MBK A - Legal entities (LTD., Inc., limited partnership, economic interest grouping, holding) s CUSTOMER INFORMATION SHEET - LEGAL ENTITY IDENTIFICATION DATA The Bank is required to have updated personal data that are collected by this questionnaire pursuant to Anti-money laundering and terrorist financing Act and the related implemented regulations, EU regulations, regulations of the international community and international standards. The collected data will be used by the Bank for carrying out due diligence of the client, its transactions and fulfilment of obligations in accordance with these regulations. If the Bank cannot fulfil the requirements regarding due diligence, it cannot establish this business relationship, and may be obliged to terminate any existing business relationship. Please answer only on those questions below that are marked with the letter from header to which belongs a business entity for which you will complete the questionnaire. Name of the business entity Tax pin (ID number) Address of registered office Correspondence address Listed legal entity Yes 1 No Name of the stock exchange Business entity is a state, public sector entity, local and regional self-government unit, public agency, public fund, public institution or chamber? Yes 1 No A B ISIC code 2 ( ) Description Customer who works in sectors / branches of activity benefiting from public funds, including UE funds (e.g. public contracts, healthcare, collection and disposal of waste, renewable energy production) Yes No 1 If YES, you are not obliged to compete the Data on Customer s Beneficial Owner 2 Please enter the code of economic activity from the Decision on the classification of the Central Bureau of Statistics 1
C D (Non-Profit Organization) Type of beneficiaries of the activities: Social assistance Healthcare assistance Education and training Scientific research of social interest Safeguard of civil rights Conservation, promotion and valorisation of artistic, historic and cultural patrimony Conservation and valorisation of nature, environment and territory Amateur sport General charities Other activity / other beneficiaries A B MANAGEMENT BOARD INFORMATION /OWNER OF THE CRAFTS (if more minimum two) 2. Street and house number, place and postal code, country Who are the PEP persons see in Annex PEP form, and if you are PEP person you are required to fulfil PEP form 2
C Specify one member (of the association, foundation or endowments) A B* C D * if different from the person mentioned in the previous question Data on: Legal representative Procurator Proxy Street and house number, place and postal code, country Who are the PEP persons see in Annex PEP form, and if you are PEP person you are required to fulfil PEP form
For which purpose will the account be opened with the Bank (please specify)? Company/commercial/professional needs Loan Cash transactions Domestic transaction management Foreign transaction management Domestic commercial credit disinvesting Foreign commercial credit disinvesting Corporate treasury management Supply management Employees salary management Investments Savings Documentary letters of credit and Bank guarantees Factoring How much is the expected average annual turnover? Up to EUR 100.000,00 Up to EUR 00.000,00 Up to EUR 800.000,00 Up to EUR 000.000,00 Over EUR 000.000 Origin of money: Self-financing (funds from regular business) Grants from business partners, sponsors, etc. (borrowing etc.) Project financing and/or from EU funds Other Country where the main economic activity is carried out? See Appendix No. 2
Country with which the Customer does business significantly (if different from the Country where the main economic activity is carried out)? 2.. A) Who are the business partners of the company? Where are they located? Supplier Name Country Economic sector Clients Customers Name Country Economic sector B) A business entity has no business partners (suppliers / customers (buyers) Newly founded business entity Business Entity has no suppliers, customers Other Hereby I confirm that all data given in this document are true and the Bank has the right to check them. I will personally inform the Bank about any changes regarding data given above. PERSONAL DATA PROTECTION Privredna banka Zagreb dd, Radnička cesta 0, Zagreb, OIB 0269772, registered in the Court Registry of the Commercial Court in Zagreb under the MBS 080002817 (hereinafter: the Bank), as the personal data controller, operates in accordance with the principles of Regulation (EU) 2016/679 OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 9/6/EC (General Data Protection Regulation). When collecting personal data of its clients, whether collected from a client at the time of their collection, or collected from another source, the Bank provides information in accordance with Articles 1 and 1 of the General Data Protection Regulation, such as information about the Bank as the personal data controller, the purposes and the legal basis of the processing of personal data, the categories of data collected (for example, the personal data necessary for establishing a business relationship under the Anti Money Laundering Act and the Financing of Terrorism, and other data necessary for the execution of a particular contract or to take acts before the conclusion of the contract or fulfillment of any other legal obligations, legitimate interests of the Bank as the personal data controller or a third party), data retention period, data recipients, sources of data as well as rights regarding the protection of personal data (eg, right of access to data, objection, etc.). Contact details of data protection officer: sluzbenik.za.zastitu.osobnih.podataka@pbz.hr By signing this document, I certify that Privredna banka Zagreb d.d. as the personal data controller, pursuant to Articles 1 and 1 of the General Data Protection Regulation, when collecting personal data, informed me about the processing and protection of my personal data through the Personal Data Processing Information document and I am aware that this document is available at www.pbz.hr and in the business premises of the Bank Signature and stamp Date Bank employee first and last name Date Signature of the Banks employee Comment of the bank See Appendix No. 2