# Commission Implementing Regulation (EU) 2017/394 of 11 November 2016 laying down implementing technical standards with regard to standard forms, templates and procedures for authorisation, review and evaluation of central securities depositories, for the cooperation between authorities of the home Member State and the host Member State, for the consultation of authorities involved in the authorisation to provide banking-type ancillary services, for access involving central securities depositories, and with regard to the format of the records to be maintained by central securities depositories in accordance with Regulation (EU) No 909/2014 of the European Parliament and of the Council (Text with EEA relevance), Division SECTION 4: Template for the request for ESMA assistance

Extent: E+W+S+N.I.

[Name of the authority referring the matter to ESMA]
Contact details of the authority referring the matter to ESMA
Name of person(s) responsible for further contacts:
Function:
Telephone number:
Email address:
Reasons for request:
[Reasons for the referral to ESMA]
Done at …on [insert date] …
On behalf of [Name of authority referring the matter to ESMA]
[signature]
Done at …on [insert date] …
On behalf of [Name of authority referring the matter to ESMA]
[signature]

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Source: https://www.legislation.gov.uk/eur/2017/394/annex/VI/division/Forms/section/4 (the official version)
Page: https://openlegislation.uk/eu-regulation-2017-394/annex-VI/division-Forms/section-4
Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.