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. ...................................................................................................................................................................... ...................................................................................................................................................................... ...................................................................................................................................................................... ...................................................................................................................................................................... ...................................................................................................................................................................... ...................................................................................................................................................................... /Please state, if you submit other documents/ Date ................................. Signature: ........................................ City .................................