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ACKNOWLEDGEMENT OF RECEIPT OF AN APPLICATION (Article 58(3) of Council Regulation (EC) No 4/2009 of 18 December 2008 on jurisdiction, applicable law, recognition and enforcement of decisions and cooperation in matters relating to maintenance obligations ()) This acknowledgement of receipt must be sent within 30 days from the date of receipt of the application.

1. Requesting Central Authority 1.1. Reference number of the requesting Central Authority: … 1.2. Surname and given name(s) of the person responsible for following up the application: … 2. Requested Central Authority 2.1. Reference number of the requested Central Authority: … 2.2. Person responsible for following up the application: 2.2.1. Surname and given name(s): … 2.2.2. Telephone: … 2.2.3. Fax: … 2.2.4. E-mail: … 3. Date received: … (dd/mm/yyyy) 4. Initial steps which have been or will be taken to deal with the application… … … … 5.  Further necessary documents or information (please specify) … … … A status report will be sent within 60 days. Done at: … on: … (dd/mm/yyyy) Name and signature of the authorised official of the requested Central Authority: …