To be filled by bank Registration number Activity code TIN Name: Registered office: BALANCE SHEET on ______________________ - in 000 RSD Group of accounts, account 1 ITEM 2 ADP 3 ASSETS 00 (except 002), 010, 025, 05 (except 050, 052 and part of 059), 060, 07, 085, 196, Cash and deposits at the Central Bank 296 and parts of accounts 009, 019, 029, 069, 089, 199 and 299 0001 Pledged financial assets 0002 120, 220, 125 and 225 Financial assets at fair value through profit and loss account held for trading 0003 121 and 221 Financial assets initially recognized at fair value through profit and loss account 0004 122, 222, part of 129 Available-for-sale financial assets and part of 229 0005 124, 224, part of 129 Held-to-maturity investments and part of 229 0006 002, 01 (except 010 and part of 019), part of 020, 028, 050, 052, 06 (except 060 and part of 069), 080, 088, 10, 11, 16, 20, 21, 26, 190, 191, 290, 291, part of 493 and part of Loans and receivables from banks and 593 as deductible other financial organizations items (SSKR-SS code 1 (except code 17), code 70 and parts of codes 71 and 74) and parts of accounts 009, 029, 059. 089, 199 and 299 01 (except 010 and part of 019), part of 020, 028, 06 (except 060 and part of 069), 080, 088, 10, 11, 16, 20, 21, 26, 190, 191, 290, 291, part of 493 and part of 593 as deductible items (SSKR - SS code 17 Loans and receivables from customers and all other codes, except code 70 and parts of codes 71 and 74) and parts of accounts 029, 069, 089, 199, 299 0007 0008 Note number 4 Current year amount 5 Previous year amount Closing balance Opening balance 6 7 Previous year amount Group of accounts, account ITEM 1 2 ADP 3 123 and 223 Changes in fair value of hedged items 0009 126 and 226 Receivables from financial derivatives held for hedging purposes 0010 131, 230, part of 139 Investments in associates and joint and part of 239 ventures 0011 132, 232, part of 139 Investments in subsidiaries and part of 239 0012 33 Intangible assets 0013 34 Immovables, plants and equipment 0014 35 Investment immovables 0015 034 and part of 039 Current tax assets 0016 37 Deferred tax assets 0017 36 Permanent assets held for sale and discontinued operations 0018 021, 022, 024, 027, 03 (except 034 and part of 039), 081, 082, 084, 087, 09, 134,192, 194, 195, Other assets 234, 292, 294, 295, 30, 38 and parts of accounts 029, 089, 139, 199, 239 and 299 TOTAL ASSETS (from 0001 to 0019) 0019 0020 EQUITY AND LIABILITIES LIABILITIES 411, 416, 511 and 516 Financial liabilities at fair value through profit and loss account held for trading 0401 415 and 515 Financial liabilities initially recognized at fair value through profit and loss 0402 account 417 and 517 Liabilities arising from financial derivatives held for hedging part of 40, part of 420, part of 421, part of 490, part of 50, part of 520, part of 521, part of 590, part of 193 Deposits and other liabilities to banks, and part of 293 as other financial organizations and the deductible items central bank (SSKR-SS code 1 (except code 17), code 70 and parts of codes 71 and 74) 0403 0404 Note number 4 Current year amount Closing balance Opening balance 5 6 7 Group of accounts, account ITEM 1 2 part of 40, part of 420, part of 421, part of 490, part of 50, part of 520, part of 521, part of 590, part of 193 Deposits and other liabilities to other and part of 293 as a customers deductible item (SSKR-SS code 17 (except code 17), code 70 and parts of codes 71 and 74) 418 and 518 Changes in fair value of hedged items 410, 412, 423, 496, 510, 512, 523, 596 Debt securities issued and other and 127 as deductible borrowings items 425, 482, 497, 524, 525, 582, 597, 193 Subordinated liabilities and 293 as deductible items 450, 451, 452, 453 and 454 ADP Note number Current year amount 3 4 5 0405 0406 0407 0408 Provisions 0409 46 Liabilities from assets held for sale and assets of discontinued operations 0410 455 Current tax liabilities 0411 47 Deferred tax liabilities 0412 426, 427, 43, 44, 456, 457, 491, 492, 494, 495, 526, 527, 53, Other liabilities 591, 592, 594 and 595 TOTAL LIABILITIES (from 0401 to 0413) 0413 0414 EQUITY 80 Share capital 0415 128 Treasury shares 0416 83 Profit 0417 84 Loss 0418 81 and 82 - credit balance Provisions 0419 81 and 82 - debit balance Unrealized loss 0420 Non-controlling interests 0421 Previous year amount Closing balance Opening balance 6 7 Group of accounts, account ITEM ADP Note number Current year amount 1 2 3 4 5 TOTAL EQUITY (0415 - 0416 + 0417 - 0418 + 0419 0420 + 0421) ≥ 0 0422 TOTAL EQUITY DEFICIT (0415 - 0416 + 0417 - 0418 + 0419 0420 + 0421) < 0 0423 TOTAL EQUITY AND LIABILITIES (0414 + 0422 - 0423) 0424 In _____________________ on ___________________ S.P. Previous year amount Closing balance Opening balance 6 7 Legal bank representative ______________________ This form is mandatory pursuant to the Decision on the forms and content of items contained in the financial statements forms for banks (RS Official Gazette No 71/2014 and 135/2014)