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# ANNEX III

**Commission Implementing Regulation (EU) 2017/981 · binding · OJ L 148, 10.6.2017 · dated 7 Jun 2017 [in force]**

*In force · Commission Implementing Regulation (EU) 2017/981, OJ L 148, 10.6.2017 · Checked against EUR-Lex on 26 Oct 2026 · [Official source](https://eur-lex.europa.eu/eli/reg_impl/2017/981/oj/eng)*

<a id="annex-iii"></a>Form for reply to request for consultation

![Figure printed as an image in the official text — Annex III](../../.gitbook/assets/mifid-ii-l2-32017R0981-image-4.jpg)

Reply to a request for consultation under Article 84 of Directive 2014/65/EU
Reference number:
Date:
FROM:
Member State:
Competent authority receiving the request:
Legal address:
(Contact details of the contact point)
Name:
Telephone:
Email:
TO:
Member State:
Requesting competent authority:
Address:
(Contact details of the contact point)
Name:
Telephone:
Email:
Dear [insert appropriate name]
In accordance with Article 84 of Directive 2014/65/EU, we examined your consultation request dated [dd.mm.yyyy] with reference [insert reference number].
Where relevant, please explain any clarification you may require in relation to the information requested or to any other aspect of the relevant authorisation procedure:
If the information requested has been gathered, please provide that information here or explain how it will be provided, or make reference to the relevant annexes containing the information requested:

![Figure printed as an image in the official text — Annex III](../../.gitbook/assets/mifid-ii-l2-32017R0981-image-5.jpg)

If there is any other relevant or essential information, please provide that information here or explain how it will be provided, or make reference to the relevant annexes containing that information:
[please provide any other essential information that could influence the granting of the authorisation]
Confidentiality
[please insert any necessary confidentiality warnings or any necessary restrictions on the permissible uses of information (in compliance with Union law)].
Yours sincerely,
[signature]