ANNEX VI
Form for the branch passport notification and change of branch particulars notification (1)
(Articles 12, 17 and 19 of Commission Implementing Regulation (EU) 2017/2382)
Reference number:
Date:
Part 1 — Contact Information
Type of notification:
Branch passport notification/change of branch particulars notification
Member State in which the investment firm intends to establish a branch (2):
Name of the investment firm:
Address of the investment firm:
Telephone number of the investment firm:
Email of the investment firm:
Name of the contact person at the investment firm:
Name of the branch:
Address of the branch:
Telephone number of the branch:
Email of the branch:
Name(s) of those responsible for the management of the branch:
Home Member State:
Authorisation Status:
Authorised by [Home Member State Competent Authority]
Authorisation Date:
(1) For the purposes of a changes of branch particulars notification please complete only the parts of the forms which are relevant to the notified changes. When the investment firm intends to make changes to the investment services, activities, ancillary services or financial instruments provided by the branch, the firm shall list all investment services, activities ancillary services or financial instruments the branch will provide.
(2) Please note that national corporate law may require the previous registration to a commercial registry prior to the commencement of operations by the branch.
Part 2 — Programme of operations
Intended investment services, activities and ancillary services provided by the branch (*)
Investment Services and activities
Ancillary services
A1
A2
A3
A4
A5
A6
A7
A8
A9
B1
B2
B3
B4
B5
B6
B7
Financial Instruments
C1
C2
C3
C4
C5
C6
C7
C8
C9
C10
C11
(*) Please place an (x) in the appropriate box(es).
Business Plan and structural organisation of the branch
Business plan
1. How will the branch contribute to the strategy of the firm/group?
2. What will the main functions of the branch be?
3. Describe the main objectives of the branch;
Commercial Strategy
1. Describe the types of clients/counterparties the branch will be dealing with;
2. Describe how the firm will obtain and deal with these clients;
Organisational structure
1. Briefly describe how the branch fits into the corporate structure of the firm/group? (This may be facilitated by attaching an organisational chart)
2. Set out the organisational structure of the branch, showing functional, geographical and legal reporting lines;
3. Identify who will be responsible for the branch operations on a day to day basis? Provide details of professional experience of the persons responsible for the management of the branch (Please attach CV);
4. Identify who will be responsible for the internal control functions at the branch?
5. Identify who will be responsible for dealing with complaints in relation to the branch?
6. Explain how will the branch report to the head office?
7. Detail any critical outsourcing arrangements
Tied Agents (*)
1. Will the branch use tied agent?
2. What is the identity of the tied agent?
Name
Address
Telephone
Contact point
reference or hyperlink to the public register where the tied agent is registered
Systems & Controls
Provide a brief summary of arrangements for:
1. safeguarding client money and assets;
4. compliance with the conduct of business and other obligations that fall under the responsibility of the Competent Authority of the host Member State according to Art 35(8) and record keeping under Art 16(6);
5. staff code of Conduct, including personal account dealing;
6. anti-money laundering;
7. monitoring and control of critical outsourcing arrangements (if applicable);
8. the name, address and contact details of the accredited compensation scheme of which the investment firm is a member;
Financial forecast
Attach a forecast statement for profit and loss and cash flow, both over an initial period of thirty six month period;
(*) The investment firm shall submit a separate passport notification in respect of each tied agent the branch intends to use.