Resolution No 03-104 Amending Resolution No 03-259 on Licensing Rules for Insurance and Reinsurance Activities

BOARD OF LIETUVOS BANKAS
RESOLUTION
AMENDING RESOLUTION NO 03-259 OF THE BOARD OF LIETUVOS BANKAS OF 13 DECEMBER 2012 ON THE RULES OF ISSUANCE OF THE INSURANCE AND REINSURANCE BUSINESS LICENSE, THE RULES OF ISSUANCE OF THE BUSINESS LICENSE OF A FOREIGN COUNTRY INSURANCE OR REINSURANCE UNDERTAKING BRANCH, AND THE CONFIRMATION OF THE FORM OF LIABILITIES TO PROVIDE INFORMATION 18 July 2025 No 03-104 Vilnius The Board of Lietuvos bankas has resolved:
To amend and recast Resolution No 03-259 of the Board of Lietuvos bankas of 13 December 2012 on the rules of issuance of the insurance and reinsurance business license, the rules of issuance of the business license of a foreign country insurance or reinsurance undertaking branch, and the confirmation of the form of liabilities to provide information as follows:
“BOARD OF LIETUVOS BANKAS
RESOLUTION
ON THE APPROVAL OF THE RULES FOR THE LICENSING OF INSURANCE AND REINSURANCE ACTIVITIES AND AUTHORISATION OF BRANCH OPERATION Acting in accordance with Article 42(4)(1) of the Republic of Lithuania Law on the Bank of Lithuania, Article 16(6) and Article 78(7) of the Republic of Lithuania Law on Insurance, the Board of Lietuvos bankas has resolved:
To approve the Rules for the Licensing of Insurance and Reinsurance Activities and Authorisation of Branch Operation (enclosed).”
Chair of the Board
Gediminas Šimkus
APPROVED by Resolution No 03-259 of the Board of Lietuvos bankas of 13 December 2012 (Amended by Resolution No 03-104 of the Board of Lietuvos bankas of 18 July 2025) RULES FOR THE LICENSING OF INSURANCE AND REINSURANCE ACTIVITIES AND AUTHORISATION OF BRANCH OPERATION
CHAPTER I
GENERAL PROVISIONS
.
The Rules for the Licensing of Insurance and Reinsurance Activities and Authorisation of Branch Operation (hereinafter, the Rules) lay down the procedure for the issuance of a licence for insurance and reinsurance activities (hereinafter, the licence) or an authorisation for the operation of a branch of a third country insurance or reinsurance undertaking (hereinafter, the branch) (hereinafter, the authorisation for branch operation), the submission of documents, information on issuance or refusal to issue, the replacement of the licence and the authorisation for branch operation, a change in information after the licence or the authorisation for branch operation has been issued, the suspension and withdrawal of the licence or the authorisation for branch operation, as well as the form of application for the issuance (replacement) of a licence and the form of application for the issuance (replacement) of an authorisation for branch operation. . The terms used in the Rules shall be understood as they are defined in the Republic of Lithuania Law on Insurance, the Republic of Lithuania Law on Markets in Financial Instruments, and the Republic of Lithuania Law on the Accumulation of Pensions. . The Rules have been drawn up in accordance with the Republic of Lithuania Law on Insurance and Commission Delegated Regulation (EU) 2015/35 of 10 October 2014 supplementing Directive 2009/138/EC of the European Parliament and of the Council on the taking-up and pursuit of the business of Insurance and Reinsurance (Solvency II), and shall apply jointly. . Documents submitted and actions carried out in accordance with the Rules shall be subject to the requirements of the General Regulations on the Submission and Examination of Applications for Authorisation of Financial Market Participants Supervised by the Bank of Lithuania and on the Granting of Authorisation approved by Resolution No 58 of the Board of the Bank of Lithuania of 6 May 2004 on the approval of the general regulations on the submission and examination of applications for the authorisation of financial market participants supervised by the Bank of Lithuania and on the granting of authorisation (hereinafter, the Resolution). . Lietuvos bankas shall, in accordance with the Republic of Lithuania Law on Insurance, the Rules, and other legal acts, issue, replace, suspend, lift the suspension of, and withdraw a licence or an authorisation for branch operation.
CHAPTER II
APPLICATION FOR A LICENCE OR AN AUTHORISATION FOR BRANCH OPERATION .
In order to obtain a licence, the applicant shall submit to Lietuvos bankas the completed application specified in Annex 1 (for obtaining a licence) or Annex 2 (for obtaining an authorisation for branch operation) to the Rules, accompanied by the documents specified therein. . Documents accompanying the application shall meet the requirements for the content and form of such documents specified in the Rules and in the respective annexes. . Where during the examination of the application the information specified in the application and other submitted documents changes, the applicant must notify Lietuvos bankas of such changes no later than within 5 working days from the date of their change.
CHAPTER III
ISSUANCE OF A LICENCE OR AN AUTHORISATION FOR BRANCH OPERATION .
Having examined the application, Lietuvos bankas shall take a decision on the issuance of a licence or an authorisation for branch operation within the time limits established in the Republic of Lithuania Law on Insurance. The grounds for refusal to issue a licence are established in Article 16(2) of the Republic of Lithuania Law on Insurance, and the grounds for refusal to issue an authorisation for branch operation are established in Article 80(2) of the Republic of Lithuania Law on Insurance. . Lietuvos bankas shall notify the applicant of the decision taken with regard to the issuance or refusal to issue a licence or an authorisation for branch operation no later than within 5 working days from the date of decision, and shall publish this information on the website of Lietuvos bankas.
CHAPTER IV
REPLACEMENT OF A LICENCE OR AN AUTHORISATION FOR BRANCH OPERATION .
In cases provided for by the Republic of Lithuania Law on Insurance, an insurance or reinsurance undertaking or branch that intends to provide services not specified in the issued licence or authorisation for branch operation must apply to Lietuvos bankas for the replacement of an existing licence or authorisation for branch operation and submit Annex 1 or Annex 2 to the Rules accordingly. The application shall also be accompanied by other documents and information, specified in the Rules and the respective annex thereto, which change due to additional services to be provided. . The application for the replacement of a licence or an authorisation for branch operation shall be submitted and examined in accordance with the procedure established in Chapters II and III of the Rules. . Where information about the holder of the licence or the authorisation for branch operation (the name of the undertaking, the legal form or code of the legal entity) changes and the undertaking requests to modify the information and submits documents supporting these changes, the relevant information in the issued licence or authorisation for branch operation shall be replaced within 15 calendar days.
CHAPTER V
NOTIFICATION OF CHANGES IN INFORMATION AND DOCUMENTS .
Unless otherwise provided for in other legal acts, an insurance or reinsurance undertaking or a branch must notify Lietuvos bankas in writing of the change in the following information and/or documents:
14.1
. name, legal form, and registered office address;
14.2. trade name, if different from the name registered in the Register of Legal Entities;
14.3. actual place of business, if different from the registered office address registered in the Register of Legal Entities;
14.4. website address, contact details (phone number, email);
14.5. information about the amendments to the Articles of Association, specifying the amendments introduced;
14.6. information about the contact person of an insurance or reinsurance undertaking or a branch to be contacted by the employees of Lietuvos bankas after the issuance of a licence or an authorisation for branch operation (for supervisory purposes).
.
Lietuvos bankas must be notified of changes in the information and/or documents specified in paragraph 14 of the Rules immediately, but no later than within 15 calendar days of the date of their change, unless other legal acts regulating the applicant’s activities establish different time limits for the notification of changes in information. –––––––––––––

Annex 1
to the Rules for the Licensing of Insurance and Reinsurance Activities and Authorisation of Branch Operation APPLICATION FOR THE ISSUANCE (REPLACEMENT) OF A LICENCE FOR INSURANCE AND REINSURANCE ACTIVITIES The information provided by you in this Annex, including your personal data, is necessary and will be used for the performance of the functions of the supervisory authority. In performing such functions, it may be disclosed to third parties. Information on the processing of personal data at Lietuvos bankas is published on the website of Lietuvos bankas (https://www.lb.lt/en/personal-data-protection). Instructions for completing the application

1. For items with multiple answers, please mark the appropriate box with “X” and provide the requested information and documents. For other items, please provide the requested information and documents by completing the empty fields.
2. If you do not answer all questions and fail to explain why you have not answered them or if you do not confirm the information provided with your signature, the information provided will be considered incomplete.
3. In case of licence replacement, please only complete sections I, II, and IV (as appropriate).
   I. INFORMATION ABOUT AN INSURANCE OR REINSURANCE UNDERTAKING (APPLICANT)

Name of the applicant
2.
Legal form of the applicant
☐
Public limited liability company
☐
Private limited liability company
☐
European company (Lat.
Societas Europaea
)
3.
Is the trade name (or trademark) used (or planned to be used) by the applicant different from the name registered in the Register of Legal Entities?
☐
No
☐
Yes
Please specify all used (or planned to be used) trade names (or trademarks):

1. ...
2. ...
   ...

Legal entity code of the applicant
5.
Legal entity identifier (LEI) code of the applicant 6.
Date of establishment of the applicant
7.
Registered office address of the applicant
(municipality, city, street, building number, room number, postal code) 8.
Actual place of business of the applicant, if different from the registered office address (municipality, city, street, building number, room number, postal code) 9.
Email address of the applicant
10.
Website and social media addresses of the applicant 11.
Phone number of the applicant
12.
Information about the person responsible for the prevention of money laundering and terrorist financing (where applicable*) * For insurance undertakings carrying out insurance activities classified under the life insurance type. Contact details of the applicant’s representative (responsible for the application) 13. Natural person’s name and surname, or legal entity’s name 14. Position 15. Phone number 16. Email address
II. SUBSTANCE OF THE APPLICATION
17.
The applicant requests:
☐ To issue a licence for insurance activities
☐ To replace a licence for insurance activities:
☐ To expand a licence for insurance activities ☐ To withdraw from involvement in insurance activities in a certain insurance class (whether partly or in full) ☐ To issue a licence for reinsurance activities ☐ To replace a licence for reinsurance activities:
☐ To expand a licence for reinsurance activities ☐ To withdraw from involvement in reinsurance activities in a certain reinsurance class (whether partly or in full) 18.
Insurance classes* belonging to the life insurance or non-life insurance type that the applicant plans to carry out. Please mark all applicable answers As defined in Article 7 of the Republic of Lithuania Law on Insurance. Insurance classes under the life insurance type ☐ Life insurance other than provided for in other items ☐ Marriage and birth insurance ☐ Unit-linked life insurance (when investment risk lies with the policyholder) ☐ Tontines ☐ Pension accumulation activity Insurance classes under the non-life insurance type ☐ Accident and sickness insurance (health insurance) ☐ Motor insurance ☐ Marine and transport insurance ☐ Aviation insurance ☐ Fire and other damage to (or loss of) property insurance ☐ Third party liability insurance ☐ Credit and suretyship insurance ☐ Insurance against all risks of non-life insurance type ☐ Financial loss insurance ☐ Legal expenses insurance ☐ Assistance insurance
III. ADDITIONAL INFORMATION ABOUT THE APPLICANT
19.
List of the controlling persons of the applicant, participating undertakings, and other persons, as well as shareholders with a qualifying holding *As defined in Article 2(60) and specified in Article 15(2)(7) of the Republic of Lithuania Law on Insurance.

1. ...
2. ...
   ...
   (person’s name and surname or legal entity’s name and the acquired (or held) holding in the authorised capital and/or percentage voting rights) 20.
   List of the members of the applicant’s supervisory and management bodies, as well as the members of the supervisory and management bodies* of legal entities controlling the applicant and participating undertakings * Specified in Article 15(2)(7) and (8) of the Republic of Lithuania Law on Insurance.
3. ...
4. ...
   ...
   (person’s name and surname, position)

Have the activities carried out by the applicant (or group companies) been, or are they currently, supervised by supervisory authorities of other countries?
☐ No
☐ Yes
Please specify the name of the company, supervisory authority, and country, the trademark used, and the nature of the supervised activities as well as the period of supervision:
IV. LIST OF ACCOMPANYING DOCUMENTS
This list has been drawn up in accordance with the requirements specified in Articles 15, 19, 30(2) of the Republic of Lithuania Law on Insurance, Article 15 of the Republic of Lithuania Law on the Accumulation of Pensions, and other legal acts. Seq. No Accompanying documents Reference numbers (titles) and number of pages of the accompanying documents or reasons for non-submission 1. The applicant’s Articles of Association, Memorandum of Association (Deed of Incorporation) 2. Documents confirming the representative’s right of representation 3. Document confirming the payment of a state fee* for the issuance (replacement) of a licence Specified in the List of Specific State Fee Rates approved by Resolution No 1458 of the Government of the Republic of Lithuania of 15 December 2000 on the approval of the list of specific state fee rates and the rules for the payment and refund of the state fee. 4. Information on: the chair and other members of the Supervisory Board; the chair and other members of the Board; the head; the persons responsible for risk management and the actuarial, compliance assessment, and internal audit functions of the applicant; as well as information* on the members of the supervisory and management bodies of the legal entities controlling the insurance or reinsurance undertaking and participating undertakings Completed and signed questionnaires, drawn up in accordance with the Guidelines for the Assessment of Members of the Management Body and Key Function Holders of Financial Market Participants Supervised by the Bank of Lithuania approved by Resolution No 03-181 of the Board of the Bank of Lithuania of 14 November 2013 on the approval of the guidelines for the assessment of members of the management body and key function holders of financial market participants supervised by the Bank of Lithuania, are submitted to Lietuvos bankas. 5. Information on the controlling persons of the applicant, participating undertakings, and other persons, as well as shareholders with a qualifying holding Completed and signed questionnaires, drawn up in accordance with the Rules for the Submission of Notifications on the Acquisition and Disposal of a Qualifying Holding of the Authorised Capital and/or Voting Rights in Financial Market Participants under Supervision of the Bank of Lithuania approved by Resolution No 03-138 of the Board of the Bank of Lithuania of 12 September 2017 on the approval of the rules for the submission of notifications on the acquisition and disposal of a qualifying holding of the authorised capital and/or voting rights in financial market participants under supervision of the Bank of Lithuania, accompanied by respective annexes, are submitted to Lietuvos bankas. 6. The applicant’s business plan of a form and content prescribed by Lietuvos bankas, including a graphical representation of the applicant’s shareholder structure In accordance with the Description of Requirements for Drawing Up a Business Plan of an
Insurance or Reinsurance Undertaking approved by Resolution No 03-67 of the Board of the Bank of Lithuania of 23 April 2015 on the approval of the description of requirements for drawing up a business plan of an insurance or reinsurance undertaking. 7. Documents proving the formation of minimum capital in cash, and information on the sources of this cash 8. Documents proving that the applicant will further hold eligible own funds to cover the solvency capital requirement (financial documents, bank statements, contracts, etc.) 9. Documents proving that the applicant will further hold eligible basic own funds to cover the minimum capital requirement (financial documents, bank statements, contracts, etc.) 10. Documents proving the accumulation of cash in the organisational fund of the applicant, the use of the organisational fund, and its balance 11. Documents proving payment in cash for the shares of the insurance or reinsurance undertaking being established Not required where a legal person or legal persons are being reorganised into a new legal entity – insurance undertaking – or where a public limited liability company, a private limited liability company or a European company (Lat. Societas Europaea) are changing their previous activities into insurance or reinsurance activities. 12. Information on the sources of the organisational fund and of the funds used to pay up the shares of the insurance or reinsurance undertaking being established or to form the authorised capital of the insurance or reinsurance undertaking 13. Descriptions or policies for risk management, internal audit, and internal control systems 14. Draft rules of procedure of structural units (persons) performing the risk management, actuarial, compliance assessment, and internal audit functions 15. Description of the internal control system for the implementation of international sanctions 16. Business continuity plan 17. Conflicts of interest policy Additional documents ( depending on the specific services the applicant intends to provide or other circumstances ) Where the applicant’s founder is a legal person:
18.
Copy of the founder’s (legal person’s) registration certificate or another equivalent document 19.
Audited financial statements of the founder – legal person – for the last financial year, accompanied by the auditor’s report. This provision does not apply where the founder is not an undertaking in control of the insurance undertaking being established or participating in it Where a legal person or legal persons are being reorganised into a new legal entity – insurance undertaking – or where a public limited liability company, a private limited liability company, or a European company (Lat. Societas Europaea ) are changing their previous activities into insurance or reinsurance activities:
20.
Description of the terms of reorganisation and the decision to reorganise the legal person or change its type activity 21.
Copy of each legal person’s registration certificate or another equivalent document, description of the previous activity, audited financial statements for the last financial year, accompanied by the auditor’s report 22. Information in the form prescribed by Lietuvos bankas on the persons in control of each legal person, participating undertakings, or persons, as well as shareholders with a qualifying holding Completed and signed questionnaires, drawn up in accordance with the Rules for the Submission of Notifications on the Acquisition and Disposal of a Qualifying Holding of the Authorised Capital and/or Voting Rights in Financial Market Participants under Supervision of the Bank of Lithuania approved by Resolution No 03-138 of the Board of the Bank of Lithuania of 12 September 2017 on the approval of the rules for the submission of notifications on the acquisition and disposal of a qualifying holding of the authorised capital and/or voting rights in financial market participants under supervision of the Bank of Lithuania, accompanied by respective annexes, are submitted to Lietuvos bankas. 23. Documents proving that the funds of the insurance or reinsurance undertaking are not less than the organisational fund and the authorised capital specified in the Republic of Lithuania Law on Insurance, as well as information on the sources of these funds 24. Information on each legal person’s tax payment and debts to creditors Where a third country insurance or reinsurance undertaking is the founder of a subsidiary insurance or reinsurance undertaking:
25.
Insurance or reinsurance license issued by the supervisory authority of a third country or an equivalent document 26.
Authorisation by the supervisory authority of a third country to establish an insurance or reinsurance undertaking in the Republic of Lithuania or information that the supervisory authority of a third country does not object to the establishment of a subsidiary insurance or reinsurance undertaking in the Republic of Lithuania Where it is intended to conclude, on behalf of the applicant, outsourcing contracts whereby critical or important functions or activities would be transferred:
27.
Information in the form prescribed by Lietuvos bankas * This information is provided in the form set out in the Annex to the Regulations for the Transparent, Reliable and Prudential Governance of Insurance Undertakings approved by Resolution No 03-95 of the Board of the Bank of Lithuania of 29 May 2014 on the approval of the regulations for the transparent, reliable and prudential governance of insurance undertakings. Where the applicant intends to carry out activities related to insurance against civil liability arising out of the use of land motor vehicles (other than carrier third party liability insurance):
28.
Documents proving that the insurance undertaking has appointed a representative for handling claims in each other European Economic Area country (specifying the representative’s name and surname or name and address) Where the applicant intends to carry out insurance activities classified under the pension accumulation insurance class:

Documents* required for the establishment of a target group of pension fund members and pension asset preservation funds * Specified in Resolution No 03-159 of the Board of the Bank of Lithuania of 19 September 2018 on the approval of the description of the procedure for the establishment and liquidation of pension funds. 30. Documents proving the qualifications and work experience of persons who will make decisions on the management of pension assets Where the applicant intends to transfer the management of the pension fund to another undertaking:
31.
Documents specified in Chapter IV of the Rules Applied to the Issuance of Authorisations under the Law on Collective Investment Undertakings and the Law on Supplementary Voluntary Accumulation of Pensions* * Approved by Resolution No 03-151 of the Board of the Bank of Lithuania of 12 July 2012 on the approval of the rules applied to the issuance of authorisations under the Law on Collective Investment Undertakings and the Law on Supplementary Voluntary Accumulation of Pensions. Where the applicant intends to carry out activities classified under the life insurance type:
32.
Description of the internal control system that will be (or has been) implemented in order to perform the duties related to the prevention of money laundering and/or terrorist financing in accordance with the Republic of Lithuania Law on the Prevention of Money Laundering and Terrorist Financing Where the applicant intends to develop and/or distribute insurance and/or reinsurance products:
33.
Insurance product oversight and governance policy that complies with the requirements set out in Commission Delegated Regulation (EU) 2017/2358 supplementing Directive (EU) 2016/97 of the European Parliament and of the Council with regard to product oversight and governance requirements for insurance undertakings and insurance distributors 34. Complaints handling policy 35. Procedure for assessing and ensuring the qualifications of insurance distributors 36. Policy on the integration of sustainability risks into the investment decision-making process that complies with the requirements set out in Regulation (EU) 2019/2088 of the European Parliament and of the Council on sustainability‐related disclosures in the financial services sector (where the intention is to carry out insurance activities related to insurance-based insurance products, as well as pension accumulation activities) 37. Policy on the governance of investment directions (where the intention is to carry out insurance activities classified under the unit-linked life insurance class) Where an insurance undertaking carrying out life insurance activities intends to carry out insurance activities of insurance classes referred to in Article 7(3)(1) and (2) of the Republic of Lithuania Law on Insurance that are classified under the non-life insurance type, or an insurance undertaking carrying out the activities of non-life insurance classes referred to in Article 7(3)(1) and (2) of the Republic of Lithuania Law on Insurance intends to carry out the activities of insurance classes referred to in Article 7(2) of the Republic of Lithuania Law on Insurance that are classified under the life insurance type:
38.
Documents proving that the eligible basic own funds of the insurance undertaking to cover the minimum capital requirement meet the absolute floor of the minimum capital requirement for life insurance undertakings and the absolute floor of the minimum capital requirement for non-life insurance undertakings, as specified in Article 40(4)(5) of the Republic of Lithuania Law on Insurance, and that the applicant undertakes to continue to meet the following minimum financial obligations Where an insurance undertaking carrying out non-life insurance activities intends to carry out activities related to insurance against civil liability arising out of the use of land motor vehicles, insurance against civil liability arising out of the use of aircraft, insurance against civil liability arising out of the use of ships (sea and internal waters), general civil liability insurance, credit and/or suretyship insurance:
39.
Documents proving that the minimum capital meets the amount specified in Article 40(4)(3) of the Republic of Lithuania Law on Insurance (except where Lietuvos bankas has this information based on the last quarterly report submitted) Where an insurance undertaking intends to carry out insurance activities of other insurance classes classified under the same insurance type or to extend its insurance activities to cover all risks of the same insurance class:
40.
Decision of the general meeting of shareholders or management body of the insurance undertaking to carry out activities other than those specified in the licence Other documents additionally submitted by the applicant (where other documents are additionally submitted, this table must be extended to include the titles of the submitted documents) 41. ... I, the undersigned, hereby:
Confirm that this application and its accompanying documents contain all information established by legal acts, and the data provided are correct, complete, not misleading, and relevant.

Understand that if I provide incorrect, misleading, and/or incomplete information, the assessment of my application may be prolonged, and a decision may be made to refuse to consider my application on the merits or to refuse to issue (or replace) a license. Undertake to notify Lietuvos bankas without undue delay, no later than within 5 working days, of changes in the information provided in this application that occurred before the issuance (or replacement) of the licence requested in this application. Am ready to submit all other documents, information, and explanations requested by Lietuvos bankas to perform the assessment concerning the issuance (or replacement) of a licence. Understand that Lietuvos bankas:
5.1. may verify the data and information provided in this application, as well as other data and information provided by me, in accordance with the procedure established by the legal acts of the European Union and the Republic of Lithuania;
5.2. for the purpose of verifying the data and information provided in this application and accompanying documents, may involve respective authorities of the Republic of Lithuania and other countries to which the data and information provided by me to Lietuvos bankas may be disclosed in accordance with the procedure established by legal acts.
Date of completion
Name and surname, position (if signed by the representative of the legal entity), electronic signature ___________
Annex 2
to the Rules for the Licensing of Insurance and Reinsurance Activities and Authorisation of Branch Operation APPLICATION FOR THE ISSUANCE (REPLACEMENT) OF AN AUTHORISATION FOR THE OPERATION OF A BRANCH OF A THIRD COUNTRY INSURANCE OR REINSURANCE UNDERTAKING The information provided by you in this Annex, including your personal data, is necessary and will be used for the performance of the functions of the supervisory authority. In performing such functions, it may be disclosed to third parties. Information on the processing of personal data at Lietuvos bankas is published on the website of Lietuvos bankas (https://www.lb.lt/en/personal-data-protection). Instructions for completing the application

1. For items with multiple answers, please mark the appropriate box with “X” and provide the requested information and documents. For other items, please provide the requested information and documents by completing the empty fields.
2. If you do not answer all questions and fail to explain why you have not answered them or if you do not confirm the information provided with your signature, the information provided will be considered incomplete.
   I. INFORMATION ABOUT A THIRD COUNTRY INSURANCE OR REINSURANCE UNDERTAKING (APPLICANT)

Name of the applicant
2.
Legal form of the applicant

Trade name (or trademark) used by the applicant 4.
Legal entity code of the applicant
5.
Legal entity identifier (LEI) code of the applicant 6.
Date of establishment of the applicant
7.
Registered office address of the applicant
(country, city, street, building number, room number, postal code) 8.
Actual place of business of the applicant, if different from the registered office address (country, city, street, building number, room number, postal code) 9.
Email address of the applicant
10.
Website and social media addresses of the applicant 11.
Phone number of the applicant
12.
Information about the person responsible for the prevention of money laundering and terrorist financing (where applicable*) * For insurance undertakings carrying out insurance activities classified under the life insurance type. Contact details of the applicant’s representative (responsible for the application) 13. Natural person’s name and surname, or legal entity’s name 14. Position 15. Phone number 16. Email address
II. SUBSTANCE OF THE APPLICATION
17.
The applicant requests:
☐ To issue an authorisation for the operation of a branch of a third country insurance undertaking ☐ To replace an authorisation for the operation of a branch of a third country insurance undertaking:
☐ To expand an authorisation for branch operation ☐ To withdraw from involvement in insurance activities in a certain insurance class (whether partly or in full) ☐ To issue an authorisation for the operation of a branch of a third country reinsurance undertaking ☐ To replace an authorisation for the operation of a branch of a third country reinsurance undertaking:
☐ To expand an authorisation for branch operation ☐ To withdraw from involvement in reinsurance activities in a certain reinsurance class (whether partly or in full) 18.
Insurance classes* belonging to the life insurance or non-life insurance type that the applicant plans to carry out. Please mark all applicable answers As defined in Article 7 of the Republic of Lithuania Law on Insurance. Insurance classes under the life insurance type ☐ Life insurance other than provided for in other items ☐ Marriage and birth insurance ☐ Unit-linked life insurance (when investment risk lies with the policyholder) ☐ Tontines ☐ Pension accumulation activity Insurance classes under the non-life insurance type ☐ Accident and sickness insurance (health insurance) ☐ Motor insurance ☐ Marine and transport insurance ☐ Aviation insurance ☐ Fire and other damage to (or loss of) property insurance ☐ Third party liability insurance ☐ Credit and suretyship insurance ☐ Insurance against all risks of non-life insurance type ☐ Financial loss insurance ☐ Legal expenses insurance ☐ Assistance insurance
III. ADDITIONAL INFORMATION ABOUT THE APPLICANT
19.
List of the shareholders of a third country insurance or reinsurance undertaking, other controlling persons, and participating undertakings or persons * Specified in Article 76(2)(11) of the Republic of Lithuania Law on Insurance.

1. ...
2. ...
   ...
   (person’s name and surname or legal entity’s name and the acquired (held) holding in the authorised capital and/or voting rights, percentage) 20.
   List of the members of the supervisory and management bodies* of a third country insurance or reinsurance undertaking * Specified in Article 76(2)(11) of the Republic of Lithuania Law on Insurance.
3. ...
4. ...
   ...
   (person’s name and surname, position)

The supervisory authority of the country of the applicant’s registration, the name of the country, the nature of supervised activities, as well as the period of supervision
IV. ADDITIONAL INFORMATION ABOUT THE BRANCH
22.
Name of the branch
23.
Head of the branch (name, surname, position)
V. LIST OF ACCOMPANYING DOCUMENTS
The list has been drawn up in accordance with the requirements specified in Article 79(2) and Article 81 of the Republic of Lithuania Law on Insurance, and other legal acts.
Seq. No
Accompanying documents
Reference numbers (titles) and number of pages of the accompanying documents or reasons for non-submission 1.
Documents confirming the representative’s right of representation 2.
Document confirming the payment of a state fee* for the application for the issuance (replacement) of an authorisation for branch operation Specified in the List of Specific State Fee Rates approved by Resolution No 1458 of the Government of the Republic of Lithuania of 15 December 2000 on the approval of the list of specific state fee rates and the rules for the payment and refund of the state fee. 3. Regulations of a branch 4. Description of the internal control system for the implementation of international sanctions 5. Information on: the head of the branch; the members of the supervisory and management bodies; the persons responsible for risk management, actuarial, compliance assessment, and internal audit functions of the applicant; as well as information* on the members of the supervisory and management bodies of legal entities controlling the applicant and participating undertakings Completed and signed questionnaires, drawn up in accordance with the Guidelines for the Assessment of Members of the Management Body and Key Function Holders of Financial Market Participants Supervised by the Bank of Lithuania approved by Resolution No 03-181 of the Board of the Bank of Lithuania of 14 November 2013 on the approval of the guidelines for the assessment of members of the management body and key function holders of financial market participants supervised by the Bank of Lithuania, are submitted to Lietuvos bankas. 6. Information on the applicant’s shareholders, other controlling persons, and participating undertakings or persons Completed and signed questionnaires, drawn up in accordance with the Rules for the Submission of Notifications on the Acquisition and Disposal of a Qualifying Holding of the Authorised Capital and/or Voting Rights in Financial Market Participants under Supervision of the Bank of Lithuania approved by Resolution No 03-138 of the Board of the Bank of Lithuania of 12 September 2017 on the approval of the rules for the submission of notifications on the acquisition and disposal of a qualifying holding of the authorised capital and/or voting rights in financial market participants under supervision of the Bank of Lithuania, accompanied by respective annexes, are submitted to Lietuvos bankas. 7. Business plan of a form and content prescribed by Lietuvos bankas, accompanied by audited financial statements of the applicant for the last 3 years. An applicant that has operated for less than 3 years shall provide audited financial statements for each financial year of this period of operation. The business plan shall also include a graphical representation of the shareholder structure of the undertaking In accordance with the Description of Requirements for Drawing Up a Business Plan of an Insurance or Reinsurance Undertaking approved by Resolution No 03-67 of the Board of the Bank of Lithuania of 23 April 2015 on the approval of the description of requirements for drawing up a business plan of an insurance or reinsurance
undertaking. Where the application concerns the replacement of an authorisation for branch operation, an amended business plan with regard to the insurance activity intended to be carried out shall be provided. 8. Written confirmation from the supervisory authority of a third country that the applicant is authorised to carry out insurance or reinsurance activities in the country where it is registered 9. Authorisation by the supervisory authority of a third country to establish a branch in the Republic of Lithuania or information that the supervisory authority of a third country does not object to the establishment of a branch in the Republic of Lithuania 10. Confirmation from the supervisory authority of a third country that the applicant has complied with the requirements for the activities of insurance or reinsurance undertakings laid down in the legal acts of the third country for the last 3 years, and information on the insurance classes in which the applicant is authorised to operate or the insurance types in which the applicant is authorised to carry out reinsurance activities. If the applicant has been operating for less than 3 years, the supervisory authority of the third country shall provide confirmation for the entire period of the applicant’s operation 11. Written undertaking by the applicant to meet the solvency capital and minimum capital requirements imposed on the branch 12. Decision by the body of the applicant to establish a branch in the Republic of Lithuania, approve the regulations of the branch, and appoint the head of the branch 13. Written undertaking by the body of the applicant that the established branch will keep and store the financial accounts and other documents relating to the activities of the branch at the registered office of the branch 14. Outsourcing contracts, if any 15. Documents proving that the applicant has concluded a bank deposit contract referred to in Article 87(1) of the Republic of Lithuania Law on Insurance 16. Documents proving that the applicant has assets in the Republic of Lithuania amounting to not less than half of the minimum capital specified in Article 40(4) of the Republic of Lithuania Law on Insurance, taking into account the activities to be carried out, as well as information on the sources of all these funds 17. Descriptions or policies for risk management, internal audit, and internal control systems 18. Draft rules of procedure of structural units (persons) performing risk management and the actuarial, compliance assessment, and internal audit functions 19. Business continuity plan 20. Conflicts of interest policy Additional documents ( depending on the specific services intended to be provided or other circumstances ) Where there is an intention to carry out activities related to insurance against civil liability arising out of the use of land motor vehicles (other than carrier third party liability insurance):
21.
Documents proving that the applicant has appointed a representative with appropriate powers to handle claims in each other European Economic Area country, including the representative’s name and surname (or name in the case of a legal entity), and address Where it is intended to conclude, on behalf of the branch, outsourcing contracts whereby critical or important functions or activities would be transferred:
22.
Information in the form prescribed by Lietuvos bankas * This information is provided in the form set out in the Annex to the Regulations for the Transparent, Reliable and Prudential Governance of Insurance Undertakings approved by Resolution No 03-95 of the Board of the Bank of Lithuania of 29 May 2014 on the approval of the regulations for the transparent, reliable and prudential governance of insurance undertakings. Where there is an intention to carry out activities classified under the life insurance type*:
23.
Description of the internal control system that will be (or is) implemented in order to perform the duties related to the prevention of money laundering and/or terrorist financing in accordance with the Republic of Lithuania Law on the Prevention of Money Laundering and Terrorist Financing * As defined in Article 7(2) of the Republic of Lithuania Law on Insurance. Where the applicant’s branch carrying out non-life insurance activities intends to carry out activities related to insurance against civil liability arising out of the use of land motor vehicles, insurance against civil liability arising out of the use of aircraft, insurance against civil liability arising out of the use of ships (sea and internal waters), general civil liability insurance, credit and/or suretyship insurance:
24.
Documents proving that the minimum capital meets half the amount specified in Article 40(4)(3) of the Republic of Lithuania Law on Insurance (except where Lietuvos bankas has this information based on the last quarterly report submitted) Where the applicant intends to develop and/or distribute insurance and/or reinsurance products:
25.
Insurance product oversight and governance policy that complies with the requirements set out in Commission Delegated Regulation (EU) 2017/2358 supplementing Directive (EU) 2016/97 of the European Parliament and of the Council with regard to product oversight and governance requirements for insurance undertakings and insurance distributors 26. Complaints handling policy 27. Procedure for assessing and ensuring the qualifications of insurance distributors 28. Policy on the integration of sustainability risks into the investment decision-making process that complies with the requirements set out in Regulation (EU) 2019/2088 of the European Parliament and of the Council on sustainability‐related disclosures in the financial services sector (where the intention is to carry out insurance activities related to insurance-based insurance products, as well as pension accumulation activities) 29. Policy on the governance of investment directions (where the intention is to carry out insurance activities classified under the unit-linked life insurance class) Other documents additionally submitted by the applicant (where other documents are additionally submitted, this table must be extended to include the titles of the submitted documents) 30. ... I, the undersigned, hereby:
Confirm that this application and its accompanying documents contain all information established by legal acts, and the data provided are correct, complete, not misleading, and relevant.

Understand that if I provide incorrect, misleading, and/or incomplete information, the assessment of my application may be prolonged, and a decision may be made to refuse to consider my application on the merits or to refuse to issue (or replace) an authorisation for branch operation. Undertake to notify Lietuvos bankas without undue delay, no later than within 5 working days, of changes in the information provided in this application that occurred before the issuance (or replacement) of the authorisation for branch operation requested in this application. Am ready to submit all other documents, information, and explanations requested by Lietuvos bankas to perform the assessment concerning the issuance (replacement) of an authorisation for branch operation. Understand that Lietuvos bankas:
5.1. may verify the data and information provided in this application, as well as other data and information provided by me, in accordance with the procedure established by the legal acts of the European Union and the Republic of Lithuania;
5.2. for the purpose of verifying the data and information provided in this application and accompanying documents, may involve respective authorities of the Republic of Lithuania and other countries to which the data and information provided by me to Lietuvos bankas may be disclosed in accordance with the procedure established by legal acts.
Date of completion
Name and surname, position (if signed by the representative of the legal entity), electronic signature –––––––––––––