ANNEX I
Text of imageForm for submission of aggregated and granular information regarding all administrative sanctions and other administrative measures imposed
Aggregated and granular information regarding all administrative sanctions and other administrative measures imposed by [name of the competent authority] in [year] under Article … of …
FROM:
Member State:
Competent authority:
Address:
(Contact details of the designated contact person)
Name:
Telephone:
Email:
TO:
ESMA
(Contact details of the designated contact person)
Name:
Telephone:
Email:
Reporting period:
Dear [insert appropriate name]
In accordance with Article 25(1) of Regulation (EU) 2015/2365, we wish to provide ESMA with aggregated and granular information regarding all administrative sanctions and other administrative measures imposed by [name of the competent authority] in [year].
The aggregated information is set out in the following table:
Provisions of Regulation (EU) 2015/2365 in respect of which administrative sanctions/measures have been imposed
Number of sanctions/measures imposed in the reporting period
Pecuniary amount of financial sanctions imposed in the reporting period
[number of the Article, paragraph, subparagraph]
[number of sanctions/measures]
[pecuniary amount of financial sanctions (1)]
Total sanctions/measures (2)
[total number of sanctions/measures]
[total pecuniary amount of financial sanctions]
The granular information in respect of each of the measures and sanctions included in the table above is provided as follows.
First, we have already reported the following measures and sanctions imposed in [year] to ESMA in accordance with Article 25(3) of Regulation (EU) 2015/2365:
[List of each measure and sanction reported in the relevant period]
Secondly, copies of the decision/(s) for the following measures and sanctions imposed in [INSERT YEAR] are provided in separate email attachment/(s) accompanying this form:
[List of each measure and sanction for which a decision is being provided]
Thirdly, summaries of the following measures and sanctions are provided below:
[List in numerical order (1., 2., 3., et seq.) of each measure and sanction for which a summary is then provided below.]
1. [Reference to the first measure/sanction listed above]
[Summary of measure/sanction]
2. [Reference to the second measure/sanction listed above]
[Summary of measure/sanction]
[For the third and each subsequent summary being provided, continue in numerical order by using the format above.]
Yours sincerely,
[signature]
(1) Please insert a value in Euro or in national currency. Where the relevant sanction refers not only to breaches of the relevant Article of Regulation (EU) 2015/2365, but also to other provisions, add the mention ‘AGGREGATED FIGURE’ to each value.
(2) As sanctions/measures imposed may be based on more than one legislative provision, the sum of the different rows (number of sanctions or measures/pecuniary amount of financial sanctions) may not correspond to the total number of sanctions/measures or to the total value of fines imposed.