Name: Series: Date of issue: Name of authority that issued the document: Department code (if available) The migration card is not required

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1 CUSTOMER DETAILS OJSC CB "UNISTREAM" - INDIVIDUAL ENTREPRENEUR (When filling out information must not be any blank lines in the absence of props is filled with "no") 1. Surname 2. Name 3. Patronymic (unless otherwise follows from the law or national custom) 4. Date of birth 5. Place of birth 6. Citizenship (nationality) 7. Requisites of the document proving the identity Name: Series: Date of issue: Name of authority that issued the document: Department code (if available) 8. Data migration card card: Start date of period of stay: End date of period of stay: 9. The data of the document confirming the right of a foreign citizen or stateless person) for stay in the Russian Federation (visa, temporary residence permit, etc.) The migration card is not required Name: Visa Residence permit The temporary residence permit Other document confirming in accordance with the legislation of the Russian Federation the right of the foreign citizen or the person without citizenship on stay (residing) in the Russian Federation. Specify the name of the other document: Serial number (if available): Start date of period of stay End date of period of stay 10. Address of residence (registration) address or place of residence 11. Postal address Residential address: The address of the place of stay: 12. Presence or absence at their place of location of a legal entity, its permanent management body, other body or person authorized to act on behalf of legal entity without power of attorney 13. Contact telephone numbers and Fax numbers present missing Phone: Fax: 14. /website 15. Taxpayer identification number (TIN)

2 16. Information about registering as an individual entrepreneur 17. Information about licenses for carrying out activities subject to licensing Registration number (OGRNIP): Date of state registration: Name of the registering authority The place of registration: Do You have a license (permit) for the implementation of its activities (operations) Yes f Yes, specify: The number of licenses License type License number Date of issue The name of the body issued the license The term of the license The list of types licensed activities listed in the license 18. Information about the availability of office/production/warehouse space There are (If any mark in the "Is" you should provide information about the size, ownership/rental, actual location) 19. Information on the number of employees sole proprietor: There are (If any mark in the "Is" you should provide information on the number of employees) 20. Information about the beneficial owners (for the purposes of Federal law 115 of beneficial the owner is a natural person who, in accordance with the contract (agreement) has the right to control Your decisions related to business activities. There are (In the presence of a mark in the "Is" you should provide information about all beneficial owners on established by the Bank form) 21. nformation about representatives (the person who represents and acts on Your behalf under power of attorney, law or act of the authorized state body or local self-government, as well as the person who provided or will be provided to the authority to dispose of the Bank account (contribution), including using technologies of remote banking services (including Internet banking) Yes (If the mark in the "Yes" box must to provide information about all of the representatives) 22. Information about beneficiaries and information on the grounds, indicating that the client is acting for the benefit of another person (beneficiary), in particular the presence of: the Agency contract, contract of Agency, Commission and trust management (it is t planned to carry out banking operations and other transactions under Agency agreements, Commission, asset management, Agency contracts (or other civil law contracts in favor of third parties), all transactions and payments are for your own comfort and at your own expense). There are (If any mark in the "is" should fill the Application Details "beneficiary". If several beneficiaries, the form submitted by the Bank, to be completed for each beneficiary separately).

3 23. Types of business activities (including manufactured goods, performed work, rendered services) (primary is listed first). 24. Codes of forms of Federal state statistical observation The provision of services Wholesale / Retail (underline) Construction Activities associated with the production of weapons, or brokerage activities on the implementation of arms Tourism activity (tour operator and travel Agency activities, and other activities the organization of trips) Commission activities (vehicles, art, Antiques, furniture) (underline) Activities associated with the maintenance of totes and gambling establishments (casinos, bookmakers, etc.), organization and holding of lotteries, totalizators (mutual betting) and other risk-based games, including in electronic form, as well as the activities of pawnshops; Transactions with precious metals, gemstones, and jewelry containing precious metals and precious stones, and scrap of such products Transactions with immovable property and the rendering of intermediary services in transactions with real estate Energy Charity Other (specify which) ОКВЭД ОКАТО ОКПО ОКОГУ ОКФС ОКОПФ ОКТМО 25. Do You plan in the framework of service in OJSC CB "UNISTREAM" implementation of the operation(s) to transfer money to the accounts of the contractors non resident, non-resident of the Republic of Belarus or the Republic of Kazakhstan, and acting in their own interests or on behalf of third parties, on made with them foreign trade agreements (contracts), which will be the importation of goods purchased from residents of the Republic of Belarus or the Republic of Kazakhstan respectively, from the territory of the Republic of Belarus or the Republic of Kazakhstan on commodity-transport waybills (shipping documents), issued by the shippers of the Republic of Belarus or the Republic of Kazakhstan? Yes 26. Information about how to establish and intended nature of business relations with OJSC CB "UNISTREAM" (tick the appropriate) 27. Information about goodwill (tick the appropriate) 28. Information on the objectives of financial and economic activity (tick the appropriate) short-term (one year) long term (1 year or more) The planned length of the relationship: the presence of existing relations with the Bank settlement and cash services Depository services operations on purchase/sale of cash foreign currency remote banking services lending documentary operations (letters of credit, guarantees, collections) Other (please specify) Review(s) in a random writing from other credit institutions Review(s) in any written form other clients of JSC CB "UNISTREAM" Review(s) in any written form from the counterparty of the client OJSC CB "UNISTREAM" Review(s) not provided Information about the planned operations on the account in a month: Number of operations: to 100, inclusive above 100 up to 1000, inclusive over 1000

4 The amount of the proposed transactions (the anticipated account turnover per month) including withdrawals of funds in cash and transactions associated with the transfers of funds within the framework of foreign trade in rubles up to ,00 rubles inclusive from ,01 to ,00 rubles inclusive from to ,01 000,00 rubles inclusive from to ,01 000,00 rubles inclusive ,00 rubles The types of contracts, which is planned to be implemented through the Bank (note necessary): commercial contract (purchase and sale, on payment/provision of services, etc.) loan agreement lease agreement international contract the contract of purchase and sale of securities the contract for the provision of banking services (loans, etc.). Other (specify) Information about main contractors, plan payers and recipients on operations with monetary funds on the account (specify no more than 5 contractors for each type) Payers (name/name, TIN/KIO): Recipients (name/name, TIN/KIO): 29. Information (documents) financial position (note necessary) 30. Information about the sources of funds and (or) other property copies of the annual financial statements (balance sheet, statement of financial results) a copy of the annual (or quarterly) tax Declaration with the tax authority of their adoption or without the mark with the application or receipt copy, send a registered letter with a list of contents (when sending by mail), and a copy of the submission confirmation on paper (when sending in electronic form) a copy of the audit report on the annual report for the past year, which confirmed the reliability of the financial (accounting) statements and compliance of the order of conducting accounting to the legislation of the Russian Federation/international financial reporting standards (IFRS) certificate of execution by the taxpayer (payer of fees, tax agent) of the obligation to pay taxes, fees, fines, penalties issued by the tax authority. information about absence in respect of an individual entrepreneur of the proceedings on insolvency (bankruptcy), which entered into force court decisions on the recognition its insolvent (bankrupt) (letter from client in any form) information about absence in respect of an individual entrepreneur liquidation procedures, as of the date of submission of documents to the Bank (letter from client in any form) information about the absence of facts of non-fulfillment by the individual entrepreneur of their monetary obligations due to lack of funds on Bank accounts (letter from client in any form)

5 31. Information about in whose interests account is opened 32. Whether You are a founder (leader) of the legal entity? in the interests of the Individual entrepreneur in the interests of the legal entity (specify the name, TIN/KIO, the basic state registration number, place of state registration, address of actual location; these powers in cases where applicable) on behalf of another natural person or Individual entrepreneur (indicate your name, nationality, date of birth, data of the identity document (series (if any), number, date of issue, issuing authority, expiration date, address of residence (registration), address of place of residence, INN (if available), data proxy (in cases where applicable) (For non-residents also shows the data of the document confirming the right to stay/residence in the territory of the Russian Federation (document type, series, number, date of issue, expiration date), data migration card (series, number, date of issue, period action) Yes (If the mark in the "Yes" box must to provide information about all the organizations with names/, INN/KIO, thepost/stake) 33. Do You have other employment? Yes (If the mark in the "Yes" box must to provide information about all the organizations with names, INN/KIO, position) 34. Do You have accounts in other Banks and, if so, provide the names of credit institutions in which You have an account? Name of the credit institution Location (country, city) The nature of the relationship (specify the name of the services You use) The length of the relationship (the date of the beginning of the relationship) 35. Other information about the individual entrepreneur Whether You are in compliance with Federal law from FZ "About activity on reception of payments of physical persons by payment agents": - paying agent operator on reception of payments - payment subagent - not a payment agent or subagent Operators to receive payments, with whom You have a contract on the implementation of the activity on reception of payments of physical persons Vendors with whom Your company has a contract on the implementation of the activity on reception of payments of physical persons Whether You are in compliance with Federal law from FZ "About activity on reception of payments of physical persons by payment agents" suppliers of goods (works, services): Operators receiving Yes payments that Your company the contract on the implementation activities for reception payments individuals

6 35.3. Whether You are a U.S. taxpayer in accordance with the requirements of US Law called the foreign account tax (FOREIGN ACCOUNT TAX COMPLIANCE, FATCA)? Yes Date of registration on the portal of the IRS (IRS) Status is obtained by registering on the portal of the IRS (IRS) Code GIIN / TIN Whether You are a foreign public official, an official of a public international organizations, as well as a substitute (occupying) state posts of the Russian Federation, positions of the members of the Board of Directors of the Central Bank of the Russian Federation, Federal office the public service? Yes (If the mark in the "Yes" box you have to provide information) Surname, Name, Patronymic, signature of the person who filled in the questionnaire on paper / stamp (subject to availability) 20 г.

Adopted by the State Duma on July 13, 2001 Approved by the Federation Council on July 20, Chapter I. General Provisions

Adopted by the State Duma on July 13, 2001 Approved by the Federation Council on July 20, Chapter I. General Provisions FEDERAL LAW NO. 129-FZ OF AUGUST 8, 2001 ON THE STATE REGISTRATION OF LEGAL ENTITIES AND INDIVIDUAL BUSINESSMEN (with the Amendments and Additions of June 23, December 8, 23, 2003, November 2, 2004, July