Model notification letter regarding persons responsible for a branch to be submitted by EU AIFM to the competent authority of its home Member State intending to establish a branch in other Member States under Article 33(3), letter (c), of Directive 2011/61/EU
ANNEX VSupplementary provisions
ANNEX V Model notification letter regarding persons responsible for a branch to be submitted by EU AIFM to the competent authority of its home Member State intending to establish a branch in other Member States under Article 33(3), letter (c), of Directive 2011/61/EU NOTIFICATION LETTER NOTIFICATION OF PERSONS RESPONSIBLE FOR A BRANCH ( 1 ) RELATED TO THE INTENTION OF AN AIFM TO ESTABLISH A BRANCH IN A MEMBER STATE OTHER THAN ITS HOME MEMBER STATE IN ACCORDANCE WITH ARTICLE 33, PARAGRAPH (3), LETTER (C), OF DIRECTIVE 2011/61/EU. IN ______________________________________ ( the host Member State ) Identification of the AIFM AIFM AIFM LEI National identification code of the AIFM (where available) AIFM’s home Member State Address and, where different from address, registered office/domicile Identification of the branch Name of the branch National identification code of the branch in AIFM’s Home State (where available) National identification of the branch in the Member State where the branch is established (where available) Address and, where different from address, registered office/domicile Are you notifying amendments to information already provided in an initial notification? Yes ☐ No ☐ In case the answer to this question is ‘Yes’, please highlight below the updated information compared to the previous notification and indicate the date of the previous notification: ________________ NOTIFICATION OF A PERSON RESPONSIBLE FOR: ☐ The management of the branch ☐ The termination of the operations of the branch ( 2 ) Identification of notified person and contact details Surname First name Position or function performed Start date for this position End date for this position (where relevant) Telephone number Email address Additional remarks Additional remarks, where indicated (e.g. former name in case of name changes, position changes etc.) Date Signature of notified person Date Name and capacity of the signatory for the AIFM/branch ( 3 ) Signature ( 1 ) Please submit one separate form for each relevant person and one form per electronic file only. ( 2 ) Notification of a person responsible for the termination of a branch should only be filled as an update where the termination of the branch is envisaged. ( 3 ) Should not be identical with notified person.