ANNEX II
Format for the list of the personal data of persons having regular access to inside information referred to in Article 2(1)
Date and time of creation of this insider list: [yyyy-mm-dd, hh:mm UTC (Coordinated Universal Time)]
Date and time (last update): [yyyy-mm-dd, hh:mm UTC (Coordinated Universal Time)]
Date of transmission to the competent authority: [yyyy-mm-dd]
|
First name(s) of the insider |
Surname(s) of the insider |
Surname(s) of the insider at birth (if different) |
Professional telephone number(s) (work direct telephone line and work mobile numbers) |
Company name and address |
Function and reason for being insider |
Obtained (the date and time at which the insider obtained regular access to the inside information) |
Ceased (the date and time at which the insider ceased to have regular access to the inside information) |
National Identification Number (if applicable) or otherwise Date of Birth |
Personal full home address (street name; street number; city; post/zip code; country) (If available at the time of the request by the competent authority) |
Personal telephone numbers (home and personal mobile telephone numbers) (If available at the time of the request by the competent authority) |
|
[Text] |
[Text] |
[Text] |
[Numbers (no space)] |
[Address of issuer] |
[Text describing role, function and reason for being on this insider list/] |
[yyyy-mm-dd, hh:mm UTC] |
[yyyy-mm-dd, hh:mm UTC] |
[Number and/or text or yyyy- mm-dd for the date of birth] |
[Text] |
[Numbers (no space)] |