Name: 
Address: Address: Address: 
Tel. Tel. Tel. 
Mobile: Mobile: Mobile: 
Fax Fax Fax 
E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list 
o HU o MT o SK 
Name: Name: Name: 
Address: Address: Address: 
Tel. Tel. Tel. 
Mobile: Mobile: Mobile: 
Fax Fax Fax 
E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list 
o EE o LV o LT 
Name: Name: Name: 
Address: Address: Address: 
Tel. Tel. Tel. 
Mobile: Mobile: Mobile: 
Fax Fax Fax 
E-mail: E-mail: E-mail: o See attached list o See attached list o See attached list 
o SI 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
13. Any other Information In the rlght-holcler', possession, e.g.: 
-Country or countries of production 
-Routes used by traffickers 
-Technical differences between the authentic and the suspect goods: 
-eN tariff heading: 
-Other useful Information 
14. Date of filing application: 
Date on which drawn up Place o CV 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: IPINIllEEClE13 
Page 25 
o See attached list 
o CZ 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
o PL 
Name: 
Address: 
Tel. 
Mobile: 
Fax 
E-mail: o See attached list 
Number of documents attached (9) 0 
Number of documents attached (9) 0 
Number of documents attached (9) 0 
Number of documents attached (9) 0 
Appllcenfs signature(-) 
DDIMMlYY: . .t. J .. . ............................................................................ . ................................................................................ IP/N/llEEClE13 
Page 26 
15. Decision by customs authorities (within the mesnlng of Article 5(7) and (8) of Regulation (Ee) No 138312003) 
o The application is approved Registration number of application for action: ..................................... . 
Date Place Signature and stamp 
DDIMMlYY: .. J .. .I ... 
o The application is vaJid until: . J. J ... Any request for extension of the validity period should be sent to the competent authority of box 2, at the latest 
30 working days before the validity of the application expires. 
o The application has been refused 
A reasoned decision stating the grounds for refusal and information concerning the appeal procedure are attached. 
Date Place Signature and stamp 
DDIMMlYY: .. J .. .I ... 
16. Acknowledgement of receipt 
Concerning application made by ................................................................................................................................................ (narne of the applicant) 
OAT o OK o FR o FI o LU NAME: 
OBE o EL o lE o SE o NL 
ODE DES o IT o UK o PT 
o CY o HU OMT o SK o CZ PLACE AND DATE OF RECEIPT: o EE o LV o LT o PL 
o SI 
SIGNATURE AND STAMP: 
(0) See box 9 (for further Information see 'Notes on completlon', Annex 11 • A). 
(.., 11 the applicant Is a representative 01 the rlght-holder, he must provide proof that he Is empowered to 
represent the rlght-holder. 
(1) Tick the appropriate box(es). 
(2) Council Regulation (EC) No 40194 (OJ L 11, 14.11.1994, p. 1). 
(3) Council Regulation (EC) No 61.2002 (OJ L 3, 5.1.2002, p. 1). 
(4) Council Regulallon (EEC) No 176&'92 or Regulation (EC) No 161!l196 01 the European Parliament and of the Council (OJ L '198,8.8.1996, p. 30). 
(5) CounCil Regulallon (EEC) No 2081192 and (EC) No 1493199 (OJ L 179, 14.7.1999, p. 1). 
(11) Council Regulation (EC) No 2100194 (OJ L 227,1.9.1994, p. 1). 
(1) Regula1lon (EEC) No 157&'89 (OJ L 160, 12.6.1989, p. 1). 
(11) Insert the relevant number, 11 none are attached, In88rt O. 
(9j Insert the relevarrl number, 11 none are attached, Insert O. ANNEX Il-A 
NOTES ON COMPLETION 
I. OBLIGATORY INFORMATION ON RIGHTS AND ABILITY TO ACT 
(a) Where the holder of the right makes the application himself: IP/N/lIEECIEI3 
Page 27 
-in the case of a right that is registered or for which an application has been lodged, proof of registration with 
the relevant office or lodging of the application, 
-in the case of a copyright, related right or design right which is not registered or for which an application has 
not been lodged, any evidence of authorship or of his status as original holder. 
(b) Where the application is made by any other person referred to in Article 2(2)(b) authorised to use one of the rights 
referred to in Article 2(I)(a), (b) and (c) of the basic Regulation, in addition to the proof required under point (a) of 
this Article, the document by virtue of which the person is authorised to use the right in question; 
(c) Where a representative of the holder or of any other person referred to in Article 2(2)(a) and (b) authorised to use 
one of the rights referred to in Article 2(I)(a), (b) and (c) of the basic Regulation applies, in addition to the proof 
required under points (a) and (b) of this Article, proof of authorisation to act. 
The natural or legal person who fills in box 3 of the Application for action must. in an cases. be the one 
who will provide the documents foreseen in box 10 of the Application for action. 
(d) Box 5 contains all geographical indications. Protected designation of origin (PDO) and protected geographical 
indication (pG!) mean the official indications designated in accordance with Regulations (EEC) No 2081/92, (Eq 
No 1107/96 and (EC) No 2400/96.'Geographical indications for wines'means indications within the meaning of 
Regulation (Eq No 1493/99.'Geographical designations for spirituous beverages' means the official designations 
according to Regulation (EEC) No 1576/89. Individual producers as well as groups and their representatives are 
entitled to make an application. 
(e) Registration and specifications are required when an application is made: for protected designation of origin and 
protected geographical indication. 
n. WHAT DOES THE APPLICATION FOR ACTION HAVE TO CONTAIN? 
(Article 5(4): Where the applicant is the holder of a Communio/ trademark. a Communio/ design, a Communio/ plant varieo/ 
right or a designation of origin or geographical indication protected by the Communio/. an application may. in addition to 
requesting lICtion by the customs authorities of the Member State in which it is lodged, request action by the customs authorities of 
one or more other Member States'). 
An application for action can be used by the right-holder, free of charge, either as a preventive measure or where he 
has reason to think that his intellectual property right or rights have been or are likely to be infringed. The application 
must contain all the information needed to make the goods in question readily recognisable by the customs 
authorities, and in particular: 
-an accurate and detailed technical description of the goods, 
-any specific information the right-holder may have concerning the type or pattern of fraud. 
-the name and address of the contact person appointed by the right-holder, 
-the undertaking required of the applicant by Article 6 of the basic Regulation and proof that the applicant holds 
the right for the goods in question. IP/NI1 IEEClE13 
Page 28 
The application for action can be submitted electronically if an electronic data exchange system is available. In all 
other cases. the form is to be completed by mechanical means or in legible handwriting and must not contain erasures 
or overwriting. 
-The right-holders must imperatively retum the proof of receipt of the notification which was addressed to them by 
the Customs Service. according to Articles 4 (ex officio) and 9. It must be done immediately after having received 
this notification. The legal deadlines (three working days -ten working days) start from the moment of receipt of 
the notification. It is imperative that the right-holder. as soon as he is contacted by the customs authorities. 
confirms immediately the receipt of the notification. 
-Within the meaning of the basic Regulation 'working day' (reference to Regulation (EEC) No 1182/71) is 
considered every day other than public holidays. Saturdays and Sundays. Moreover. the calculation of working 
days as included in Articles 4 and 13. has to be carried out taking into account the fact that the day of receipt of 
the notification is not included. The deadlines to be taken into account within the meaning of the basic regulation 
commence therefore as from the day after the receipt of the notification. 
Ill. HOW TO FILE AN APPUCATION FOR ACTION 
The right-holder must submit his application for action to the relevant office referred to in box 2 of the fonn. On 
receipt of the application. the competent customs office will process it and notify the applicant in writing of its 
decision within 30 working days. If the office refuses the application by reasoned decision. the applicant has the right 
of appeal. The period during which the customs authorities will take action is set at one year. renewable annually. 
IV. EXPLANATIONS OF THE MAIN BOXES TO BE FILLED IN BY THE APPLICANT 
Box 3: Name, address and capacity of the applicant. Within the meaning of Article 2(2). the applicant may be the 
right-holder himself. a person authorised to use the intellectual property right or a designated representative. 
The natural or legal person who fills in box 3 of the application for action must, in all cases, be the one who 
will provide the documents foreseen in box 10 of the application for action. 
Box 4: Status of the applicant. Tick the appropriate box. 
Box 5: Type of right concerned by the application for action. Tick the appropriate box. 
Box 6: Tick the box for the Member States in which action by the customs authorities is requested. You are strongly 
advised to file an application for action in every Member State. 
Boxes 7, 8 and 9: These boxes are very important. Accurate, practical details must be provided to enable the customs 
authorities to quickly identify the goods detained (photos. documents, etc.). 
Specific information relating to the type or pattern of fraud will facilitate risk analysis. The information should be as 
detailed as possible to allow the customs authorities to identify suspect consignments simply and effectively using risk 
analysis. These boxes should be used to provide customs with more accurate intelligence in relation to products and 
so improve its understanding of trafficking. Additional supporting details can be prOvided such as: the pre tax value of 
the legal goods, the location of the goods or their intended destination. particulars identifying the consignment or 
packages, the scheduled arrival or departure date of the goods, the means of transport used, the identity of the 
importer, exporter or holder. 
Boxes 11 and 12: Contact details for the applicant's contact persons dealing with administrative matters and questions 
of technical expertise should be entered in Boxes 11 and 12. Box 12 is for the contact details of the person who 
would be responsible for meeting the customs authorities to discuss technical details of the goods detained. The 
person concerned must be easily reachable at short notice. IPINI1 IEEClE13 
Page 29 
Box 14: By signing this box, the right-holder certifies that he accepts the terms of the regulation and his obligations. 
Box 15: The duly completed and signed form, together with as many extracts as the number of Member States 
indicated in Box 6, must be submitted to the customs office specified in Article 5(2) of the basic regulation. The 
application for action may have to be translated into the language of the Member States where it is to be filed. 
The customs offices listed in Annex II-C are at your disposal for any further information. IP /NI 1 IEEClE13 
Page 30 
ANNEX lI-B 
DECLARATION ACCORDING TO ARTIa.E 6 OF COUNCIL REGULATION (Ee) No 1383/2003 
I, the undersigned ................................ . 
right-holder, within the meaning of Article 2(2) of CouncU Regulation (Eq No 1383/2003 hereinafter 'the basic 
Regulation', of the intellectual property rights certified by the attached documents, hereby undertake in accordance 
with Article 6 of the Regulation to assume liability towards the persons involved in a situation referred to in Article 
1 (1) in the event that a procedure initiated pursuant to present Regulation is discontinued owing to an act or omission on 
my part or in the event that the goods in question are subsequently found not to infringe an intellectual property right. 
- I hereby undertake to pay all costs incurred under the basic Regulation by keeping goods under customs control 
pursuant to Article 9, and where applicable Article 11, including costs occasioned by the destruction of goods 
infringing an intellectual property right pursuant Article 17. 
- I hereby certify that the undertaken is given in every Member State in which the decision granting the application 
applies. I further agree to bear any translation costs required. 
- I confirm that I have taken note of Article 12 of the basic Regulation and undertake to notify the department 
indicated in Article 5(2) of any alteration to or loss of my intellectual property rights. 
Done at ............................. on ... / ........ /20 .. 
(Signature) ANNEX II-C IPINI1 IEEC/E/3 
Page 31 
NAMES AND ADDRESSES FOR nIE SUBMISSION OF AN APPLICATION FOR ACTION 
BELGIUM 
Monsieur le Directeur general des douanes et accises 
Service 'Gestion des Groupes cibles' -Direction 1 (Contrefa~on-Piraterie) 
Boite 37 Boulevard du Jardin Botanique 50 
B-1 010 Bruxelles 
Telephone (32-2) 2103138 
TeJecopieur (32-2) 2103213 
Courrier electronique: org.contr.reg.div@minfin.fed.be 
De heer Directeur-generaal van de Administratie der Douane en Accijnzen Dienst Diverse regelingen 
Directie 1 'Namaak en Piraterij' 
Rijksadministratief Centrum 
Financietoren 
bus 37 Kruidtuinlaan 50 
B-1 0 10 Brussel 
TeL: (32-2) 210 31 38 
Fax: (32-2) 210 32 13 
E-mail: org.contr.reg.diV@minfm.fed.be 
DENMARK 
Central Customs and Tax Administration 
Customs Control 
0stbanegade 123 
DK-2100 Copenhagen 
Tel. +45 72379000 
Fruc +45 72372917 
E-mail: toldskat®toldskat.dk 
Internet: www.erhverv.toldskatdk 
GERMANY 
Oberfmanzdirektion Niimberg Zentralstelle Gewerblicher Rechtsschutz 
SophienstraSe 6 
D-80333 Miinchen 
TeL: (49-89) 59 95 23 49 
Fruc (49-89) 59 95 23 17 
E-mail: zgr@ofdm.bfinv.de 
Internet: www.zoll.de/eO_downloadsfbO_vordrucke/eO_vub/index.htrnl 
SPAIN 
Departamento de Aduanas e impuestos Especiales 
Subdireccion General de Gestion Aduanera 
Avenida del Uano Castellano 17 
E-28071 Madrid 
TeL: (34) 917 28 98 54 
Fax: (34) 917 29 12 00 
FRANCE 
Direction generale des douanes 
Bureau E4 -Section de la propriete intellectuelle 
8 rue de la Tour des dames 
F-75436 Paris Cedex 09 
Telephone (33-1) 55074860 
Telecopieur (33-1) 55074866 IP/N/llEEClE13 
Page 32 
IRELAND 
Office of the Revenue Commissioners 
Customs Branch 
Unit 2 
Government Offices 
Nenagh 
Co Tipperary 
Ireland 
Tel. (353 67 63238) 
Fax (353 67 32381) 
E-mail: tariff@revenue.ie 
Internet: www.revenue.ie 
ITALY 
Agenzia Delle Dogane 
Ufficio Antifrode 
Via Mario Carucci. 71 
1-00144 Roma 
TeI.: (39-6) 50 24 20 81 -50246596 
Fax: (39-6) 50 95 73 00 -50242021 
E-mail: dogane.antifrode@agenziadogane.it 
LUXEMBOURG 
Direction des douanes et accises 
Division 'Attributions Securitaires' 
Bolte postale 1605 
L-1016 Luxembourg 
Telephone (352) 290191 
Telecopieur (352) 498790 
NETHERLANDS 
Douane-NoordJkantoor Groningen. afdeling IER 
P.O. Box 380 
9700 AJ Groningen 
Nederland 
TeI. +31 505232175 
Fax: +31 505232176 
E-mail: Douane.hier@tiscalimail.nl 
Internet: www.douane.nl 
AUSTRIA 
Zollamt Villach 
Competence Center Gewerblicher Rechtsschutz 
Ackerweg 19 
A-9500 Villach 
TeI.: (43) 42 42 30 28-(39. 41 <> 52) 
Fax: (43) 42 42 30 28-71 oder 73 
E-mail: post.425-pdp.zaktn@bmf.gv.at 
PORTUGAL 
Ministeno das Financ;as 
Direcc;ao-Geral das Alfandegas e dos Impostos 
Especiais sobre 0 Consumo 
Direcc;ao de Servicos de Regulac;ao Aduaneira 
Rua da Alfandega. n.o 5 R/C 
P-1149-006 Lisboa 
TeI.: +351 21 881 3890 
Fax: +351 21 881 3984 
E-mail: dsra@dgaiec.min-financas.pt 
Internet: www.dgaiec.min-fmancas.pt FINLAND 
Tullihallitus 
Valvontaosasto 
PL 512 
FI-00101 Helsinki 
Tel.: (358) 20 492 27 48 
Fax: (358) 20 492 26 69 
Enforcement Department 
National Board of Customs 
Box 512 
FI -00101 Helsinki 
SWEDEN 
Tullverkets huvudkontor 
Handelsenheten 
Box 12854 
S-l12 98 Stockholm 
Tel.: (46) 771 520 520 
Fax: (46-8) 405 05 50 
From July 2004 the address will be: 
Tullverket 
Kc Ombud 
Specialistenheten 
Box 850 
S-201 80 Malmo 
Tel: (46) 771 520 520 
Fax: (46-40) 661 30 13 
Internet: www.tullverket.se 
UNITED KINGDOM 
HM Customs & Excise 
CITOPS1 SI Floor West 
Alexander House 
21 Victoria Avenue 
Southend-on-Sea 
Essex SS99 !AA 
United Kingdom 
Tel. +441702367221 
Fax +44 1702 366825 
Internet: www.hmce.gov.uk 
GREECE 
A mKA CUSTOMS DISTRICT 
PI. Ag. Nikolaou 
GR-18510 Pireas 
Tel. (+30 210) 4282461, 4515587 
Fax: (+30 210) 451 10 09 
Internet: www.e-oikonomia.gr 
SLOVAK REPUBUC 
Customs Directorate of the Slovak Republic 
Mierova 23 
SK-815 11 Bratislava 
Tel.: +421 2 48273101 
Fax: +421 2 43336448 
Internet: www.colnasprava.sk IPINIl/EEC/E/3 
Page 33 IP INIllEEClE13 
Page 34 
ESTONIA 
Maksu-ja Tolliamet 
NaJVa mnt 9j 
EE-15176 TaIlinn 
Tee +372 683 5700 
Fax: +372 683 5709 
E-mail: toll@customs.ee 
LITHUANIA 
Customs Departtnent under the Ministry of Finance of the Republic of Lithuania 
A. Jaksto 1/25 
LT-2600 Vilnius 
Tel.: +370 5 2666111 
Fax.: +370 5 2666005 
CZECH REPUBUC 
CUSTOMS DIRECTORATE HRADEC KRALOVE 
uI. Bohuslava Martinu 1672/8a 
P.O. BOX 88 
CZ-501 01 HRADEC KRALOVE 
Tel.: 00420 49 5756 111. 00420 495756214. 00420 495756267 
Fax: 00420 49 5756 200 
E-mail: posta0601@cs.mfcr.cz 
Internet: www.cs.mfcr.cz 
MALTA 
Director general of Customs 
Customs House 
Lascaris Wharf ValIetta 
Tel.: +356 25685101 
Fax: +356 25685243 
E-mail: carmel.v.portelli@gov.mt 
Internet: www.customs.business-line.com/ 
SLOVENIA 
Customs Administration of Republic of Slovenia 
General Customs directorate 
Smartinska 55 
SLO-1523 Ljubljana 
Tel.: +386 1 478 38 00 
Fax: +386 1 478 39 04 
E-mail: ipr.curs@gov.si 
CYPRUS 
Customs Headquarters 
Address: 
M. Karaoli 
1096 Nicosia 
Cyprus 
Postal Address: 
Customs Headquarters 
1440 Nicosia 
Cyprus 
TeI.: 00357-22-601652. 00357-22-601858 
Fax: 00357-22-602769 
E-mail: headquarters@customs.mof.gov.cy REPUBLIC OF LATVlA 
Intellectual Property Rights Subdivision 
Enforcement Division 
National Customs Board 
State Revenue Service 
Republic of Latvia 
Kr. Valdemara Street la 
LV 1841-Riga 
Tel.: +371 7047442. +371 7047400 
Fax: +371 7047423 
E-mail: customs@dep.vid.govJv 
intemet: www.vid.govJv 
HUNGARY 
17. SZ. Vamhivatal (Customs Office no. 17) 
Address: 
H-1143 Budapest 
Hungaria krt. 112-114 
Postal Address: 
H-1591 Budapest 
Pf. 310. 
Te!': +361 470-42-60. +361 470-42-61 
Fax: +361 470-42-78. +361 470-42-79 
E-mail: vhI7000@mail.vpop.hu 
POLAND 
The Customs Chamber in Warsaw 
Str. Modlinska 4 
PL-03 216 Warsaw 
Te!.: +48 22 5104611 
Fax: +48 22 8115745 IP/NI1 IEEC/E/3 
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