ANNEX

| (1) | Whether the complainant party is a consumer or a trader; | (2) | The name and e-mail and geographical address of the consumer; | (3) | The name and e-mail, website and geographical address of the trader; | (4) | The name and email and geographical address of the complainant party’s representative, if applicable; | (5) | The language(s) of the complainant party or representative, if applicable; | (6) | The language of the respondent party, if known; | (7) | The type of good or service to which the complaint relates; | (8) | Whether the good or service was offered by the trader and ordered by the consumer on a website or by other electronic means; | (9) | The price of the good or service purchased; | (10) | The date on which the consumer purchased the good or service; | (11) | Whether the consumer has made direct contact with the trader; | (12) | Whether the dispute is being or has previously been considered by an ADR entity or by a court; | (13) | The type of complaint; | (14) | The description of the complaint; | (15) | If the complainant party is a consumer, the ADR entities the trader is obliged to or has committed to use in accordance with Article 13(1) of Directive 2013/11/EU, if known; | (16) | If the complainant party is a trader, which ADR entity or entities the trader commits to or is obliged to use.

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Source: EUR-Lex (Cellar) · retrieved 2026-11-05 · Text as adopted (Official Journal); later amendments are not incorporated in this text.