ANNEX I

Form for annual submission of aggregated and anonymous information regarding all sanctions and measures imposed and investigations undertaken

Aggregated and anonymous information regarding measures and sanctions imposed and investigations undertaken in accordance with Articles 30, 31 and 32 of Regulation (EU) No 596/2014 in [year] FROM: Member State: Competent authority: Address: (Contact details of the designated contact point) Name: Telephone: Email: TO: ESMA (Contact details of the designated contact point) Name: Telephone: Email: Dear [insert appropriate name] In accordance with Article 33(1) and (2) of Regulation (EU) No 596/2014, I wish to provide you with the following aggregated information regarding: — all administrative sanctions and measures imposed by [name of the competent authority], in section 1; — all criminal sanctions imposed by judicial authorities in [name of the Member State], in section 2, if applicable; — all administrative investigations undertaken [name of the competent authority], in section 3; — all criminal investigations undertaken by judicial authorities in [name of the Member State], in section 4, if applicable. Yours sincerely, [signature]

SECTION 1 Administrative measures and sanctions imposed (including settlement decisions where applicable) over the reporting period Number of measures and sanctions Number of persons concerned by the measures and sanctions Imposed () Published Under appeal Natural persons Legal persons Total administrative measures and sanctions Number of measures and sanctions by type of infringements and nature of the measure/sanction Pecuniary sanctions (including sub-total for disgorgement where applicable) Other than pecuniary Settlement decisions (where applicable) In numbers (+) Aggregated monetary amount () In numbers (+) In numbers (+) Aggregated monetary amount () For prohibitions under Article 14 of Regulation (EU) No 596/2014 For prohibitions under Article 15 of Regulation (EU) No 596/2014 For other infringements (+) As measures and sanctions may cover more than one infringement, the sum of the number of measures and sanctions in this table may not correspond to the total number of measures or sanctions contained in the box under ‘imposed’ in the previous table. (*) The figure expected concerns the sanctions and measures that a competent authority has decided to impose. () Please insert value in Euro or in national currency. If the relevant penalties refer not only to breaches relating to the relevant article of Regulation (EU) No 596/2014, but also to other provisions, add the mention ‘AGGREGATED FIGURE’ to each value.

SECTION 2 Criminal sanctions imposed over the reporting period in accordance with the second subparagraph of Article 30(1) of Regulation (EU) No 596/2014 (if applicable) (+) As measures and sanctions may cover more than one infringement, the sum of the number of measures and sanctions in this table may not correspond to the total number of measures or sanctions contained in the box under ‘imposed’ in the previous table. () The figure expected concerns the sanctions and measures that an authority has decided to impose. (**) Please insert value in Euro or in national currency. If the relevant penalties refer not only to breaches relating to the relevant article of Regulation (EU) No 596/2014, but also to other provisions, add the mention ‘AGGREGATED FIGURE’ to each value. Number of sanctions Number of persons concerned by the sanctions Imposed () Under appeal Natural persons Legal persons Total criminal sanctions Number of sanctions by type of infringements and nature of the criminal sanction (+) Pecuniary (**) Imprisonment Settlement decisions Other kind For prohibitions under Article 14 of Regulation (EU) No 596/2014 For prohibitions under Article 15 of Regulation (EU) No 596/2014 For other infringements

SECTION 3 Administrative investigations undertaken over the reporting period (+) Some investigations can cover several infringements and concern more than one person. Type of investigation Number of investigations that have been ongoing during year [yyyy] (+) Outcome of the closed investigations Total Opened Closed Initiation of administrative enforcement proceedings (including settlement decisions) Referral to criminal authorities Other actions (e.g., prohibitions) Closed without further actions For prohibitions under Article 14 of Regulation (EU) No 596/2014 For prohibitions under Article 15 of Regulation (EU) No 596/2014 For other type of infringements

SECTION 4 Criminal investigations undertaken over the reporting period in accordance with the second subparagraph of Article 30(1) of Regulation (EU) No 596/2014 (if applicable) (+) Some investigations can cover several infringements and concern more than one person. Type of investigation Number of investigations that have been ongoing during year [yyyy] (+) Outcome of the closed investigations Total Opened Closed Initiation of criminal enforcement proceedings (including settlement decisions) Closed without further actions Other actions (e.g.: prohibitions) For prohibitions under Article 14 of Regulation (EU) No 596/2014 For prohibitions under Article 15 of Regulation (EU) No 596/2014 For other type of infringements