ANNEX VI
Form for the communication of services passport notification
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Competent authorities of the home Member State: |
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Name of the relevant department: |
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General email address of the relevant department (if any): |
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Name of the contact person: |
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Telephone number: |
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Email: |
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Address of the competent authorities of the host Member State: |
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[Date] |
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Ref: |
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Communication of services passport notification |
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[The communication shall contain the following information: |
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— name and national reference code of the credit institution available in the credit institution register maintained by the EBA; |
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— LEI of the credit institution; |
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— competent authorities responsible for the authorisation and supervision of the credit institution; |
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— statement on the credit institution’s intention to carry out activities in the territory of the host Member State in the exercise of the freedom to provide services.] |
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[Contact details] |
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