‘ANNEX V

Form of the report (1) on irrecoverable amounts corresponding to the entitlements to own resources

Unless otherwise stated, all information must be provided if available and relevant. All amounts are to be indicated in the currency of the respective Member State at the time of reporting.

1. GENERAL DATA

Member State: …

Reference of the report: …

(the Member State’s code/year of reporting/serial number of the year of reporting)

Reference to a related information form sent beforehand pursuant to Article 5(1) of Regulation (EU, Euratom) 2021/768: …

Justification of absence of a reference to the aforementioned information form:

…

Case related to a Union inspection (Yes/No)

Reference to a related Union inspection: …

Total amount irrecoverable: …

(Please specify here the entire irrecoverable amount arising from the same circumstances – irregularities or fraud involving at least one common main debtor and discovered as a result of the same clearance or post-clearance control)

Authority that declared or deemed the amount irrecoverable: …

National reference of the administrative decision of irrecoverability: …

(See third column of Annex IV)

Date of the administrative decision on irrecoverability: …

Date on which the amount was to be deemed irrecoverable: …

2. DEBT INCURRED

Date or period during which the debt was incurred: …

Legal basis for the incurrence of the debt: …

(Legal bases preceding Council Regulation (EEC) No 2913/92 (2) are to be indicated by using the relevant article of Regulation (EEC) No 2913/92)

Indirect representation (Article 18 of Regulation (EU) No 952/2013 of the European Parliament and of the Council (3) or precursors): (Yes/No)

Customs situation: …

(Customs procedure in force, situation of the goods or customs-approved treatment at the time of the customs debt being incurred)

Additional details to be indicated in the case of transit movements (for each movement separately):

— Date(s) of acceptance of the customs declaration (4): …

— Member State(s) of departure or entry into the Union (ISO Code): …

— Member State(s) of destination or exit from the Union (ISO Code):

— MRN (5)(s) of the transit declaration(s) or TIR operation(s): …

— TIR carnet number(s): …

Type of check that led to the establishment of the entitlement: …

— Checks not related to the acceptance of a customs declaration: …

— Checks during clearance of a customs declaration including sample taking: …

— Checks after clearance but before discharge of the customs procedure: …

— Checks after discharge of the customs procedure for the goods: …

— Checks after clearance and release for free circulation: …

Date(s) of presumed discharge of the customs procedure(s), to be communicated exclusively in the case of customs situations involving suspensive arrangements, under the Union Customs Code special procedures referred to in Article 210 of Regulation (EU) No 952/2013 of the European Parliament and of the Council, such as in case of fraudulent transit arrival confirmation, initially considered authentic:

…

Comprehensive description of events leading to the establishment of the entitlement:

(The following questions shall be always addressed: What triggered the checks or investigations and when? When ended the checks or investigations (give data of report)? Which goods were involved? Give details of the grounds for which duties were evaded. Did the check or investigation allow for the calculation of additional duties and the identification of debtor(s)? Give the date, when the different debtors were identified and if applicable indicate the parts of the debt for which they became debtors.)

Date when the investigation/customs inspection/control started: …

Date when the report of the customs inspection/control was produced, allowing to identify the debtor(s) and the amount of additional duties: …

3. MUTUAL ASSISTANCE

Case related to Mutual assistance (MA) within the meaning of Council Regulation (EC) No 515/97 (6) involving Commission departments (Yes/No)

Reference of the MA communication: …

Date of receipt: …

Comments (optional): …

OLAF File reference (format: LL/yyyy/nnnn): …

Joint Customs Operation (JCO) reference(if applicable):

…

Case related to a Risk information Form (RIF) or to a Common Priority Control Area (CPCA) (Yes/No)

RIF reference (if applicable): …

CPCA reference (if applicable): …

4. ESTABLISHMENT OF THE ENTITLEMENT (Article 2 of Regulation (EU, Euratom) No 609/2014 (7))

Office of establishment: …

Date of establishment: …

Accounting reference of establishment (optional): …

Date of entry in the B account (Article 6 of Regulation (EU, Euratom) No 609/2014): …

Accounting reference of the B account (optional): …

Entry in the accounts or notification of the customs debt deferred in order not to prejudice a criminal investigation affecting the financial interests of the Union (the second subparagraph of Article 13(2) of Regulation (EU, Euratom) No 609/2014) (yes/no)

Total amount of traditional own resources established:

(Please specify here the entire amount established arising from the same circumstances – irregularities or fraud involving at least one common main debtor and discovered as a result of the same clearance or post-clearance control)

…

Amount of customs and agricultural duties established, not including countervailing and antidumping duties: …

…

Amount of countervailing and antidumping duties established: …

Amount of sugar levies established: …

Corresponding established amount of national excise duties and VAT (optional):

…

Amount of correction (8) of traditional own resources (increase or decrease) after the initial establishment:

…

Amount of correction of customs and agricultural duties (increase or decrease) after the initial establishment, not including countervailing and antidumping duties: …

…

Amount of correction of countervailing and antidumping duties (increase or decrease) after the initial establishment: …

…

Amount of correction related to sugar levies (addition or deduction) after the initial establishment: …

…

Corresponding amount of correction related to national excise duties and VAT (addition or deduction) after the initial establishment (optional): …

Total amount of traditional own resources to be recovered after correction

Total amount of security/guarantee (9): …

(Amount covering Union own resources and if applicable national duties. It can be nil if there is a waiver or if a security is not lodged. In the case of a comprehensive guarantee less than 100 % of the reference amount, the reference amount shall also be indicated)

Part of security to be allocated to Union own resources: …

Type of security (compulsory, optional, not planned): …

Type of compulsory security: …

Additional explanations as regards security

(Reason why a planned security was not lodged, comments on application of Articles 89(4), subparagraph 3, of Regulation (EU) No 952/2013, …): …

Security amount made available to the Union: …

Date on which the security amount was made available to the Union: …

5. RECOVERY PROCESS

(If there are several debtors for the same debt, the following information needs to be provided for each debtor)

Quality of debtor (10): …

Amount owed, if less than total amount established: …

Date of notification of the debt: …

Date(s) of payment reminders: …

Establishment subject to an appeal procedure within the meaning of Article 243(1) of Regulation (EEC) No 2913/92 or Article 44 of Regulation (EU) No 952/2013 or a remission procedure within the meaning of Articles 236, 238 and 239 of Regulation (EEC) No 2913/92 or Articles 117 to 120 of Regulation (EU) No 952/2013 (Yes/No)

Levels attained in appeal/remission procedure: …

Date of first appeal/remission lodged: …

Date on which the definitive judgment is notified: …

Comments

(Please also specify here, if applicable, the different periods of appeal/remission): …

Suspension of implementation within the meaning of Articles 222 and 244 of Regulation (EEC) No 2913/92 and Article 876a of Commission Regulation (EEC) No 2454/93 (11) or Articles 108(3) and 45 of Regulation (EU) No 952/2013 (Yes/No)

Security lodged on suspension (Yes/No)

Amount of security on suspension: …

Reasons why no security was lodged on suspension: …

(Member States need to specify whether or not a security was waived because of foreseeable economic and social difficulties and the grounds for such a decision)

Payment facilities within the meaning of Article 229 of Regulation (EEC) No 2913/92 or Article 112 of Regulation (EU) No 952/2013 (no request/request rejected/request accepted)

Description of payment facility arrangements: …

Security lodged pursuant to payment facilities (Yes/No)

Amount of security pursuant to payment facilities: …

Reason why no security was lodged on payment facilities: ….

(Member States need to specify whether or not a security was waived because of foreseeable economic and social difficulties and the grounds for such a decision)

Date of issue of enforcement order: …

Notification of enforcement order (Yes/No)

Date of notification of enforcement order: …

Comments on enforcement order (indication of the legal instrument under national law): …

Date(s) of any payment(s) (including from attachment and from bankruptcy proceedings) received and made available to the Union: …

Corresponding amount(s) of payment(s) received and made available to the Union: …

Total amounts paid and made available: …

Date(s) of attachments: …

Amount obtained by way of attachment: …

Comments on the attachment (optional): …

Date of opening of bankruptcy/liquidation/insolvency proceedings: …

Date of declaring the claim in those proceedings: …

Date of closure of bankruptcy/liquidation/insolvency proceedings: …

Amount of own resources recovered from bankruptcy/liquidation/insolvency proceedings: …

…

Mutual assistance by other Member States in recovery (Council Directive 2010/24/EU (12) or precursors) (Yes/No)

Reference of Mutual assistance in recovery: …

Member State contacted: …

Date of request: …

Amount recovered: …

Date of reply: …

Comments on the reply (in particular if the Member State contacted has not acted on the request): …

…

6. REASONS WHY RECOVERY HAS PROVED IMPOSSIBLE FOR THE REMAINING AMOUNT

(In this part, the Member States shall clearly indicate for instance all the specific enforcement measures taken and the reasons why in the case of a bankruptcy/liquidation/insolvency procedure the amount received was not sufficient to cover the debt or why it covers only a part of the debt. Also, Member States shall explain in detail the circumstances if entry in the accounts or notification of customs debts was deferred in order not to prejudice criminal investigations affecting the financial interests of the Union.)

(Member States do not need to provide information they have already provided under points 1 to 5)

7. OTHER INFORMATION