# ANNEX I — Standard form for submitting an application for authorisation to offer asset-referenced tokens to the public and to seek their admission to trading, submitted in accordance with [Article 18(1)](../../articles/18.md) of Regulation (EU) 2023/1114 of the European Parliament and of the Council, and with Commission Implementing Regulation (EU) 2025/1126 **Commission Implementing Regulation (EU) 2025/1126 · binding · OJ L, 2025/1126, 15.9.2025 · dated 5 Jun 2025 [in force]** *In force · Commission Implementing Regulation (EU) 2025/1126, OJ L, 2025/1126, 15.9.2025 · Checked against EUR-Lex on 26 Oct 2026 · [Official source](https://eur-lex.europa.eu/eli/reg_impl/2025/1126/oj/eng)* Place and date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ FROM: Name of the applicant: Trading name, if different: Address: Contact details of the designated contact person within the [applicant issuer](https://www.headlesslaw.com/definitions/mica/applicant-issuer): Name: Position in the [applicant issuer](https://www.headlesslaw.com/definitions/mica/applicant-issuer): Phone: Email: Contact details of the designated professional adviser: Name: Address: Phone: Email: TO: Competent Authority: Address: Member State: This is an application for authorisation to [offer to the public](https://www.headlesslaw.com/definitions/mica/offer-to-the-public) or to seek admission to trading of an [asset-referenced token](https://www.headlesslaw.com/definitions/mica/asset-referenced-token), submitted in accordance with [Article 18(1)](../../articles/18.md) of Regulation (EU) 2023/1114 of the European Parliament and of the Council, and with Commission Implementing Regulation (EU) 2025/1126 laying down implementing technical standards with regard to standard forms, templates and procedures for the information to be included in the application. 1. Type of application (tick the relevant box): ☐ (a) First authorisation to offer to the public or to seek admission to trading an [asset-referenced token](https://www.headlesslaw.com/definitions/mica/asset-referenced-token) ☐ (b) Further to a previously granted authorisation by the same competent authority in relation to an asset-referenced token, new authorisation to offer to the public or to seek admission to trading of another asset-referenced token Voluntary classification of asset-referenced tokens as a significant asset-referenced token Please specify if the application includes the request for voluntary classification of the asset-referenced token as a significant asset-referenced tokens (please tick Yes or No) ☐ Yes ☐ No We certify that the information provided in this application is true, accurate, complete and not misleading. Unless specifically stipulated otherwise, the information is up-to-date on the date of this application. Information indicating a future date is explicitly identified in the application and we undertake to notify the authority in writing without delay if any such information should turn out to be untrue inaccurate, incomplete or is misleading. In case of a new application following a previous authorisation to offer to the public or to seek admission to trading of an asset-referenced token granted by the same competent authority, the submission letter should contain the following statement: We acknowledge that an authorisation to offer to the public/to seek admission to trading of an asset-referenced token was granted by \[this competent authority: name of the competent authority] on \[DD/MM/YYYY] and in accordance with [Article 18(3)](../../articles/18.md) of Regulation (EU) 2023/1114 the current application does not include information that was previously submitted to the competent authority where such information would be identical and would not have changed in the meantime. We also certify that any information which has not been resubmitted in the current application is identical to that already in possession of the competent authority and that it is still true, accurate and up-to-date.