Annex II

CALCULATION OF FEES

Reference period

NAME

TOTAL ASSETS

Date

MFI Code

LEI code

Item

Type of institution

Confirmation of auditor's verification (Yes/No)

Total assets

Comments

010

020

030

040

010

TOTAL ASSETS in accordance with Article 51 of Regulation (EU) No 468/2014 (ECB/2014/17)

(1), (2), (3), (4), (5)

020

TOTAL ASSETS in accordance with Article 7(2)(a) or (b) of this Decision

(6) or (7)

030

TOTAL ASSETS in accordance with Article 7(3)(b) of this Decision: Item 030 is equal to 031 minus 032 plus 033 minus 034

(8)

031

Total assets of all group entities established in participating Member States

032

Intragroup positions among supervised entities established in participating Member States (from reporting packages used for the elimination of balances for group reporting purposes) — optional

033

Goodwill included in the consolidated financial statements of the parent undertaking of a supervised group — obligatory

034

Goodwill allocated to subsidiaries established in non-participating Member states or third countries — optional

040

Total assets for a supervised entity or supervised group classified as less significant on the basis of an ECB decision made in accordance with Article 6(4) of Regulation (EU) No 1024/2013 in conjunction with Article 70(1) and Article 71 of Regulation (EU) No 468/2014 (ECB/2014/17) and Article 10(3)(d) of Regulation (EU) No 1163/2014 (ECB/2014/41).

(9)

Please ensure that this template is completed in accordance with the instructions provided separately.