Annex VII - FORM FOR THE SUBMISSION OF AN INITIATIVE TO THE EUROPEAN COMMISSION

1. Title of the initiative:

2. Commission registration number:

3. Date of registration:

4. Number of valid statements of support received (must be at least one million):

5. Number of signatories certified by Member States:
BE BG CZ DK DE EE IE EL ES FR HR IT CY LV LT LU
Number of signatories
HU MT NL AT PL PT RO SI SK FI SE UK TOTAL
Number of signatories

6. Full names, postal addresses and e-mail addresses of the contact persons (representative and substitute of the group of organisers)1 or of the legal entity managing the initiative and its representative.

7. Indicate all sources of support and funding received for the initiative, including the amount of financial support at the time of submission.

8. I hereby declare that the information provided in this form is correct and that all relevant procedures and conditions set out in Regulation (EU) 2019/788 of the European Parliament and of the Council of 17 April 2019 on the European citizens' initiative have been complied with.

Date and signature of one of the contact persons (representative/substitute2) or of the representative of the legal entity:

9. Annexes: (Include all certificates)




Regulation on the European citizens’ initiative(pdf).
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