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EUROPEAN PRESERVATION ORDER CERTIFICATE (EPOC-PR) FOR THE PRESERVATION OF ELECTRONIC EVIDENCE Under Regulation (EU) 2023/1543 of the European Parliament and of the Council the addressee of this European Preservation Order Certificate (EPOC-PR) must, without undue delay after receiving the EPOC-PR, preserve the data requested. The preservation must cease after 60 days, unless extended by the issuing authority by an additional 30 days, or the issuing authority confirms that a subsequent request for production has been issued. If the issuing authority confirms within those time periods that a subsequent request for production has been issued, the addressee must preserve the data for as long as necessary to produce the data once the subsequent request for production is received. The addressee must take necessary measures to ensure the confidentiality, secrecy and integrity of the EPOC-PR and of the data preserved.

SECTION A: Issuing/validating authority: Issuing State:… Issuing authority:… Validating authority (where applicable):… NB: details of issuing and validating authority to be provided at the end (Sections F and G) File number of the issuing authority:… File number of the validating authority:… SECTION B: Addressee Addressee:… Designated establishment Legal representative This order is issued in an emergency case to the specified addressee because the designated establishment or the legal representative of a service provider did not react to the EPOC-PR within the deadlines or has not been designated or appointed within the deadlines set out in Directive (EU) 2023/1544 of the European Parliament and of the Council Address:… Tel. No/Fax No/email (if known):… Contact person (if known):… File number of the addressee (if known):… Service provider concerned (if different from addressee):… Any other relevant information:…

SECTION C: Information to support identification of the data requested to be preserved (complete to the extent this information is known and necessary to identify the data) IP address(es) and timestamps (incl. date and time zone):… Tel. No:… Email address(es):… IMEI number(s):… MAC address(es):… The user(s) of the service or other unique identifier(s) such as user name(s), login ID(s) or account name(s)… Name(s) of the relevant service(s):… Other:… If applicable, the time range of the data for which preservation is requested:… Additional information if needed:…

SECTION D: Electronic evidence to be preserved This EPOC-PR concerns (tick the relevant box(es)):

(a) subscriber data: name, date of birth, postal or geographic address, contact information (email address, phone number) and other relevant information pertaining to the identity of the user/subscription holder date and time of initial registration, type of registration, copy of a contract, means of verification of identity at the moment of registration, copies of documents provided by the subscriber type of service and its duration, including identifier(s) used by or provided to the subscriber at the moment of initial registration or activation (e.g. phone number, SIM-card number, MAC-address) and associated device(s) profile information (e.g. user name, screen name, profile photo) data on the validation of the use of service, such as an alternative email address provided by the user/subscription holder debit or credit card information (provided by the user for billing purposes), including other means of payment PUK-codes other:… (b) data requested for the sole purpose of identifying the user as defined in Article 3, point (10) of Regulation (EU) 2023/1543: IP connection records such as IP addresses / logs / access numbers together with other identifiers, such as source ports and time stamps or equivalent, the user ID and the interface used in the context of the use of the service strictly necessary for identification purposes; please specify, if necessary:… time range of the data for which preservation is requested (if different from Section C):… other:… (c) traffic data:

(i) for (mobile) telephony: outgoing (A) and incoming (B) identifiers (phone number, IMSI, IMEI) time and duration of connection(s) call attempt(s) base station ID, including geographical information (X/Y coordinates), at the time of initiation and termination of the connection bearer / teleservice used (e.g. UMTS, GPRS) other:… (ii) for internet: routing information (source IP address, destination IP address(es), port number(s), browser, email header information, message-ID) base station ID, including geographical information (X/Y coordinates), at the time of initiation and termination of the connection(s) volume of data date and time of connection(s) duration of connection or access session(s) other:… (iii) for hosting: logfiles tickets other:… (iv) other: purchase history prepaid balance charging history other:… (d) content data: (web)mailbox dump online storage dump (user-generated data) pagedump message log/backup voicemail dump server contents device backup contact list other:… Additional information in case necessary to (further) specify or limit the range of the requested data:…

SECTION E: Information on the underlying conditions (a) This EPOC-PR concerns (tick the relevant box(es)): criminal proceedings in respect of a criminal offence; execution of a custodial sentence or a detention order of at least four months following criminal proceedings, imposed by a decision that was not rendered in absentia, in cases where the person convicted absconded from justice.

(b) Nature and legal classification of the offence(s) for which the EPOC-PR is issued and the applicable statutory provision …

SECTION F: Details of the issuing authority The type of issuing authority (tick the relevant box/boxes): judge, court, or investigating judge public prosecutor other competent authority as defined by the law of the issuing State If validation is necessary, please fill in also Section G. Please note that (tick if applicable): This EPOC-PR was issued for subscriber data, or data requested for the sole purpose of identifying the user in a validly established emergency case without prior validation, because the validation could not have been obtained in time, or both. The issuing authority confirms that it could issue an order in a similar domestic case without validation, and that ex post validation will be sought without undue delay, at the latest within 48 hours (please note that the addressee will not be informed). This emergency case refers to an imminent threat to the life, physical integrity or safety of a person or an imminent threat to a critical infrastructure as defined in Article 2, point (a), of Council Directive 2008/114/EC , where the disruption or destruction of such critical infrastructure would result in an imminent threat to the life, physical integrity or safety of a person, including through serious harm to the provision of basic supplies to the population or to the exercise of the core functions of the State. Details of the issuing authority and/or its representative certifying the content of the EPOC-PR as accurate and correct: Name of authority:… Name of its representative:… Post held (title/grade):… File number:… Address:… Tel. No: (country code) (area/city code)… Fax No: (country code) (area/city code)… Email:… Language(s) spoken:… If different from above, authority/contact point (e.g. central authority) which can be contacted for any question related to the execution of the EPOC-PR: Name of authority/name:… Address:… Tel. No: (country code) (area/city code)… Fax No: (country code) (area/city code)… Email:… Signature of the issuing authority or its representative certifying the content of the EPOC-PR as accurate and correct: Date:… Signature :…

SECTION G: Details of the validating authority (complete if applicable) The type of validating authority: judge, court or investigating judge public prosecutor Details of the validating authority or its representative, or both, certifying the contents of the EPOC-PR as accurate and correct: Name of the authority:… Name of its representative:… Post held (title/grade):… File number:… Address:… Tel. No: (country code) (area/city code)… Fax No: (country code) (area/city code)… Email:… Language(s) spoken:… Date:… Signature :…