Annex | STOR template

Please note that *all* fields in Sections 1-4 are mandatory. Where information cannot be provided for a specific field, please indicate ‘NA’ and briefly explain the reasons thereof.
SECTION 1 – IDENTITY OF ENTITY/PERSON SUBMITTING THE STOR Persons professionally arranging or executing transactions in crypto assets – Specify in each case:
Name of the natural person	[First name(s) and surname(s) of the natural person in charge of the submission of the STOR within the submitting entity.]
Position within the reporting entity	[Position of the natural person in charge of the submission of the STOR within the submitting entity.]
Name of the reporting entity	[Full name of the reporting entity, including for legal persons: the legal form as provided for in the register of the country pursuant to the law of which it is incorporated, where applicable, and the Legal Entity Identifier (LEI) code in accordance with ISO 17442 LEI code.]
Address of the reporting entity	[Full address (e.g. street, street number, postal code, city, state/province) and country.]
Acting capacity of entity with respect to the orders, transactions or behaviours related to the functioning of the DLT that could constitute market abuse	[Description of the capacity in which the reporting entity was acting with regards to the order(s), transaction(s) or behaviour(s) related to the functioning of the distributed ledger technologyor ‘DLT’ means a technology that enables the operation and use of distributed ledgers; that could indicate the existence of market abuse, e.g. executing orders on behalf of clientsmeans any natural or legal person to whom a crypto-asset service provider provides crypto-asset services;, operating a trading platform ...]
Type of trading activity (market making, arbitrage etc.) and type of crypto-assetmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology; traded by the reporting entity	[Description of any corporate, contractual or organisational arrangements or circumstances or relationships.]
Contact for additional request for information	[Person to be contacted within the reporting entity for additional request for information relating to this report (e.g. compliance officer) and relevant contact details, if not the same as person in charge of the submitting of the STOR: first name(s) and surname(s), position of the contact person within the reporting entity, professional email address, professional phone number.]
Have the facts already been reported to public authorities?	Please state whether the facts have already been reported to public authority (and in that case indicate the name of the authority).
SECTION 2 – TRANSACTION/ORDER/BEHAVIOUR AND OTHER ASPECTS RELATED TO THE FUNCTIONING OF THE DISTRIBUTED LEDGER TECHNOLOGYor ‘DLT’ means a technology that enables the operation and use of distributed ledgers;
Description of the crypto-assetmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology;:	Describe the crypto-assetmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology;(s) which is the subject of the STOR, specifying: the full name (including Digital Token Identifier (DTI) in accordance with ISO 24165-2 or an equivalent unique identifier as referred to in Article 15 of Commission Delegated Regulation (EU) 2025/1140(¹)Commission Delegated Regulation (EU) 2025/1140 of 27 February 2025 supplementing Regulation (EU) 2023/1114 of the European Parliament and of the Council with regard to regulatory technical standards specifying records to be kept of all crypto-asset services, activities, orders and transactions undertaken (OJ L, 2025/1140, 10.6.2025, ELI: http://data.europa.eu/eli/reg_del/2025/1140/oj). specifying records to be kept of all crypto-asset servicesmeans any of the following services and activities relating to any crypto-asset:providing custody and administration of crypto-assets on behalf of clients;operation of a trading platform for crypto-assets;exchange of crypto-assets for funds;exchange of crypto-assets for other crypto-assets;execution of orders for crypto-assets on behalf of clients;placing of crypto-assets;reception and transmission of orders for crypto-assets on behalf of clients;providing advice on crypto-assets;providing portfolio management on crypto-assets;providing transfer services for crypto-assets on behalf of clients;, activities, orders and transactions undertaken) or description of the crypto-assetmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology; in the absence of DTI. Where the suspicious behaviour involves a trading pair, please list both crypto-assetsmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology; in the pair, the type of crypto-assetmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology; (asset-referenced tokenmeans a type of crypto-asset that is not an electronic money token and that purports to maintain a stable value by referencing another value or right or a combination thereof, including one or more official currencies; (ART), e-money token (EMT), other crypto-assetmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology;) and for ARTs and EMTs, the value, right or official currencymeans an official currency of a country that is issued by a central bank or other monetary authority; (or combination thereof) which the crypto-assetmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology; references in order to maintain a stable value.
Name(s) of the distributed ledgermeans an information repository that keeps records of transactions and that is shared across, and synchronised between, a set of DLT network nodes using a consensus mechanism;(s):	[Provide the full name(s) of the distributed ledgermeans an information repository that keeps records of transactions and that is shared across, and synchronised between, a set of DLT network nodes using a consensus mechanism;(s) where the suspicious behaviour was observed]
Trading platform where order was placed or the transaction was executed	[Specify name and Market Identifier Code (MIC) in accordance with ISO 10383 to identify the trading platform where the order was placed or the transaction was executed. Where the order/transaction was not identified in a trading platform, please mention ‘outside a trading platform’ and the LEI of the crypto-asset service providermeans a legal person or other undertaking whose occupation or business is the provision of one or more crypto-asset services to clients on a professional basis, and that is allowed to provide crypto-asset services in accordance with Article 59; that carried out the transaction where applicable.]
Location (country)	[Full name of the country and the ISO 3166-1 two-character country code.] [Specify where: the order is given the transaction is executed, the behaviour related to functioning of the distributed ledger technologyor ‘DLT’ means a technology that enables the operation and use of distributed ledgers; takes place.]
Description of the order, transaction or suspicious behaviour related to the functioning of the DLT	[Describe at least the following characteristics of the order(s) transaction(s) or behaviour(s) reported: date(s) and time(s) of the order(s), transaction(s) or behaviour(s). (Dates and times should be reported in UTC per the format in ISO 8601). transaction reference number or order reference number or transaction hash. settlement date and time, purchase price/sale price, volume/quantity of crypto-assetsmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology;, for orders only, the type of order (e.g. ‘buy with limit EUR x’)], [Where there are multiple orders or transactions that could constitute market abuse the details on the prices and volumes of such orders and transactions can be provided to the competent authoritymeans one or more authorities:designated by each Member State in accordance with Article 93 concerning offerors, persons seeking admission to trading of crypto-assets other than asset-referenced tokens and e-money tokens, issuers of asset-referenced tokens, or crypto-asset service providers;designated by each Member State for the application of Directive 2009/110/EC concerning issuers of e-money tokens; in an Annex to the STOR.] Information on the order cancellation or alteration including: the nature of the alteration (e.g. change in price or quantity) and the extent of the alteration, [Where there are multiple orders or transactions that could constitute insider dealing, market manipulation or attempted insider dealing or market manipulation, the details on the prices and volumes of such orders and transactions can be provided to the competent authoritymeans one or more authorities:designated by each Member State in accordance with Article 93 concerning offerors, persons seeking admission to trading of crypto-assets other than asset-referenced tokens and e-money tokens, issuers of asset-referenced tokens, or crypto-asset service providers;designated by each Member State for the application of Directive 2009/110/EC concerning issuers of e-money tokens; in an Annex to the STOR.] the means to alter the order (e.g. via email, phone, etc.). In case of reporting a suspicious behaviour related to the functioning of the distributed ledgermeans an information repository that keeps records of transactions and that is shared across, and synchronised between, a set of DLT network nodes using a consensus mechanism;, please provide as much detail as possible, including the impact it had on the validation of transactions and the method used to alter the functioning of the DLT.
SECTION 3 – DESCRIPTION OF THE NATURE OF THE SUSPICION
Nature of the suspicion	[Specify the type of breach based on which the reported order(s), transaction(s), behaviour(s) related to the functioning of the DLT, could constitute market abuse].
Reasons for the suspicion	[Description of the activity (transactions and orders, way of placing the orders or executing the transaction and characteristics of the orders and transactions that make them suspicious, behaviours related to the functioning of the DLT) and how the matter came to the attention of the reporting person and specify the reasons for suspicion. For crypto-assetsmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology; admitted to trading on/traded on a trading platform, a description of the nature of the order book interaction/transactions that could constitute market abuse.]
SECTION 4 – IDENTIFICATION OF PERSON(S) RESPONSIBLE FOR THE ORDERS, TRANSACTIONS OR BEHAVIOUR RELATED TO THE FUNCTIONING OF THE DISTRIBUTED LEDGER TECHNOLOGYor ‘DLT’ means a technology that enables the operation and use of distributed ledgers; THAT COULD CONSTITUTE MARKET ABUSE (‘SUSPECTED PERSON’)
Name	[For natural persons: the first name(s) and the last name(s).] [For legal persons: full name including legal form as provided for in the register of the country pursuant to the laws of which it is incorporated, where applicable, and Legal Entity Identifier (LEI) code in accordance with ISO 17442.]
National Identification Number	[Number and/or text]. [Where the National Identification Number is not applicable or known, provide a date of birth (for natural persons only) in the ISO 8601 format]
Address	[Full address (e.g. street, street number, postal code, city, state/province) and country.]
Information about the employment: – Place – Position	[Information about the employment of the suspected person, from information sources available internally to the reporting entity (e.g. account documentation in case of clientsmeans any natural or legal person to whom a crypto-asset service provider provides crypto-asset services;, staff information system in case of an employee of the reporting entity).]
Account number(s) and wallet address(es)	[Numbers of the cash account(s), any joint accounts or any Powers of Attorney on the account the suspected entity/person holds. Wallet address(es) involved in the transaction or suspected behaviour]
Clientmeans any natural or legal person to whom a crypto-asset service provider provides crypto-asset services; identifier	[In case the suspected person is a clientmeans any natural or legal person to whom a crypto-asset service provider provides crypto-asset services; of the reporting entity.]
Relationship with the issuermeans a natural or legal person, or other undertaking, who issues crypto-assets; of the crypto-assetmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology; concerned	[Description of any corporate, contractual or organisational arrangements or circumstances or relationships]
SECTION 5 – ADDITIONAL INFORMATION Other information relevant to the report, depending on the activity
[The following list is indicative and not exhaustive. Other information deemed useful by the reporting person may be provided where relevant to the STOR.] the position of the suspected person (e.g. retail clientmeans any natural or legal person to whom a crypto-asset service provider provides crypto-asset services;, institutions), the nature of the suspected entity’s/person’s intervention (on own account, on behalf of a clientmeans any natural or legal person to whom a crypto-asset service provider provides crypto-asset services;, validator of transactions in a distributed ledgermeans an information repository that keeps records of transactions and that is shared across, and synchronised between, a set of DLT network nodes using a consensus mechanism; system, other). Where the suspected behaviour is conducted on a DLT, other relevant information may include: whether the transaction passed through a public or private (encrypted) queue of transactions (i.e. mempool) before it was validated on the DLT; whether the DLT is public (permissionless) or private (permissioned); potential interactions with smart contracts, including specification of the contract address and the function called; the size of the suspected entity’s/person’s portfolio, the date on which the business relationship with the clientmeans any natural or legal person to whom a crypto-asset service provider provides crypto-asset services; started if the suspected entity/person is a clientmeans any natural or legal person to whom a crypto-asset service provider provides crypto-asset services; of the reporting person/entity, the type of activity of the trading desk, where available, of the suspected entity, trading patterns of the suspected entity/person. For guidance, the following are examples of information that may be useful: trading habits of the suspected entity/person, comparability of the size of the reported order/transaction with the average size of the orders submitted/transactions carried out by the suspected entity/person for the past 12 months, habits of the suspected entity/person in terms of crypto-assetsmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology; it has traded for the past 12 months, in particular whether the reported order/transaction relates to a crypto-assetmeans a digital representation of a value or of a right that is able to be transferred and stored electronically using distributed ledger technology or similar technology; which has been traded by the suspected entity/person for the past year. Other entities/persons known to be involved in the orders or transactions of which could constitute market abuse: names, activity (e.g. executing orders on behalf of clientsmeans any natural or legal person to whom a crypto-asset service provider provides crypto-asset services;, dealing on own account, operating a trading platform, validating transactions.)
SECTION 6 – DOCUMENTATION ATTACHED
[List the supporting attachments and material together provided with this STOR]. [Examples of such documentation are e-mails, recordings of conversations, order/transaction records, distributed ledger technologyor ‘DLT’ means a technology that enables the operation and use of distributed ledgers; records, confirmations, broker reports, Powers of Attorney documents, and comment by media where relevant. Where the detailed information about the orders/transactions/behaviours related to the functioning of the distributed ledger technologyor ‘DLT’ means a technology that enables the operation and use of distributed ledgers; referred to in Section 2 is provided in a separate annex, indicate the title of that annex.]