ANNEX IV
MEMBERS OF SENIOR MANAGEMENT AND THE BOARD OF THE APPLICANT
Name | Board member | Member of senior management | Date of birth | Place of birth | Role | Submitted documents | ||
CV | Proof of the absence of criminal records referred to in Article 1(2), point (a), of Commission Delegated Regulation (EU) 2025/2180 | Declaration of fitness and propriety and conflicts of interest referred to in Article 1(2), point (b), of Commission Delegated Regulation (EU) 2025/2180 | ||||||
[First name] [Last name] | [Yes/No] | [Yes/No] | [DD/MM/YYYY] | [City, Country] | [Unique reference number] | [Unique reference number] | [Unique reference number] | |