ANNEX IIISupplementary provisions
ANNEX III Form for the reply to a request for cooperation or exchange of information Text of image Reply to a request for cooperation or exchange of information Reference number: Date: General information FROM: Member State: Requested Authority: Legal address: (Contact details of the contact point) Name: Telephone: Email: TO: Member State: Requesting Authority: Legal address: (Contact details of the contact point) Name: Telephone: Email: Dear [insert appropriate name] We confirm that your request dated [dd.mm.yyyy] with reference [insert request reference number] has been processed by us. Information gathered [If the information has been gathered, please set out the information here or provide an explanation of how it will be provided] Text of image The information provided is confidential and is disclosed to [insert name of the requesting authority] pursuant to the [insert provision of MiFID II] and on the basis that the information shall remain confidential in accordance with [insert provision of MiFID II]. The [insert name of the requesting authority] shall observe the requirements of the [insert provision of MiFID II] with respect to confidentiality restrictions and the permissible uses of that information. [Insert any other necessary confidentiality warnings or any necessary restrictions on the permissible uses of information (in compliance with Union law). Where relevant, please explain any clarification you may require in relation to the precise information requested: Please provide, on your own initiative, any essential information that could further assist the cooperation or exchange of information for the purposes of the request: Yours sincerely, [signature]