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:
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                         (a)  | 
                     
                         has been convicted of any criminal offence;  | 
                  
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                         (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;  | 
                  
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                         (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;  | 
                  
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                         (d)  | 
                     
                         has to his or her knowledge been subject to any existing or previous investigation by any regulatory authority or government bodies or agencies;  | 
                  
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                         (e)  | 
                     
                         has been involved with an undertaking whose registration or authorisation was withdrawn by a regulatory body;  | 
                  
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                         (f)  | 
                     
                         has been refused the right to carry on activities which require registration or authorisation by a regulatory body;  | 
                  
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                         (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;  | 
                  
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                         (h)  | 
                     
                         has been involved with an undertaking which was investigated or suspended by a regulatory body and which resulted in an enforcement action;  | 
                  
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                         (i)  | 
                     
                         has been investigated, suspended or sanctioned by a regulatory body;  | 
                  
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                         (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.  |