ANNEX II Template for the compliance statement referred to in Article 26(3) of Regulation (EU) 2016/1011

A. General Information

(1) Date of creation of this document and, where applicable, of the latest update to it

Created: [dd/mm/yy]

Last updated: [dd/mm/yy]

(2) Name of the administrator

[As it appears in the "Register of administrators and benchmarks" published by the FCA]

The following section:

• identifies the non-significant benchmark or non-significant benchmarks in respect of which provisions do not apply,
• identifies the provisions that the administrator has chosen not to apply, and
• explains why it is appropriate for the administrator not to comply with each such provision.

If this document relates to a family of non-significant benchmarks provided by the administrator, a separate section must be completed for each set of benchmarks in respect of which:

• the provisions that the administrator chooses not to apply are the same for all those benchmarks, and
• for each provision, the explanation why it is appropriate for the administrator not to comply with the provision is the same for all those benchmarks.

B. [Insert name of the administrator as set out in item 2 of section A] chooses to not apply the following provisions of Regulation (EU) 2016/1011 in respect of the non-significant benchmark or non-significant benchmarks identified below

(1) The benchmark or benchmarks in respect of which the provision(s) do not apply

[Insert name of the benchmark, or each of the benchmarks, including its international securities identification number (ISIN) or, where no ISIN is available, any other identifier available]

(2)(i) The provision or provisions of Regulation (EU) 2016/1011 that do not apply

(2)(ii) For each provision, the reasons why it is appropriate for the administrator not to comply with that provision

[For each provision, insert the Article number, paragraph and, where applicable, specific point of Regulation (EU) 2016/1011, and the full text of the provision]

[For each provision, insert a specific, detailed and clear explanation of why it is appropriate for the administrator not to comply with the provision.]