ANNEX IV
Application form for authorisation to provide data reporting services as a CTP
Reference number: Date: From: Name of the applicant: Address: Legal Entity Identifier (where applicable): (Contact details of the designated contact person at the applicant) Full name: Telephone: Email: To: ESMA: Address: (Contact details of the designated contact point at ESMA) Address: Telephone: Email: Dear [insert appropriate name], In accordance with Article 8 of Commission Implementing Regulation (EU) 2025/1157 please find the authorisation application. CONTENT Please insert the information referred to under Commission Delegated Regulation (EU) 2025/1143. Please set out that information under the appropriate section or make reference to the relevant annexes containing the information. Information on the ownership (Article 16 of Delegated Regulation (EU) 2025/1143): Information on the organisation (Article 17 of Delegated Regulation (EU) 2025/1143): Information on corporate governance (Article 18 of Delegated Regulation (EU) 2025/1143): Information on the members of the management body (Article 19 of Delegated Regulation (EU) 2025/1143): Information on internal controls (Article 20 of Delegated Regulation (EU) 2025/1143): Information on conflicts of interest (Article 21 of Delegated Regulation (EU) 2025/1143): Information on business operativity (Article 22 of Delegated Regulation (EU) 2025/1143): Information on outsourcing (Article 23 of Delegated Regulation (EU) 2025/1143): Information on market data fees and licensing models (Article 24 of Delegated Regulation (EU) 2025/1143): Information on digital operational resilience (Article 25 of Delegated Regulation (EU) 2025/1143): Information on energy efficiency (Article 26 of Delegated Regulation (EU) 2025/1143): Information on record keeping arrangements (Article 27 of Delegated Regulation (EU) 2025/1143): Information on organisational requirements (Article 28 of Delegated Regulation (EU) 2025/1143): Information on reception, consolidation and dissemination of data and data quality (Article 29 of Delegated Regulation (EU) 2025/1143): Information from joint applicants (Article 30 of Delegated Regulation (EU) 2025/1143): Notes: Person at the applicant in charge of preparing the application: Full name: Status/position: Telephone: Email: Date: Signature: Nature of the application:
|