Source: OJ L, 2025/294, 13.2.2025
Current language: EN
- Markets in crypto-assets
Crypto-asset service provider
- RTS on CASP complaints handling
Annex TEMPLATE FOR THE FILING OF COMPLAINTS
FILING OF A COMPLAINT (to be sent by the client to the crypto-asset service provider)
1.a. Information about the complainant
Last name/Legal entity name:
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First name:
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EUID or if not available national Registration or ID number:
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Legal Entity Identifier (if available):
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Clientmeans any natural or legal person to whom a crypto-asset service provider provides crypto-asset services; reference (if available):
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Address (street, number, floor) (for legal entities, registered office):
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Postcode:
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City:
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Country:
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Telephone:
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Email address:
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1.b. Contact details (if different from 1.a)
Last name/Legal entity name:
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First name:
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Address (street, number, floor) (for legal entities, registered office):
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Postcode:
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City:
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Country:
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Telephone:
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Email address:
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2.a. Information about the legal representative (if applicable) (a power of attorney or other official document as proof of the appointment of the representative to be provided as an attachment to this form)
Last name/Legal entity name:
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First name:
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Registration number and LEI (if available):
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Address (street, number, floor) (For legal entities, registered office)
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Postcode:
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City:
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Country:
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Telephone:
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Email address:
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2.b. Contact details (if different from 2.a)
Last name/Legal entity name:
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First name:
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Address: street, number, floor (For firms registered office)
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Postcode:
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City:
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Country:
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Telephone:
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Email:
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3. Information about the complaint
3.a. Full reference of the crypto-asset service to which the complaint relates (i.e. name of the crypto-asset service provider, crypto-asset service reference number, or other references of the relevant transactions …)
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3.b. Description of the complaint’s subject-matter
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Please provide any documentation supporting the facts mentioned.
3.c. Date(s) of the facts that have led to the complaint
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3.d. Description of damage, loss or detriment caused (where relevant)
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3.e. Other comments or relevant information (where relevant)
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In ___________________________________(place) on ____________________(date)
SIGNATURE COMPLAINANT/LEGAL REPRESENTATIVE OF THE COMPLAINANT
Documentation provided (please check the appropriate box):
Power of attorney or other official document as proof of the appointment of the representative
?
Copy of the contractual documents of the investments to which the complaint relates
?
Other documents supporting the complaint:
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Springlex and this text is meant purely as a documentation tool and has no legal effect. No liability is assumed for its content. The authentic version of this act is the one published in the Official Journal of the European Union.