In this act Annex VI of 6
ANNEX VI
Financial servicesLevel 2RTSPSD2In forceOfficial source
Notification template for the exchange of information in relation to start of branch/agent/distributor passport activities by payment institutions and e-money institutions
| Start of activities | ||
| 1) | Home Member State | |
| 2) | Name of the competent authority of the home Member State | |
| 3) | Date of the initial application according to Annex II or III or IV. | |
| 4) | Member State where the branch/agent/distributor is to start activities | |
| 5) | Type of Institution | □Payment Institution □E-Money Institution |
| 6) | Name of the payment institution/e-money institution | |
| 7) | Head office address of the payment institution/e-money institution | |
| 8) | Unique identification number of the payment institution/e-money institution in the format of the home Member State as specified in Annex I (where applicable) | |
| 9) | Legal Entity Identifier (LEI) of the payment institution/e-money institution (where available) | |
| 10) | Home Member State authorisation number of the payment institution/e-money institution (where applicable) | |
| 11) | Type of passporting | □Branch □Agent □Distributor |
| 12) | For agents/distributors, | a. If legal person: i. Name ii. Unique identification number in the format of the Member State where the agent/distributor is located as specified in Annex I (where applicable) iii. Legal Entity Identifier (LEI) of the agent/distributor (where available) iv. Telephone number b. If natural person: i. Name, date and place of birth ii. Unique identification number in the format of the Member State where the agent/distributor is located as specified in Annex I (where applicable) |
| 13) | For agents and branches, date of entry in the register of the competent authorities of the Home Member State | DD/MM/YYYY |
| 14) | Start date of the branch/agent/distributor activities (for agents and branches, the date shall not precede the date of entry of the agent/branch in the register of the home Member State as referred to in Article 28(3) of Directive (EU) 2015/2366) | DD/MM/YYYY |