Article 109 5.

the name, legal form and legal entity identifier of the crypto-asset service provider and, where applicable, of the branches of the crypto-asset service provider;

the commercial name, physical address, telephone number, email and website of the crypto-asset service provider and, where applicable, of the trading platform for crypto-assets operated by the crypto-asset service provider;

the name and address of the competent authority that granted authorisation and its contact details;

the list of crypto-asset services provided by the crypto-asset service provider;

the list of host Member States in which the crypto-asset service provider intends to provide crypto-asset services;

the starting date, or, if not available at the time of the notification by the competent authority, the intended starting date, of the provision of crypto-asset services;

any other services provided by the crypto-asset service provider not covered by this Regulation with a reference to the applicable Union or national law;

the date of authorisation and, where applicable, of the withdrawal of an authorisation.