Basis For Action: European Commission Industry Intelligence Submission Form New Trends

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EUROPEAN COMMISSION

Industry Intelligence Submission Form

NEW TRENDS
Basis for Action

Countries or region:

Rightholder:

IP right infringed (EU): IP Registry:

IP right infringed
(National): IP Registry:

Registration number:

Reference to applicable Customs application:

Profiling Information - Complete as many boxes as possible

Routing Information
Ù Country of Consignment:
Ù Country of Origin:
Ù Country Transit/Transhipment:
Ù Country of Destination:
Ù Consignment Note Number:
Ù Packaging Details/Markings:
Ù Known Concealment Techniques:
Ù Any other information:

Quantity
Kg Lbs Litres Gallons
Units:

Other:

Flight/Shipment

Date: STA/ETA:

Airport: Sea/River Port: Express:

Carriers:

Land border: Rail Border Mail:

Consignor & Consignee Details

Consignor
Name:
Address:
Tel.:

Consignee
Name:
Address:
Tel.:

Name: Signature: Date:

Position: Tel.: E-mail:

Mod. 11.3049 This form creates no legal obligations for Customs or Right Holders. In case of doubt, contact your legal department.

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