ANNEX VI SELF DECLARATION (Article 15(2))

In the self-declaration to be provided under Article 15(2)(b), each member of the senior management shall state whether the relevant person falls under any of the following categories:

1. (a)

   has been convicted of any criminal offence;

2. (b)

   has been subject to or has been notified of any proceedings of a disciplinary nature brought by a regulatory body or of a criminal nature;

3. (c)

   has been subject to any adverse finding in civil proceedings in connection with the provision of financial services, misconduct, fraud or the management of a legal entity;

4. (d)

   has to his or her knowledge been subject to any existing or previous investigation by any regulatory authority or government bodies or agencies;

5. (e)

   has been involved with an undertaking whose registration or authorisation was withdrawn by a regulatory body;

6. (f)

   has been refused the right to carry on activities which require registration or authorisation by a regulatory body;

7. (g)

   has been involved in the management of an undertaking which has gone into insolvency, liquidation or administration while this person was connected to the undertaking or within a year of the person ceasing to be connected to the undertaking;

8. (h)

   has been involved with an undertaking which was investigated or suspended by a regulatory body and which resulted in an enforcement action;

9. (i)

   has been investigated, suspended or sanctioned by a regulatory body;

10. (j)

    has been disqualified from acting as a director, disqualified from acting in any managerial capacity, dismissed from employment or other appointment in an undertaking as a consequence of allegations of misconduct or malpractice.