ANNEX IISupplementary provisions
ANNEX II ‘ANNEX XIV Template for a request for data stored in the Union Registry under Article 80(3) of Commission Delegated Regulation (EU) 2019/1122 ( 1 ) Request to the [specify if the request is submitted to the central or national administrator] of the Union Registry pursuant to Article 80(3) of Delegated Regulation (EU) 2019/1122 1. Entity submitting the request: 2. Date of the request: 3. Purposes for the request from the exhaustive list laid down in Article 80(4) of Delegated Regulation (EU) 2019/1122 4. Description of the legal or administrative context in which the data will be used: 5. Precise description of the data requested, including the time period for which the data is requested: 6. Contact point for any queries in relation to the request: As required by Articles 80(4) and 80(5) of Delegated Regulation (EU) 2019/1122, we commit to use the confidential information received pursuant to this request only for the purpose for which such information was provided and to not make the data received available deliberately or accidentally to persons not involved in the intended purpose of the data use. [Name and signature] ’ ( 1 ) Commission Delegated Regulation (EU) 2019/1122 of 12 March 2019 supplementing Directive 2003/87/EC of the European Parliament and of the Council as regards the functioning of the Union Registry ( OJ L 177, 2.7.2019, p. 3 ).