ANNEX XIII

Form for the communication by the competent authority of the home Member State to the competentauthority of the host Member State on the termination of the operation of a branch or of the cessationof the use of a tied agent established in a Member State outside its home Member State
(Articles 19(2) and 20(2) of Commission Implementing Regulation (EU) 2017/2382)
Reference number:
Date:
Communication in accordance with Article 35(10) of Directive 2014/65/EU regarding thetermination of the operation of a branch/the use of a tied agent established in a Member Stateoutside its home Member State (1)
FROM:
Member State:
Competent authority of the home Member State:
Address:
Designated contact point:
Telephone number:
Email:
TO:
Member State:
Competent Authority of the host Member State:
Address:
Designated contact point:
Telephone number:
Email:
In accordance with Article 35(10) of Directive 2014/65/EU, we wish to inform you that [Name of firm], an investment firm/credit institution authorised by [name of the competent authority of the home Member State], has notified us the intention to terminate the operation of the branch/the use of the tied agent established in your territory with effect [date of termination].
Please find attached a copy of the notification regarding the termination of the operation of [name of the branch]/the cessation of the use of the [name of the tied agent].
If you have any queries, please do not hesitate to contact us.
Yours sincerely,
[Signature]
(1) Please amend accordingly.