ASSETERA TOKEN LISTING

Issuer

Name *

First

Last

Email address *

Phone *

Jurisdiction *

Company Register No.

(if available or similar unique national identifier)

LEI:

(20-character code; if available)

FATCA ID:

(6-character code; if available)

GIIN:

(19-charcter code; if available)

Securities offering

Issuing Volume: *

(in millions)

Currency: *

(Issuing volume currency)

Placed Volume: *

(in millions)

Initial Offering Closing: *

(dd. mmm. yy)

Denomination: *

(e.g. 000'000.00000000)

Accepted means of payment, and cryptocurrencies: *

Investors targeted:

Retail Investors / Non-Qualified Investors *

YES
NO

Qualified Investors *

YES
NO

Art. 2 (e) Regulation (EU) 2017/1129

Other Trading Venues: *

Supervisory authority:

Has this security token offering been approved by a local financial supervisory authority? *

YES
NO

If the answer is yes, please provide the name and country of supervisory authority:

Legal:

Is there a qualified legal opinion available from a law firm available to verify that this token is considered a a financial instrument under MiFID II? *

YES
NO

Is there a prospectus available according to Regulation (EU) 2017/1129? *

YES
NO

If the answer is yes, please provide a written consent of person responsible for drawing up such prospectus according Art. 5 (1) second sub-paragraph of Regulation (EU) 2017/1129.

Provided if applicable

If the answer is no, is this based on an exemption from the EU Prospectus Regulation?

YES
NO

Please state the basis for the exemption:

Is there a PRIIPs KID available according to Regulation (EU) No 1286/2014? *

YES
NO

Has an AML/CTF and sanctions check of the investors been carried out? *

YES
NO

If the answer is yes, please provide the legal basis of the AML/CTF checks:

Is there a custodian appointed to safeguard this security token? *

YES
NO

If the answer is yes, please provide name and domicile of the custodian:

Technical:

Blockchain: *

(e.g. Ethereum, etc.)

Token Standard: *

(e.g. ERC-20, etc.)

Token Identifier: *

Important note:

Our LISTING TEAM will get in touch with you immediately after receiving your request.