☐ I declare that the information provided in this application is true and complete to the best of my knowledge and that I am aware that any deliberately false or incomplete statements may lead to legal consequences under the law of the Member State in which the application is lodged or to liability pursuant to Article 13 of Regulation (EU) No 655/2014.
☐ Dearbhaim go bhfuil an fhaisnéis atá tugtha san iarratas fíor agus iomlán a mhéid is eol dom agus gur feasach mé go bhféadfadh iarmhairtí dlíthiúla faoi dhlí an Bhallstáit ina bhfuil an t-iarratas taiscthe nó dliteanas de bhun Airteagal 13 de Rialachán (AE) Uimh. 655/2014, go bhféadfadh sin teacht as aon ráiteas bréagach nó neamhiomlán a rinneadh d'aon ghnó.