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# ANNEX IV

**Commission Implementing Regulation (EU) 2018/292 · binding · OJ L 55, 27.2.2018 · dated 26 Feb 2018 [in force]**

*In force · Commission Implementing Regulation (EU) 2018/292, OJ L 55, 27.2.2018 · Checked against EUR-Lex on 26 Oct 2026 · [Official source](https://eur-lex.europa.eu/eli/reg_impl/2018/292/oj/eng)*

![Figure printed as an image in the official text — Annex IV](../../.gitbook/assets/mar-l2-32018R0292-image-9.jpg)

<a id="annex-iv"></a>Form for the provision of unsolicited assistance
Unsolicited assistance
Reference number:
Date:
Annexes: [Specify the number of documents/supporting documents attached]
General information
FROM:
Member State:
Transmitting Authority:
Legal address:
[Insert the contact details of the contact point designated pursuant to Article 2 of Commission Implementing Regulation (EU) 2018/292]
Name:
Telephone:
Email:
TO:
Member State:
Recipient Authority:
Legal address:
[Insert the contact details of the contact point designated pursuant to Article 2 of Commission Implementing Regulation (EU) 2018/292]
Name:
Telephone:
Email:
Dear [Insert appropriate name]
In accordance with Article 10 of Commission Implementing Regulation (EU) 2018/292, we are providing the following information we believe may be of assistance in carrying out your duties.
Information provided
[Please set out the details of the information here, including if relevant a description of any supporting documents or material attached]

![Figure printed as an image in the official text — Annex IV](../../.gitbook/assets/mar-l2-32018R0292-image-10.jpg)

The information provided is confidential and is disclosed to [Insert name of the competent authority receiving the unsolicited information] pursuant to Article 25 of Regulation (EU) No 596/2014 and on the basis that the information shall remain confidential in accordance with Article 11 of Commission Implementing Regulation (EU) 2018/292 andArticle 27 of Regulation (EU) No 596/2014.
The [Insert name of the competent authority receiving the unsolicited information] shall observe the requirements of the Article 11 of Commission Implementing Regulation (EU) 2018/292 with respect to the permissible uses of that information, and of Article 28 of Regulation (EU) No 596/2014 with respect to personal data processing and transfer.
If the [Insert name of the competent authority receiving the unsolicited information] intends to use or disclose the information received for purposes different than those stated in Article 11(3) of Commission Implementing Regulation (EU) 2018/292, it shall notify [Insert name of the competent authority providing the unsolicited information] and, unless the exception referred to in Article 27(3) of Regulation (EU) No 596/2014 applies, shall obtain the prior consent of [Insert name of the competent authority providing the unsolicited information]. If [Insert name of the competent authority providing the unsolicited information] consents to such a use or disclosure of the information, it may subject it to certain conditions.
Yours sincerely,
[Name and signature]
