The court/tribunal has examined your claim form and considers it to be inadequate or insufficiently clear or not properly filled in: please complete and/or rectify your form in the language of the court/tribunal as indicated below as soon as possible and at the latest byThe court/tribunal shall dismiss your application under the conditions provided for in Regulation (EC) No 861/2007 if you fail to complete and/or rectify it within the time limit set out above.Your claim form has not been filled in in the correct language. Please fill it in in one of the following languages.BulgarianCzechCroatianGermanSpanishGreekEstonianIrishItalianFrenchLithuanianHungarianLatvianDutchPolishMalteseRomanianSlovakPortugueseFinnishSwedishSloveneEnglishOther: (please specify)The following sections of the claim form must be completed and/or rectified as stated below:————Done at:Date: / /Signature and/or stamp: