Article 5(2) RRF - OJ 2005, Suppl. to No. 1/2005, page 45

Appendix to Annex B.2
Particulars to be supplied in the batch debit order

- OJ 2005, Suppl. to No. 1/2005, page 45 -

Order for batch debiting by diskette

Name and address of user:

Number of user's deposit account:

Number of diskette:

Date diskette prepared:

Number of fees to be debited:

Total payments in euro:

Number (quantity) of applications:

Immediate printout of debited fees:

Yes/No

Contact person in case of problems:

- name

- telephone

- fax

- e-mail

Place

Date

Signature