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In this act Annex IV of 6

ANNEX IV

Financial servicesLevel 2RTSPSD2In forceVerifiedOfficial source

Notification of an infringement or suspected infringement

Reference number:

FROM:

Date:

TO:

Member State:Member State:
Competent authority:Competent authority:
Address:Address:
Name:Name:
Telephone:Telephone:
Email:Email:

Dear [name]

Under Article 29 of Directive (EU) 2015/2366 on payment services in the internal market, please find below information on [an infringement/a suspected infringement].

[Please provide all indispensable information on the infringement/suspected infringement, which must include the type of infringement and any action taken by your competent authority, including any precautionary measures or penalties]

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[Please provide any other information on the infringement/suspected infringement that could be of interest and benefit to the notified competent authority]

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[Please add any further comments on the confidentiality and potential use of the information provided]

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Yours sincerely,

[signature]