ANNEX III
Template for informing of potential risks
| Potential Risks | ||
| Identification of the reporting competent authority | ||
| 
 | C0010 | |
| Name of the competent authority | R0010 | 
 | 
| Reporting timestamp | R0020 | 
 | 
| Reporting period | R0030 | 
 | 
| Name of the main liaison | R0040 | 
 | 
| Function of the main liaison | R0050 | 
 | 
| Phone number of the main liaison | R0060 | 
 | 
| Email address of the main liaison | R0070 | 
 | 
| Identification of any potential risks resulting from the internalised settlement activity in the jurisdiction | ||
| Identification of any potential risks resulting from the internalised settlement activity in the jurisdiction | R0080 | 
 |