(Concluded October 2nd, 1973)
International Certificate
(Hague Convention of . . . Concerning the International Administration of the Estates of Deceased Persons)
A Issuing Authority
1 Country:
B Information concerning the deceased
3 following the death on . . . at . . . of . . .1 (marital status, sex of deceased, date and place of birth)
4 whose last known address was . . .
5 of . . . nationality2
6 whose last habitual residence was in (State, town, street)
7 whose will has/has not been produced to the authority
8 and whose marriage contract dated . . . has/has not been presented
C Holder of the certificate
9 name . . . address . . . (of the person or body)
10 is/are entitled under . . . law to effect all acts in respect of all corporeal or incorporeal movables in the estate and to act in the interest or on behalf of such movable estate3,
or
is/are entitled under . . . law to effect all acts in respect of all corporeal or incorporeal movables in the estate, and to act in the interest or on behalf of such movable estate3,
with the exception of: . . .
a in respect of all assets: . . .
b in respect of any particular asset or category of assets: . .
or
is/are entitled under . . . law to effect the acts indicated in the annexed schedule3.
D Powers, if any, over immovables4:
E Power to appoint an agent:
Yes/No
F Other remarks:
G Date, if any, of expiry of the powers:
H Date, if any, of the entry into force of the certificate:
I Date of the certificate and signatures:
Drawn up on the . . . at . . .
Signature/seal of the issuing authority:
or
a Signature/seal of the person drawing up the certificate, and
b Signature/seal of the confirming authority.
1 For married persons, indicate, according to custom, maiden name or name of spouse.
2 If the issuing authority knows that the deceased had more than one nationality, it may indicate them.
3 The issuing authority may indicate the capacity in which the holder of this certificate may act (e.g. executor, administrator, heir).
4 See Article 30 of the Convention.
Schedule
Acts which may be carried out in respect of the corporeal or incorporeal movables in the estate, and in the interest or on behalf of such estate |
Put "No" against acts which the bearer may not carry out |
Severally |
Jointly |
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To obtain all information concerning the assets and debts of the estate To take cognisance of all wills and other documents relating to the estate To take any protective measures To take any urgent measures To collect the assets To collect the debts and give a valid receipt To perform and rescind contracts To open, operate and close a bank account To deposit To let or hire To lend To borrow To charge To sell To carry on a business To exercise the rights of a shareholder To make a gift To bring an action To defend an action To effect a compromise To make a settlement To settle debts To distribute legacies To divide the estate To distribute the residue Any other acts1: |
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Particular assets or categories of assets in respect of which acts cannot be carried out– a Particular assets or categories of assets: b Acts which may not be carried out: |
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1 See in particular Article 30 of the Convention.