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Annex III

Annex III

ANNEX III

Notification of intention to carry out an on-site inspection in the host Member State

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, I intend to carry out an on-site inspection in your country, as detailed below.

Information on the payment institution to be inspected:

…

…

…

…

Information on the scope of and plan for the on-site inspection, if possible:

…

…

…

…

Planned dates of the on-site inspection:

…

…

Yours sincerely,

[signature]

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