ANNEX I
Request for cooperation or information exchange
Reference number: FROM: | Date: TO: |
Member State: | Member State: |
Competent authority: | Competent authority: |
Address: | Address: |
Name: | Name: |
Telephone: | Telephone: |
Email: | Email: |
Dear [name],
Under Article 29 of Directive (EU) 2015/2366 on payment services in the internal market, we are seeking your input on the matter(s) detailed below.
I would be grateful to receive a response to this request by [insert indicative date for the reply] or, if that is not possible, for an indication of your estimated date of response.
Type of request
Please tick the appropriate box(es):
Provision of information | ☐ |
On-site inspection | ☐ |
Delegation of inspection | ☐ |
Other – please provide details below | ☐ |
Please provide the main reasons for the request:
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Please provide a detailed description of the information sought:
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Please provide any additional information that could be of interest and could help the authority concerned provide a swift reply:
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If the request is urgent, please explain why it is urgent and why the deadline is short:
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Please add any further comments on data confidentiality and how you expect to use the information provided:
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Yours sincerely,
[signature]