ANNEX IV
Form for the notification for the provision of arrangements to facilitate access to an MTF or OTF
(Articles 8 and 10 of Commission Implementing Regulation (EU) 2017/2382)
Reference number:
Date:
Part 1 — Contact Information:
Type of notification:
Provision of arrangements to facilitate access to an MTF/OTF/changes to the particulars of the notification for the provision of arrangements to facilitate access to an MTF/OTF
Member State(s) in which the investment firm/market operator intends to provide arrangements:
Name of investment firm/market operator:
Address:
Telephone number:
Email:
Name of the contact person at the investment firm/market operator:
Home Member State
Authorisation Status (of the investment firm)/Applicable Law (of the market operator):
Authorised/Licensed/Supervised by [Home Member State Competent Authority]
Authorisation Date (for investment firms):
Name of the MTF/OTF:
Date from which the arrangements will be provided:
With immediate effect
Part 2 — Description of [name of the MTF/OTF] business model:
[Please include at least the following information]
Type of traded financial instruments:
[to be completed by investment firm/market operator]
Type of trading participants:
[to be completed by investment firm/market operator]
Type of appropriate arrangements:
[to be completed by investment firm/market operator]
Marketing:
[to be completed by investment firm/market operator]