ANNEX IV

Attestation of the competent authority of compensation schemes intended to protect investors pursuant to Article 17(3), first subparagraph, and Article 18(2), second subparagraph, of Directive 2009/65/EC

ATTESTATION ESTABLISHED BY ______________________________________ (name of the competent authority of the management company’s home Member State)

Section 1.   Department responsible for the establishment of this attestation within the competent authority of the management company’s home Member State

Department
Address of the competent authority
Email address of the department establishing the statement

Section 2.   Identification of management company this attestation relates to

Management company
Management company’s LEI
National identification code of the management company (where available)
Management company’s home Member State
Address and, where different from address, registered office/domicile

Section 3.   Identification of the investor compensation scheme

Investor compensation scheme
Address of the investor compensation scheme
Registered office/domicile of the investor compensation scheme where different from its address
Details of the investor compensation scheme’s website

(The attestation shall be signed and dated by a representative of the competent authority of the UCITS home Member State. The signatory shall state his or her full name and capacity.)

Date
Name and capacity of the signatory
Signature