CROATIAN NATIONAL BANK

Prudential Regulation and

Bank Supervision Area

Trg hrvatskih velikana 3

10000 Zagreb

APPLICATION FOR APPROVAL TO ACQUIRE A QUALIFYING HOLDING IN A CREDIT INSTITUTION

No. / INFORMATION to be included in the application for approval to acquire a qualifying holding / EXPLANATION
(list the requested data or indicate the number of annex in which they can be found)
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1. / Name and registered office of the credit institution to which the respective application refers
2. / Name/firm, registered office, address of the applicant
3. / Name and function of the person that will represent the applicant in the decision-taking procedure regarding the application
4. / Name of the person authorised for contact in connection with the application and telephone and fax numbers and e-mail address of that person
5. / Code of the sector/subsector of the acquirer (company, financial institution, households) and description of activity/occupation
6. / Data on the acquirer of a qualifying holding (for natural persons) / - 
7. / Data on the financial condition of the acquirer (for natural persons) / - 
8. / Data on the acquirer of a qualifying holding (for legal persons) / - 
9. / Ownership structure of the applicant (for legal persons) / - 
10. / A list of persons acting in concert with the acquirer of a qualifying holding (in the manner referred to in Article 16 of the Credit Institutions Act), and a list of persons constituting a group of connected persons (in accordance with Article 4, paragraph (39) of Regulation EU 575/2013), specifying the type of connection
11. / Where the applicant is a legal person, audited financial statements for the last two business years (balance sheet and profit and loss account) should be provided
12. / Evidence that the applicant (acquirer) has not been convicted of crimes referred to in Article 25, paragraph (1), item (1), subitem (i) and evidence on whether criminal or minor offence proceedings are pending against the acquirer
13. / Evidence that no bankruptcy proceedings have been initiated over the property of the acquirer
14. / Where the acquirer is a credit institution as a member of the group which includes one or more foreign financial institutions, state the name and address of the competent supervisory authority and provide the opinion or approval from the competent supervisor
15. / Proposed members of the supervisory board and the management board of the credit institution (where the acquisition results in changes in the existing supervisory board and the management board of the credit institution)
16. / Detailed description of the transaction which is the subject of the application and explanation of the intended objectives
17. / A description of the actions already taken by the applicant before submitting the application
18. / The estimated cost of implementation and the source of financing
19. / Ownership structure of the credit institution before and after the acquisition of a qualifying holding
20. / Opinion on the impact of the requested acquisition on the operation of the credit institution in the capital of which a qualifying holding is acquired (only for the acquisition of control of or a dominant influence over the operation of the credit institution)
21. / Business strategy of the credit institution (only for the acquisition of control of or a dominant influence over the operation of the credit institution)
22. / Business plan of the credit institution with projections of financial statements (balance sheet, profit and loss account) for the following three years (five years would be desirable) - only for the acquisition of control of or dominant influence over the operation of the credit institution) / - 
23. / Organisational, management and personnel structure of the credit institution (only for the acquisition of control of or dominant influence over the operation of the credit institution)
24. / Internal bylaws defining the operating policies and procedures of the credit institution (only for the acquisition of control of or a dominant influence over the operation of the credit institution)
25. / Information technology of the credit institution (in case of planned significant changes in the existing system as well as in the case of acquisition of a qualifying holding by another credit institution)
26. / Is there an intention of a direct or indirect use of the credit institution for certain private or business transactions? If this is the case, an explanation should be provided (only for the acquisition of control or a dominant influence over the operation of the credit institution)

The applicant hereby declares that all data and information stated in the application and enclosed with the application are correct and complete and that he/she will notify the Croatian National Bank without delay of any change that might affect the authorisation decision.

Place and date:

Name and surname and signature of the authorised person:

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