Access Form for Using the Reporting Submission Service for Investment Fund Management Companies, Pension Fund Management Companies, Pension Funds and Investment Funds

HANFA
REPUBLIC OF CROATIA
CROATIAN FINANCIAL SERVICES AGENCY ACCESS FORM for using the reporting submission service for investment fund management companies, pension fund management companies, pension funds and investment funds

1. Business entity data – reporting obligor
   naziv poslovnog subjekta registered office – place and address registration number telephone number
2. Data on the authorized person designated for reporting submission
   first and last name personal ID number
3. Reports that the authorized person is entitled to submit (check one or more)

• NAV □ VIF
• IFON □ TI-UDIF
• TI-UDIF-10 □ FI-DZU_Novi
• FI-UCITS_Novi □ IK-DZU_UCITS
• FI-UAIF-Novi □ FI-OAIF_Novi
• FI-ZAIF_Novi □ FI-ZAIF-BPO_Novi
• IK-UAIF □ FI-FHB_Novi
• FI-OMD_Novi □ FI-OMF_Novi
• IK-OMD □ FI-DMD_Novi
• FI-DMF_Novi □ IK-DMD
• DI-DMF-M □ DI-DMF-T
• DI-DMF-G □ IL-OMF

HANFA
REPUBLIC OF CROATIA
CROATIAN FINANCIAL SERVICES AGENCY
4. List of funds for which the authorized person is entitled to submit reports (if applicable)
1. 2.
3. 4.
5. 6.
7. 8.
9. 10.
11. 12.
13. 14.
15. 16.
17. 18.
19. 20.
21. 22.
23. 24.
25. 26.
27. 28.
29. 30.
_____ signature of the authorized representative In , on