ANNEX V

The form’s text as printed in the original act (OJ L 340, 20.12.2017); the consolidated version prints the form only as an image, above.

Form for the communication regarding a notification for the provision of arrangements tofacilitate access to an MTF or OTF by the competent authority of the home Member State to the competent authority of the host Member State (Article 9 of Commission Implementing Regulation (EU) 2017/2382) Reference number: Date: Communication in accordance with Article 34(7) of the Directive 2014/65/EU (1) FROM: Member State: Competent authority of the home Member State: Address: Designated contact point: Telephone number: Email: TO: Member State: Competent Authority of the host Member State: Address: Designated contact point: Telephone number: Email: In accordance with Article 34(7) of the Directive 2014/65/EU, we wish to inform you that the [name of the Market Operator/Investment Firm] which operates the [name of the MTF or OTF] under the [name of the applicable national law] in [name of the home Member State], intends to provide arrangements in [name of the Member State in which intends to provide arrangements] in order to facilitate access to and trading on [name of the MTF/OTF] by remote users, members or participants established in [name of the Member State in which intends to provide arrangements], according to the attached notification. If you have any queries, do not hesitate to contact us. Yours sincerely, [Signature] (1) Please amend accordingly.