The prescribed standard statement referred to in Paragraph HC-3.1.3 is as follows:

"We, the Directors of [insert licensee name], do hereby confirm that we have undertaken the review required under Rule HC-3.1.1 of Volume 4 of the CBB Rulebook. The scope of this review was in accordance with the requirements specified in Section HC-3.2 of Volume 4 of the CBB Rulebook.

The summary results of this review, setting out (i) the actions taken to carry out this review; (ii) any material deficiencies identified as a result of the review; and (iii) an action plan and timescales for the correction of any such deficiencies (where appropriate), are attached.

We understand that it is breach of our licensing conditions to provide false or misleading information to the CBB, or to withold material information that may reasonably be expected to be provided to the CBB.

[signed and dated by all Board Directors]"