To:
NLB Tututnska banka AD Skopje
Business Planning and Analysis Department
Majka Tereza 1
1000 Skopje
Macedonia
Subject: Instructions for dividend payout
I, __________________________________________(name and surname as written in passport),
with passport number ______________ would like, the dividend upon holding shares of NLB
Tutunska banka, to be paid into my bank account number _________________________________
at _______________________________ bank AD ________________(name of a bank residing in
the Republic of Macedonia).
Therefore, enclosed you can find a copy of my passport and copy of the transction account card.
These instructions for dividend payout are valid until my written cancelation.
Date:
Applicant:
___________________
* For any issues concerning the dividend payout, the Bank can reach me on this telephone number
___________________________ or e-mail ____________________________.