Aggregated information regarding all penalties and measures imposed by

[name of the competent authority] in [year]

FROM:

Member State:

Competent authority:

Address:

(Contact details of the designated contact person)

Name:

Telephone:

E-mail:

TO:

ESMA

(Contact details of the designated contact person)

Name:

Telephone:

E-mail:

Dear [insert appropriate name]

In accordance with Article 99e(1) of Directive 2009/65/EC, I wish to provide you with aggregated information regarding all penalties and measures imposed by [name of the competent authority].

Penalties:

Article of Directive 2009/65/EC transposed by the national provisions which were infringed

Number of penalties imposed in the reporting period

Amount of penalties imposed in the reporting period

[number of the article, paragraph, subparagraph]

[number of penalties]

[amount of penalties (*)]

Total penalties

[total number of penalties (†)]

[total amount of penalties (*) (†)]

(*) Please insert value in Euro or in national currency. If the relevant penalties refer not only to breaches relating to the relevant article of Directive 2009/65/EC, but also to other provisions, add the mention ‘AGGREGATED FIGURE’ to each value.

(†) As penalties imposed may cover more than one legislative provision, the sum of the different lines (number of penalties/amount) may not correspond to the total number/amount of penalties imposed.

Measures:

Article of Directive 2009/65/EC transposed by the national provisions which were infringed

Number of measures imposed in the reporting period

[number of the article, paragraph, subparagraph]

[number of measures]

Total measures

[total number of measures (†)]

(†) As measures imposed may cover more than one legislative provision, the sum of the different number of measures may not correspond to the total number of measures imposed.

Yours sincerely,

[signature]