ANNEX Form 1 Notification referred to in Article 15 Form 3.2 Notification of notional amount referred to in Article 17 Form 4.1 General notification referred to in Article 18 Form 4.2 Notification of notional amount referred to in Article 18

Form 1 Notification referred to in Article 15

Name of the CCP

Relevant contact details

Name(s) of trading venue(s) connected by close links

Jurisdiction(s) of trading venue(s) connected by close links

1.

2.

3.

1.

2.

3.

Form 3.2 Notification of notional amount referred to in Article 17

Trading Venue:

Traded notional amount in 2016

Asset class X:

Asset class Y:

Asset class Z:

Form 4.1 General notification referred to in Article 18

Name of the trading venue

Relevant contact details

Name(s) and jurisdiction(s) of trading venues in the same group based in the UK

Name(s) and jurisdiction(s) of CCP(s) connected by close links

1.

2.

3.

1.

2.

3.

Form 4.2 Notification of notional amount referred to in Article 18

Name of the trading venue:

Notional amount for rolling year

Notional amount for rolling year

Asset class X:

Asset class Y:

Asset class Z: