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MAM-A.4.6

Persons subject to the obligations to report irregular transactions to the CMSD shall report in the following standard format:

Description of the transaction(s)
Details of the securities, including the code of the security (ISIN Number); the market(s) concerned; the original order's entry date/time, price and size; the times and sizes of the transaction(s); the type and characteristics of the order, etc.
Reasons for Suspicion
Reasons for suspecting that the transaction(s) might constitute insider dealing/market abuse/ market manipulation
Identities of persons carrying out transaction(s)
Names, addresses, telephone number, location, account number, client Identification code used by the firm, etc.
Identities of any other persons known to be involved in the transaction(s)
Names, addresses, telephone number, location, relation to person carrying out the transaction, position held, role played, etc.
Capacity in which the person performing the transaction(s) acts
e.g. broker, underwriter, agent, investment/fund manager, auditor, insider.
Any information which may be of significance (along with a list of any accompanying documents/evidence)
Details of the person making notification
Name of person, name of firm, position held within firm, contact details, etc.
Signed ........... (person making report)

Dated ........... (date of report)
November 2010