Appendix No. 1 Application for Admission as a Eurosystem Monetary Policy Counterparty

Appendix No 1
to Article 4, paragraph 1
TO THE DEPUTY GOVERNOR OF THE
BULGARIAN NATIONAL BANK
HEAD OF THE ISSUE DEPARTMENT
APPLICATION FOR ADMISSION AS A EUROSYSTEM MONETARY POLICY COUNTERPARTY by
1.................................................................................................................................
........................................................................................................[name, position],
2................................................................................................................................
.........................................................................................................[name, position],
in his capacity as representative of ..........................................................................
................................................................................................................(Applicant), UIC: .......................................................................................................................,
with registered address and head office: .................................................................
................................................................................................................................, address for correspondence (if different from the head office)
....................................................................................................................................
APPLICANT DATA
Type of institution:
RIAD code:
LEI code:
Supervisory authority:
Is the institution a branch? – YES/NO
If a branch:
Parent company, registered office and head office: .......................................................
.........................................................................................................................................,
Telephone and e-mail: ......................................................................................................
............................................................................................................................................
Parent company identification code (RIAD code and LEI code):
Parent company supervisory authority:
Contact person(s) for the eligibility assessment:
............................................................................................................................................
Telephone:
Email:
WE DECLARE:
We are familiar with and accept the General Terms and Conditions of the Bulgarian National Bank for the Implementation of the Eurosystem Monetary Policy. We undertake to provide the BNB and/or the ECB with any information that is necessary in connection with the assessment of the applicant's eligibility as a Eurosystem monetary policy counterparty, including the assistance of the parent company, if applicable. We undertake to notify the Bulgarian National Bank immediately if the circumstances declared change, as well as in the event that the company represented by us ceases to meet any of the eligibility criteria set out in Article 3, paragraph 2 of Ordinance No 45 of the BNB of 17 April on the Establishment and Regulation of the Bulgarian National Bank’s Legal Relationships with Monetary Policy Counterparties. Attachments:

1. Specimen of the signatures of the persons representing the
   applicant institution.
2. Notarised power of attorney (if applicable).
   Date:………………………..
   Applicant:
   Signature: Signature:
   …………………………….. ………………………………..
   (names) (names)