Annex 2 – Notification form for exercising the freedom of establishment

Date of transmission of this notification 1 from the home to the host competent DD/MM/YYYYY authority

2 Host Member State

3 Type of notification

First notification Change to previous notification

4 Name of credit intermediary

5 Date of birth in case of natural person DD/MM/YYYYY

6 Home State registration number

7 Head office address

8 Email

9 Telephone number

10 Fax number

11 Name of home competent authority

12 Home Member State

13 Web address of the online register

Branch details (to the extent available at the time of notification)

• Address 14 • Telephone number
• Email
• Fax number Name(s) and date(s) of birth of natural person(s) responsible for the 15 management of the branch (to the extent available at the time of notification)

To the extent available, services to be 16 provided by the credit intermediary in the host Member State	offers/presents credit agreements assists in preparatory/pre-contractual administration work concludes credit agreements provides advisory services Yes
17 Tied credit intermediary	No

In the case of a tied credit intermediary:

a) Name and registration number of a) ………………………………………………….. the creditor(s) or groups to which the intermediary is tied in the host Member State

b) Whether the credit intermediary is b) ..................................................... exclusively tied to only one creditor
c) Confirmation that the creditor(s) c) ..................................................... take full and unconditional responsibility for the credit intermediation activities

1. Overview

Summary	Regulation

Requirements
Source	Requirement

Standards
Source	Requirement

EBA -
EN: Guidelines and other publications of the European Banking Authority (EBA), https://www.eba.europa.eu/. © European Banking Authority. Reproduction is authorised provided the source is acknowledged (EBA legal notice). Divided into sections and converted into the GRCA format, the wording unchanged. Only the versions published by the EBA are authoritative.

DE: Leitlinien und weitere Veröffentlichungen der Europäischen Bankenaufsichtsbehörde (EBA), https://www.eba.europa.eu/. © European Banking Authority. Wiedergabe mit Quellenangabe gestattet (Rechtlicher Hinweis der EBA). In Abschnitte aufgeteilt und in das GRCA-Format umgewandelt, der Wortlaut unverändert. Maßgeblich sind allein die von der EBA veröffentlichten Fassungen.