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ANNEX I

ANNEX I

Template for the written minutes and notes referred to in Article 6(2)(d) of Delegated Regulation (EU) 2016/960 where inside information is disclosed

Item

Text field

i.

Identity of the disclosing market participant

Full names of the disclosing market participant and of the person within the disclosing market participant providing the information and the contact details used for the communication.

ii.

Identity of the person receiving the communication

Full name of the person receiving the communication and the contact details used for the communication.

iii.

Date and time of the communication

Date and time(s) of the communication specifying the time zone.

iv.

Clarification of the nature of the conversation in accordance with Article 3(3)(a) of Delegated Regulation (EU) 2016/960

Record of the statement that the communication takes place for the purposes of a market sounding.

v.

Confirmation of the identity of the person receiving the market sounding in accordance with Article 3(3)(c) of Delegated Regulation (EU) 2016/960

Record of the information about the confirmation from the contacted person that the disclosing market participant is communicating with the person entrusted by the potential investor to receive the market sounding.

vi.

Clarification in accordance with Article 3(3)(d) of Delegated Regulation (EU) 2016/960 that inside information will be communicated

Record of the statement clarifying that, if agreeing to receive the market sounding, the person receiving the communication of information will receive information which the disclosing market participant considers to be inside information and a reference to the obligation set forth in Article 11(7) of Regulation (EU) No 596/2014.

vii.

Information on the estimation of when the information ceases to be inside information, in accordance with Article 3(3)(e) of Delegated Regulation (EU) 2016/960

Record of the information given, if any, on the estimated time when the information is expected to be made public or the transaction launched, with an explanation of why this may be subject to change and how the person receiving the market sounding will be informed in case the estimated time is no longer valid.

viii.

Statement regarding the obligations of the person receiving the communication in accordance with Article 3(3)(f) of Delegated Regulation (EU) 2016/960

Record of the statement explaining to the person receiving the communication the obligations that apply to the possession of inside information, in accordance with points (b), (c) and (d) of subparagraph 1 of Article 11(5) of Regulation (EU) No 596/2014.

ix.

Confirmation of consent in accordance with Article 3(3)(g) of Delegated Regulation (EU) 2016/960

Record of the information about the consent of the person receiving the market sounding to receive the inside information, as referred to in point (a) of subparagraph 1 of Article 11(5) of Regulation (EU) No 596/2014 (request and reply).

x.

Disclosure of information in accordance with Article 3(3)(h) of Delegated Regulation (EU) 2016/960

Description of the information disclosed for the purposes of the market sounding, identifying the information considered to be inside information.