‘ANNEX VII

Form of the report referred to in the third subparagraph of Article 17(3) of Regulation (EC, Euratom) No 1150/2000

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 6(5) of Regulation (EC, Euratom) No 1150/2000: …

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

Case related to a Community inspection (Yes/No)

Reference to a related Community inspection: …

Total amount irrecoverable: …

Authority that declared or deemed the amount irrecoverable: …

National reference of the administrative decision of irrecoverability: …

(See second column of Annex IIIa to Decision 97/245/EC as amended by Commission Decision 2006/246/EC, Euratom (1))

Date of the administrative decision on irrecoverability: …

Date on which the amount was 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)

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 regimes: …

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

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

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

— 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 discharge to be communicated in the case of customs situations involving suspensive arrangements: …

…

Concise description of events leading to the establishment of the entitlement: …

3. MUTUAL ASSISTANCE

Case related to Mutual assistance (MA) within the meaning of Council Regulation (EC) No 515/97 (3) involving Commission departments (Yes/No)

Reference of the MA communication: …

Date of receipt: …

Comments (optional): …

4. ESTABLISHMENT OF THE ENTITLEMENT

Office of establishment: …

Date of establishment: …

Accounting reference of establishment (optional): …

Date of entry in the B account (Article 6 of Regulation (EC, Euratom) No 1150/2000): …

Accounting reference of the B account (optional): …

Total amount established: …

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

…

Amount of countervailing and antidumping duties established: …

Amount of sugar/isoglucose levies established: …

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

Total amount corrected (addition or deduction) after the initial establishment: …

Amount of customs and agricultural duties corrected (addition or deduction) after the initial establishment, not including countervailing and antidumping duties: …

Amount of countervailing and antidumping duties corrected (addition or deduction) after the initial establishment: …

…

Amount of sugar/isoglucose levies corrected (addition or deduction) after the initial establishment: …

…

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

Total amount of security: …

(Amount of Community own resources and if applicable national duties. It can be nil if there is a waiver or if a security is not lodged)

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

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

Type of compulsory security: …

Reason why a planned security was not lodged: …

Security made available to the Community: …

Date on which the security was made available: …

5. RECOVERY PROCESS

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

Principal debtor or jointly liable debtor: …

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 (Yes/No)

Levels attained in appeal procedure: …

Date of first appeal lodged: …

Date on which the definitive judgment is notified: …

Comments (optional): …

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 (4) (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 (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 (optional): …

Date of first payment: …

Amount of first payment: …

Date of last payment: …

Amount of last payment: …

Total amount paid: …

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 2008/55/EC (5) or Council Directive 76/308/EEC (6) (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 should 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.)

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

7. OTHER INFORMATION