In this act Annex VI of 6
ANNEX VI
Financial servicesLevel 2RTSPSD2In forceIn force on the date shown, by the dates in the Official Journal.VerifiedIdentical to the official source.Official source
Form to be used for reporting data for monitoring compliance with the provisions of national law transposing Titles III and IV of Directive (EU) 2015/2366
Payment institutions or electronic money institutions headquartered in a Member State and providing payment services in a different Member State via branches or agents under the right of establishment must provide the following additional data when required by the host competent authorities to enable the authorities to monitor compliance with national law transposing Titles III and IV of Directive (EU) 2015/2366.
Table 1: General information on the payment institution/electronic money institution
| 1) | Person(s) responsible for the payment institution’s activity and/or the compliance officer (if different) in the host Member State, where applicable | a. Name of representative b. Address c. Telephone number d. Email |
| 2) | Central contact point, if appointed and/or required in accordance with Article 29(4) of Directive (EU) 2015/2366 | a. Name of representative b. Address c. Telephone number d. Email |
| 3) | Complaints handling | Do you have an internal procedure to handle and follow up on customer complaints? ☐ Yes ☐ No Please provide contact details for the person(s) responsible for handling complaints: Name: Address: Telephone: Email: Is this procedure available in the official language of the host Member State? ☐ Yes ☐ No If not, please state the languages in which the customer complaints procedure is available. Please provide a brief description of your internal procedure for handling payment service user complaints in the host Member State (max. 300 words) |
| 4) | Business model | Is this your first report, which includes a brief description of your business model? ☐ Yes ☐ No If so, please provide a brief description of your business model, focusing on the products and payment services provided and how you employ agents/distributors in the host Member State (max. 300 words) If not, have you made any significant changes to your business model over the reporting period? ☐ Yes ☐ No If so, please briefly describe the changes (max. 300 words). |
Table 2. Detailed breakdown of complaints
| Agents | Branches | |||||||
| Received | Settled | Not settled | Not replied | Received | Settled | Not settled | Not replied | |
| Number of complaints received from payment service users (PSUs) concerning the rights and obligations under Titles III and IV of Directive (EU) 2015/2366 and security-related matters in the reporting period | ||||||||
Table 3. Requests for refunds
| Agents | Branches | |||
| Refunded | Not refunded | Refunded | Not refunded | |
| Aggregated number of requests for refunds received from payment service users for unauthorised and/or incorrectly executed payment transactions in the reporting period | ||||
| PSUs | ASPSPs | |||
| Refunded | Not refunded | Refunded | Not refunded | |
| Aggregated number of requests for refunds received for losses resulting from the liabilities referred to in Article 5(2) of Directive (EU) 2015/2366 in the reporting period | ||||
| Aggregated number of requests for refunds received for losses resulting from the liabilities referred to in Article 5(3) of Directive (EU) 2015/2366 in the reporting period | ||||
Table 4. Detailed breakdown of the total value of refunds made
| Agents | Branches | |||
| Unauthorised | Incorrectly executed | Unauthorised | Incorrectly executed | |
| Total value of refunds made to payment service users for unauthorised and/or incorrectly executed payment transactions in the reporting period | ||||
| Where applicable, total value of refunds made to payment service users for losses resulting from the liabilities referred to in Article 5(2) of Directive (EU) 2015/2366 in the reporting period | ||||
| Where applicable, total value of refunds made to ASPSPs for losses resulting from the liabilities referred to in Article 5(2) of Directive (EU) 2015/2366 in the reporting period | ||||
| Unauthorised access to/use of payment account information | Fraudulent access to/use of payment account information | |
| Where applicable, total value of refunds made to payment service users for losses resulting from the liabilities referred to in Article 5(3) of Directive (EU) 2015/2366 in the reporting period | ||
| Where applicable, total value of refunds made to ASPSPs for losses resulting from the liabilities referred to in Article 5(3) of Directive (EU) 2015/2366 in the reporting period |
Table 5. Operational and security incidents
| Agents | Branches | |
| Number of major operational and/or security incidents in the reporting period |
Table 6. Amendments to framework contracts in the reporting period
| Please tick the box(es) to indicate any amendments made in the reporting period to the following conditions of the framework contract governing payment accounts that you operate | ☐ Fees and charges ☐ Interest/exchange rates ☐ Payment service users’ rights ☐ Payment service users’ obligations ☐ Payment initiation procedure |
| Please tick the box(es) to indicate any amendments made in the reporting period to the following conditions of the framework contract governing credit cards issued by you | ☐ Fees and charges ☐ Interest/exchange rates ☐ Spending limits ☐ Payment service users’ rights ☐ Payment service users’ obligations ☐ Payment initiation procedure |
| Please tick the box(es) to indicate any amendments made in the reporting period to the following conditions of the framework contract governing debit cards issued by you | ☐ Fees and charges ☐ Exchange rates ☐ Spending limits ☐ Payment service users’ rights ☐ Payment service users’ obligations ☐ Payment initiation procedure |
| Please tick the box(es) to indicate any amendments made in the reporting period to the following conditions of any other framework contract (please specify) to which you are party | ☐ Fees and charges ☐ Interest/exchange rates ☐ Spending limits ☐ Payment service users’ rights ☐ Payment service users’ obligations ☐ Payment initiation procedure |