Regulatory Alerts2022-01-18
Added · Updated
Forms and formats for supervisory applications
De Nederlandsche Bank requires applicants for supervisory assessments to use specific application forms available in the Digital Supervision Portal, with significant banks mandated to use the SSM's IMAS portal. The document provides downloadable standardized formats for supporting documents, including CVs, propriety assessment forms, and suitability matrices, tailored to various financial sectors such as banks, insurers, pension funds, and trust offices. These formats must be completed and uploaded alongside the digital assessment applications to ensure proper submission procedures are followed.
Factsheet
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To apply for an assessment, you must use the appropriate application form available in the Digital Supervision Portal . Please make sure that you use the correct form for the assessment in question. You can find an overview of all available assessment application forms on the following webpage: Supervisory applications (dnb.nl) .
Published: 18 January 2022
If your bank is a "significant bank", you must use the form that is available in the SSM's Information Management System portal ( IMAS portal ).
We have drawn up the following formats that can be used for documents you need to upload when submitting an assessment application form. You can download these formats, complete them and upload them together with the digital assessment application form.
Please refer to the webpage documents to be submitted for more information.
For all sectors
Propriety Assessment Form
(21 June 2021 | 390KB PDF)
Standarised format CV
(13 August 2025 | 40KB DOCX)
Statement of the natural person to be assessed (and authorised representative)(only for DNO assessment
(11 April 2019 | 219KB PDF)
Signatory statement
(17 February 2021 | 161KB PDF)
Banks, Insurers, Payment institutions, Investment holding companies, Exchange institutions, Electronic money institutions, Central clearing counterparty, Clearing institutions and Payment processing service providers
Supervisory Board Suitability Matrix
(29 January 2025 | 63KB DOCX)
Management Body Suitability Matrix
(29 January 2025 | 68KB DOCX)
Second tier senior officers
Outcome of institution's own propriety assessment
(16 June 2021 | 159KB PDF)
Trust offices
Suitability Matrix for trust offices
(01 April 2017 | 82KB DOC)
Pension funds, Premium pension Institutions and General pension funds
Suitability Matrix for Pension funds and PPIs
(40KB DOCX)
FTE Score Form Pension Funds
(40KB DOCX)
Risk Management key function holder self-assessment form
(11 December 2025 | 62KB DOCX)
Internal Audit Function key function holder self-assessment form
(11 December 2025 | 75KB DOCX)
Issuer Asset referenced tokens
MiCAR Suitability Matrix Template for the assessment of collective suitability Issuer Asset Referenced Tokens
(26 September 2024 | 55KB XLSX)
Other formats for Significant Banks
Standardised CV for Banks that qualify as Significant Institution under SSM regulation
(149KB DOC)
Declaration on possible conflicts of interest
(01 August 2017 | 71KB DOCX)
Oath or affirmation
(25 May 2015 | 38KB DOCX)
Suitability Matrix for Significant Institutions
(24 July 2024 | 377KB DOCX)
Fit and proper assessments
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