Official Gazette of the Republic of Srpska Number 26/13 UNOFFICIAL TRANSLATION

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1 Official Gazette of the Republic of Srpska Number 26/13 UNOFFICIAL TRANSLATION Pursuant to Article 7 paragraph 2 point 9, Article 9 paragraph 1 point 2 of the Law on Insurance Companies (Official Gazette of the Republic of Srpska, 17/05, 1/06, 64/06, and 74/10) and Article 16 paragraph 1 point 2 of the Statute of the Insurance Agency of the Republic of Srpska (Official Gazette of the Republic of Srpska, 30/06), Administrative Board of the Insurance Agency of the Republic of Srpska at its session held on 25 th March 2013 issued the following: RULEBOOK ON AMENDMENTS TO THE RULEBOOK ON RULES OF OPENING AND BUSINESS ACTIVITIES OF BRANCH OFFICES OF INSURANCE COMPANIES IN INTER ENTITY BUSINESS ACTIVITIES Article 1 In Article 20 paragraph 1 of the Rulebook on rules of opening and business activities of branch offices of companies in inter entity business activities (Official Gazette of the Republic of Srpska, 12/13, hereinafter: Rulebook), the words on the form P is changed and shall read on the form P-F, the words on the from Š is changed and shall read on the form Š-F and the words on the from KS and the words on the form KS-F. Article 2 Form P is changed and shall read Form P-F, Form KS is changed and shall read Form KS-F. Article 3 Form Š shall be replaced by the Form Š-F which is an integral part of this Rulebook. Article 4 Reports that are delivered to the Agency after entry into force of this Rulebook shall be make according to the provisions of this Rulebook. Article 5 This Rulebook enters into force on the eight day from the day of publishing in the Official Gazette of the Republic of Srpska. Number: UO-07/13 Banja Luka, on 25 th March 2013 President of the Administrative Board Branka Bodroža

2 Name of the company/branch offices: Form: Š Report on Period from until of year in BAM Insurance code (balance as of 31 December of the previous Total (reserved +ed) PROCESSED CLAIMS Declined claims Reactively Total in regular procedure in Total processed claims from the previous Paid out of total processed claims in the end of the =(5+6) 8=(3+7) =(10+12) 15=(11+13) =( ) 23=( ) 24=(9-15) 01 Accident 02 Health 03 Vehicle excluding railroad vehicles 04 Railroad 05 Aviation 06 Watercraft 07 Transport 08 Fire and natural disasters

3 Insurance code (balance as of 1 January of the previous Total (reserved +ed) PROCESSED CLAIMS Declined claims Reactively Total in regular procedure in Total processed claims from the previous Paid out of total processed claims in the end of the =(5+6) 8=(3+7) =(10+12) 15=(11+13) =( ) 23=( ) 24=(9-15) 09 Insurance against other of the property 10 Insurance against motor vehicles 11 Insurance against aviation 12 Insurance against watercraft 13 General liability 14 Credit 15 Guaranty 16 Insurance against different financial losses 17 Legal expenses

4 Insurance code (balance as of 1 January of the previous Total (reserved +ed) PROCESSED DAMAGES Declined Reactively Total Processed in regular procedure Processed in Total processed Unpaid processed from the previous Paid out of total processed Unpaid processed in the end of the of submitting request =(5+6) 8=(3+7) =(10+12) 15=(11+13) =( ) 23=( ) 24=(9-15) 18 Insurance of assistance TOTAL NON- LIFE INSURANCES 19* Life 19** Annuities 19*** Additional along with life 19**** Other types of life TOTAL LIFE INSURANCES TOTAL Place and date: Data processed by: Branch office manager

5 Name of the company/branch office: Form: KS Structure of professional qualifications of the employees as of year Ordinal number Qualifications Number of employees Unqualified 2. Semi-skilled 3. Low-skilled 4. Skilled 5. Secondary school education 6. Highly-skilled worker 7. Non-university college degree 8. University degree 9. Ma 10. PhD TOTAL Place and date: Data processed by: Branch office manager

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