Form KZ-1 Report on Borrowing Operations Abroad

Form KZ–1
REPORT ON BORROWING OPERATIONS 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 %)

INFORMATION ON LOANS
Name of non-resident
LOAN
Type of agreement
Date of agreement
Loan type
Security instrument
Government guarantees (Montenegro) Maturity Loan agreement currency Loan repayment currency Agreed amount Disbursed amount PRINCIPAL Debt position at the beginning of the reporting period Increase of principal Principal due for payment Principal repaid in the reporting period Capitalized interest Exchange rate changes Other (specify state the type of change) Other (amount) Debt position at the end of period Total outstanding principle

INTEREST
Type of interest
Interest rate
Total interest on loan Position at the beginning of the period Accrued interest for the reporting period Repaid interest Capitalized interest Other (specify the type of change) Other (amount) Position at the end of the period Accrued outstanding interest Total accrued interest not yet payable ________________________________________ (Stamp and signature)