Regulation (EU) 2019/125 of the European Parliament and of the Council of 16 January 2019 concerning trade in certain goods which could be used for capital punishment, torture or other cruel, inhuman or degrading treatment or punishment (codification)
Annex VIII - A uthorisation form for the supply of brokering services referred to in article 21(1)
Technical specification:
The following form shall measure 210 × 297 mm with a maximum tolerance of 5 mm less and 8 mm more. The boxes are based on a unit of measurement of one tenth of an inch horizontally and one sixth of an inch vertically. The subdivisions are based on a unit of measurement of one tenth of an inch horizontally.
Explanatory notes to the form
‘Authorisation for the supply of brokering services related to goods that could be used for capital punishment or for torture (Regulation (EU) 2019/125 of the European Parliament and of the Council ’.
This authorisation form shall be used to issue an authorisation for brokering services in accordance with Regulation (EU) 2019/125.
The issuing authority is the authority defined in point (h) of Article 2 of Regulation (EU) 2019/125. It is an authority that is included in the list of competent authorities in Annex I to that Regulation.
Box 1 |
Applying broker |
Please indicate the name and full address of the applying broker. Broker is defined in point (l) of Article 2 of Regulation (EU) 2019/125. |
Box 3 |
Authorisation No |
Please fill out the number and tick the appropriate box indicating whether the authorisation is an individual or global one (see points (p) and (q) of Article 2 of Regulation (EU) 2019/125 for the definitions). |
Box 4 |
Expiry date |
Please state day (two digits), month (two digits) and year (four digits). The period of validity of an individual authorisation is from three months to twelve months and that of a global authorisation from one year to three years. When the period of validity comes to an end, an extension can be requested, if necessary. |
Box 5 |
Consignee |
Please indicate, in addition to the name and address, whether the consignee in the third country of destination is an end-user, a distributor as referred to in point (r) of Article 2 of Regulation (EU) 2019/125 or a party having another role in the transaction. If the consignee is a distributor but also uses part of the shipment for a specific end-use, please tick both ‘Distributor’ and ‘End-user’ and mention the end-use in box 11. |
Box 6 |
Third country where the goods are located |
Please state both the name of the country concerned and the relevant country code taken from the codes established pursuant to Regulation (EC) No 471/2009 of the European Parliament and of the Council ( 1 ) . See Commission Regulation (EU) No 1106/2012 ( 2 ) . |
Box 7 |
Third country of destination |
Please state both the name of the country concerned and the relevant country code taken from the codes established pursuant to Regulation (EC) No 471/2009. See Regulation (EU) No 1106/2012. |
Box 9 |
Issuing Member State |
Please state in the appropriate line both the name of the Member State concerned and the relevant country code taken from the codes established pursuant to Regulation (EC) No 471/2009. See Regulation (EU) No 1106/2012. |
Box 11 |
End use |
Please give a precise description of the use that will be made of the goods and also indicate whether the end user is a law enforcement authority as defined in point (c) of Article 2 of Regulation (EU) 2019/125 or a supplier of training on the use of the brokered goods. Leave blank if the brokering services are supplied to a distributor, unless the distributor itself uses part of the goods for a specific end-use. |
Box 12 |
Precise location of the goods in the third country from which they will be exported |
Please describe the whereabouts of the goods in the third country from which they will be supplied to the person, entity or body mentioned in box 2. The location must be an address in the country mentioned in box 6 or similar information describing the whereabouts of the goods. Note that indicating a post office box number or similar postal address is not allowed. |
Box 13 |
Description of item |
The description of the goods should include a reference to a specific item of Annex III or IV to Regulation (EU) 2019/125. Please consider including data on packaging of the goods concerned. If there is not sufficient space in box 13, please continue on an attached blank sheet, mentioning the authorisation number. Please indicate the number of attachments in box 20. |
Box 14 |
Item No |
This box needs to be completed on the back of the form only. Please ensure that the Item No corresponds to the printed item number in box 14 found next to the description of the relevant item on the view side. |
Box 15 |
HS code |
The HS code is a customs code assigned to the goods in the Harmonised System. Where the code from the EU Combined Nomenclature is known, that code may be used instead. See Commission Implementing Regulation (EU) 2016/1821 ( 3 ) for the current version of the Combined Nomenclature. |
Box 17 |
Currency and value |
Please indicate the value and currency using the price that is payable (without converting it). If that price is not known, the estimated value should be stated, preceded by the mention EV. The currency has to be indicated using the alphabetic code (ISO 4217:2015). |
Box 18 |
Specific requirements and conditions |
Box 18 concerns the item 1, 2 or 3 (please specify where appropriate) described in the boxes 14 to 16 preceding it. If there is not sufficient space in box 18, please continue on an attached blank sheet, mentioning the authorisation number. Please indicate the number of attachments in box 20. |
Box 20 |
Number of attachments |
Please indicate the number of attachments, if any (see explanations to boxes 13 and 18). |
( 1 ) Regulation (EC) No 471/2009 of the European Parliament and of the Council of 6 May 2009 on Community statistics relating to external trade with non-member countries and repealing Council Regulation (EC) No 1172/95 (OJ L 152, 16.6.2009, p. 23). ( 2 ) Commission Regulation (EU) No 1106/2012 of 27 November 2012 implementing Regulation (EC) No 471/2009 of the European Parliament and of the Council on Community statistics relating to external trade with non-member countries, as regards the update of the nomenclature of countries of countries and territories (OJ L 328, 28.11.2012, p. 7). ( 3 ) Commission Implementing Regulation (EU) 2016/1821 of 6 October 2016 amending Annex I to Council Regulation (EEC) No 2658/87 on the tariff and statistica l nomenclature and on the Common Customs Tariff (OJ L 294, 28.10.2016, p. 1). |