Annexes to COM(2011)881 - Consular protection for citizens of the Union abroad

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dossier COM(2011)881 - Consular protection for citizens of the Union abroad.
document COM(2011)881 EN
date April 20, 2015
ANNEX I

A. Common format for undertaking to repay costs of consular protection in case of financial assistance

UNDERTAKING TO REPAY COSTS OF CONSULAR PROTECTION

(FINANCIAL ASSISTANCE) — (Article 14(1) of Directive (EU) 2015/637)

I, (Mr/Ms) (full name in block capitals)



holder of passport No … issued at …

hereby acknowledge receipt from the Embassy/Consulate of …

… at …

of the sum of …

as an advance for the purpose of …

… (including any applicable fee)

and/or undertake and promise to repay on demand to the Ministry of Foreign Affairs/Government of [Member State of nationality] …

in accordance with the national law of that Member State the equivalent of that sum or the equivalent of all costs as paid on my account or advanced to me, including costs incurred by the member(s) of my family accompanying me, in (currency) …

at the rate of exchange prevailing on the day on which the advance was made or the costs were paid.

My address (*) (in block capitals) (country) …

is: …





DATE … SIGNATURE …

B. Common format for undertaking to repay costs of consular protection in case of repatriation

UNDERTAKING TO REPAY COSTS OF CONSULAR PROTECTION

(REPATRIATION) — (Article 14(1) of Directive (EU) 2015/637)

I, (Mr/Ms) (full name in block capitals)



born at (town) … in (country) …

on (date) …

holder of passport No … issued at …

on … and ID No …

and Social security No and competent authority (if applicable/where relevant)



hereby undertake to repay on demand to the Government of



in accordance with the national law of that Member State the equivalent of all costs as paid on my account or advanced to me by the consular officer

of the … Government at …

for the purpose of, or in connection with, the repatriation to …

of myself and the members of my family accompanying me, and to pay all appropriate consular fees in respect of the repatriation.

These are:

(i) (**)Fares

Subsistence

Miscellaneous costs

LESS the contribution made by me

CONSULAR FEES:

Repatriation fee

Attendance fee

Passport/emergency fees

(… hours at … per hour …)

(ii) (**)All sums on my account for the purpose of, or in connection with, the repatriation of myself and the members of my family accompanying me which cannot be determined at the time this undertaking to repay is signed by me.

My address (***) (in block capitals) (country) …

is: …





DATE … SIGNATURE …



(*)  if you have no permanent address, please indicate a contact address.

(**)  Delete as appropriate: The Consular Officer and the applicant should initial each deletion in the margin.

(***)  If you have no permanent address, please indicate a contact address.



ANNEX II

Form of the request for reimbursement

REQUEST FOR REIMBURSEMENT (Article 14(2) and (3) of Directive (EU) 2015/637)

1.Requesting Member State's embassy or consulate

2.Competent embassy or consulate or Ministry of Foreign Affairs of assisted citizen's Member State of nationality

3.Identification of the event

(date, place)

4.Data of assisted citizen(s) (to be attached separately)

Full namePlace and date of birthName and number of the travel documentKind of assistance providedCosts

5.Total costs

6.Bank account for the reimbursement

7.Attachment: undertaking to repay (if applicable)