11.3.2016
EN
Official Journal of the European Union
L 65/53
ANNEX I
TEMPLATE 1
Insider list: section related to [Name of the deal-specific or event-based inside information]
Date and time (of creation of this section of the insider list, i.e. when this inside information was identified): [yyyy-mm-dd; hh:mm UTC (Coordinated Universal Time)]
Date and time (last update): [yyyy-mm-dd, hh:mm UTC (Coordinated Universal Time)]
Date of transmission to the competent authority: [yyyy-mm-dd]
| First name(s) of the insider | Surname(s) of the insider | Birth surname(s) of the insider (if different) | Professional telephone number(s) (work direct telephone line and work mobile numbers) | Company name and address | Function and reason for being insider | Obtained (the date and time at which a person obtained access to inside information) | Ceased (the date and time at which a person ceased to have access to inside information) | Date of birth | National Identification Number (if applicable) | Personal telephone numbers (home and personal mobile telephone numbers) | Personal full home address: street name; street number; city; post/zip code; country) |
| [Text] | [Text] | [Text] | [Numbers (no space)] | [Address of issuer/emission allowance market participant/auction platform/auctioneer/auction monitor or third party of insider] | [Text describing role, function and reason for being on this list] | [yyyy-mm-dd, hh:mm UTC] | [yyyy-mm-dd, hh:mm UTC] | [yyyy-mm-dd] | [Number and/or text] | [Numbers (no space)] | [Text: detailed personal address of the insider — Street name and street number — City — Post/zip code — Country] |
