To Ministry of Economic Development

To Ministry of Economic Development

of the Russian Federation

APPLICATION

For execution of an agreement on running

business activities

I hereby request Ministry of Economic Development of the Russian Federation to make an Agreement with

(abbreviated name of the business organization /name of sole proprietor)

on running business activities in

(specify the name of the special economic zone)

(name of the constituent of the Russian Federation )

1.About the Applicant

(full and abbreviated name of the applicant, legal and business address, name of CEO, full and abbreviated name of the project, and other details)

2.The Applicant’s Profile

(abbreviated name of the business organization/name of sole proprietor)

is planning to develop the following fields of activities in the special economic zone :

2.1.

2.2.

3. Information on presumable capital investments

3.1.Total capital investments within the year effective the execution of the agreement;

3.2.amount and terms of further capital investments.

4. Information on the governmental and (or) municipal properties required for the Applicant’s activities in question

4.1.Land plot (hectares);

4.2.buildings, structures (title, area);

4.3.engineering infrastructure needed (electrical power (MW), water supply (m3/day), sewerage (m3/day), heat (Gcal/hour), hot water Gcal/hour, natural gas (m3/hour), chemical discharge disposal (m3/hour), etc.) (generation rate schedule);

4.4.transportation infrastructure needed in immediate vicinity to the land plot (stock list, cargo turnover, seasonal fluctuation, generation rate schedule);

4.5.description of premises required for lease) (if needed by the Resident) (stock list, area);

4.6.terms required for making available the premises (stages, generation rate schedule);

4.7.lodging for resident’s staff, possible needs;

4.8.other needs.

Enclosures: 1.Copy of the Certificate of State Registration in pages, copies.

2.Copy of the Certificate of Tax Authority Registration in pages, copies.

3.Copy of incorporation documents in pages, copies.

4.Business Plan in pages, copies.

5.Approval of the Business Plan by a bank or any other credit organization (other than TVZ) in pages, copies.

CEO of the legal entity or

sole proprietor Name

(signature )

Seal

To Ministry of Economic Development
of the Russian Federation

LIST OF DOCUMENTS

to be presented for review seeking to enter into an agreement on running
activities
in

Pursuant to the procedure stipulated by Federal Act No. 116-ФЗ dated 22 July 2005 On special economic zone in the Russian Federation (hereinafter referred to as the Act)

(abbreviated name of the person seeking SEZ resident status)

Represented by

(name of the authorized representative)

has submitted the following documents

No. / Title / Pages
1 / Application
2 / Copy of the Certificate of State Registration
3 / Copy of the Certificate of Tax Authority Registration
4 / Copy of Incorporation Documents (for legal entities)
Copy of the Articles of Association .
Etc.
5 / Business Plan of Project
6 / Approval of the Business Plan of the Project by
(other than TVZ)

Authorized representative

of DOAO or branch

for Name

Documents accepted on 20_