Annexes to COM(2017)344 - Centralised system for the identification of Member States holding conviction information on third country nationals and stateless persons (ECRIS-TCN system) - Main contents
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dossier | COM(2017)344 - Centralised system for the identification of Member States holding conviction information on third country nationals and ... |
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document | COM(2017)344 ![]() |
date | April 17, 2019 |
STANDARD INFORMATION REQUEST FORM AS REFERRED TO IN ARTICLE 17(1) OF REGULATION (EU) 2019/816 IN ORDER TO OBTAIN INFORMATION ON WHICH MEMBER STATE, IF ANY, HOLDS CRIMINAL RECORDS INFORMATION OF A THIRD-COUNTRY NATIONAL
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This form, which is available at www.eurojust.europa.eu in all 24 official languages of the institutions of the Union, should be addressed in one of those languages to ECRIS-TCN@eurojust.europa.eu
Requesting state or international organisation:
Name of state or international organisation:
Authority submitting the request:
Represented by (name of person):
Title:
Address:
Telephone number:
Email address:
Criminal proceedings for which the information is sought:
Domestic reference number:
Competent authority:
Type of crimes under investigation (please mention relevant article(s) of criminal code):
Other relevant information (e.g. urgency of the request):
Identity information of the person having the nationality of a third country in respect of whom information regarding the convicting Member State is sought:
NB: please provide as much available information as possible.
Surname (family name):
First name(s) (given names):
Date of birth:
Place of birth (town and country):
Nationality or nationalities:
Gender:
Previous name(s), if applicable:
Parents’ names:
Identity number:
Type and number of the person’s identification document(s):
Issuing authority of document(s):
Pseudonyms or aliases:
If fingerprint data are available, please provide these.
In case of multiple persons, please indicate them separately
A drop down panel would allow the insertion of additional subjects
Place
Date
(Electronic) signature and stamp: