Application for Temporary Administrator or Special Manager of a Bank under BNB Regulation No 9

TO
THE GOVERNOR OF THE BNB
APPLICATION under Article 6, paragraph 1 of Regulation No 9 of the BNB of 26 July 2017 on the information and documents needed to prove compliance with the requirements to temporary administrators or special managers of a bank
By: ...............................................................................................................................................................
(full name)
Personal Identity Number 
Adress: City .................................................................................................... Postcode 
Street/District ........................................................................ No ....., Bl. ....., Entr. ...... , Fl. ...... Ap. .......
Telephone .....................................................................................................................................................
Identity Document/Passport ........ / No ....................... Issued on.................... by.....................................
Dear Sir,
I hereby would like to apply for the position of:
 temporary administrator
 special manager
 temporary administrator/special manager
I herewith declare that statements made and information contained in attached documents are true and correct and I am not aware of any other available information whose provision would affect declared circumstances. If circumstances change, I hereby undertake to notify the BNB within 14 days of occurrence of the relevant change. I hereby declare that I am aware of the responsibility for submitting incorrect or inaccurate data.

Attachments:

1. a certified copy of the diploma of completed higher education with at least a masters degree;
2. the original of a conviction status certificate;
3. declarations to certify the circumstances under Article 11, paragraph 1, items 4–6 and item 8 of the
   Law on Credit Institutions;
4. a curriculum vitae containing a detailed description of the background and qualifications;
5. a record of service, a Commercial Register certificate or other documents certifying the professional
   experience in banking or finance, including the managerial positions held in line with Article 2, par￾agraph 1, item 6 of Regulation No 9 of the BNB of 26 July 2017 on the Information and Documents Proving Compliance with the Requirements to Temporary Administrators or Special Managers of a Bank;
6. a copy of the document on acquired speciality, qualification or competence, if any;
7. a completed Fitness and Probity Questionnaire Declaration under Appendix 1 to Ordinance No
   9 of the BNB of 26 July 2017 on the Information and Documents Proving Compliance with the Requirements to Temporary Administrators or Special Managers of a Bank;
8. other documents.
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   /Please state, if you submit other documents/
   Date ................................. Signature: ........................................
   City .................................