Form DI-2 Report on Residents' Direct Investments Abroad

FORM DI-2 REPORT ON RESIDENTS’ DIRECT INVESTMENTS ABROAD BASIC INFORMATION Reporting period Responsible person Period/Year Address of responsible person INFORMATION ON RESIDENT E-mail of responsible person ID number Name of resident Information on the person filling in the form Office address of resident (street and number) Name and surname Municipality Accounting agency Status of resident Phone number Activity (main activity) E-mail Date of founding Date of entry (dd-mm-yyyy) Type of entity Type of investment INFORMATION ON NON-RESIDENT Name of non-resident Office address of non-resident Country of non-resident Type of entity Activity of non-resident’s (main activity) Country of parent company Type of foreign investment Share in capital (in %)

BALANCE OF RESIDENT’S EQUITY INVESTMENTS Name of non-resident Opening position Closing position CAPITAL Initial capital Positive revaluation reserves Unpaid subscribed capital Negative revaluation reserves Issuing premium Retained earnings from the current period Legal reserves Loss from the current period Statutory and other reserves Retained earnings from the previous periods Loss from the previous period TRANSACTIONS Transaction number Type of change Month of transaction Manner of payment Amount 1 2 Total transactions OTHER CHANGES Exchange rate changes Debt-for-equity swop Amount of other changes Specify type of other changes Total amount of other changes DIVIDENDS Name of non-resident Making a decision on dividend payment Dividend payment Paid dividend from the current period Paid retained profit from the previous periods Total Month Month Year Month Year

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