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ANEXA Nr. si data/ ANNEX no. and date:

Prezenta inlocuieste Anexa nr. din data:

This annex replaces annex no. from date:

Sucursala/ Branch:

CUI: Nr.Reg.Com:

Data/ Date:

Operator de date cu caracter personal nr./ Personal data operator no.: 1547

Denumire Tituar e cont/ Account o er name:CUI/CIF: Co c ient/C ient co e:

Reprezentanti legali/ Authorised signatures

Nume si prenume/ Name and surname: Limitari/ Limitations:** Suma/ Amount:** Specimen semnaturaSignature specimen

Functia/ Position

Tip act identitate/ID type:

Serie si nr./Series and no:

CNP:

Nume si prenume/ Name and surname: Tip* Limitari/ Limitations:** Suma/Amount:** Specimen semnaturaType Signature specimen

Functia/ Position

Tip act identitate/ID type:

Serie si nr./Series and no:

CNP:

Nume si prenume/ Name and surname: Tip* Limitari/Limitations:** Suma/ Amount:** Specimen semnaturaType Signature specimen

Functia/ Position

Tip act identitate/ ID type:

Serie si nr./Series and no:

CNP:

Nume si prenume/ Name and surname: Tip* Limitari/ Limitations:** Suma/ Amount:** Specimen semnaturaType Signature specimen

Functia/ Position

Tip act identitate/ ID type:

Serie si nr./Series and no:

CNP:Imputerniciti/ Empowered

Nume si prenume/ Name and surname: Tip* Limitari/ Limitations:** Suma/ Amount:** Specimen semnatura/

Type Signature specimen

Functia/ Position

Tip act identitate/ ID type:

Serie si nr./Series and no:

CNP:

Nume si prenume/ Name an surname: Tip* Limitari/ Limitations:** Suma/ Amount:** Specimen semnatura/Type Signature specimen

Functia/ Position

Act identitate/ ID type:

Serie si nr./Series and no:

CNP:

Nume s prenume/ Name an surname: Limitari/ Limitations:** Suma/ Amount:** Specimen semnaturaS gnature spec men

Functia/ PositionTip act identitate/ID type:

Sere s nr./Seres an no:

CNP:

EMPORIKI BANK ROMANIA S.A. Capital Social:196.089.737,27 RON

Str. Berzei 19, Sector 1, Bucuresti, Romania. Pa . 1 o 2 Cod unic de inregistrare: 8490099 +40 21 310.3955, +40 21 315.9783; +40 21 310.3991 Reg. Comertului Nr. J 40/3797/1996

bank@emporiki.ro; http://www.emporiki.ro Registrul Bancar Nr. RB-PJ R-40-033/1999

I

A

B

I

A

BReprezentant4

Type

I

A

B

I

A

B

Reprezentant3

Imputernicit1

Imputernicit2

Imputernicit3

Tip*

I

A

B

*Se va marca "I" pentru semnatura individuala, "A" pentru prima semnatura si respectiv "B" pentru a doua semnatura/ To be marked "I" for individual signature, "A" for first signature and

"B" for second signature.** Se va completa de catre client cu tipul limitarii (limitare la operatiuni, sume, alte limitari agreate cu Banca)/ To be filled in by the client with the type of limitation (operations, amount,

ANEXA - SPECIMEN DE SEMNATURI - PERSOANE JURIDICEANNEX - SIGNATURE SPECIMEN - LEGAL ENTITIES

Reprezentant1

Reprezentant2

Tip*

Type

I

A

B

I

A

B

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Declaratii/ Declarations

Reprezentant legal/Authorised signature: Da/Yes Nu/No Imputernicit 1/Empowered 1: Da/Yes Nu/No

Reprezentant legal/Authorised signature: Da/Yes Nu/No Imputernicit2/Empowered 2: Da/Yes Nu/No

Reprezentant legal/Authorised signature: Da/Yes Nu/No Imputernicit 3/Empowered 3: Da/Yes Nu/No

Reprezentant legal/Authorised signature: Da/Yes Nu/No

Semnaturi / Signatures

Titular de cont Banca

Stampi a/Stamp Stampi a/Stamp

Authorised signature

EMPORIKI BANK ROMANIA S.A. Capital Social:196.089.737,27 RON

Str. Berzei 19, Sector 1, Bucuresti, Romania. Pa . 2 of 2 Cod unic de inregistrare: 8490099 +40 21 310.3955, +40 21 315.9783; +40 21 310.3991 Reg. Comertului Nr. J 40/3797/1996

bank@emporiki.ro; http://www.emporiki.ro Registrul Bancar Nr. RB-PJ R-40-033/1999

Nume/Name:

Semnatura:

Nume/Name:

Functie/Position:

Representanti

legali / Legal

representatives:

Nume/Name:

Semnatura: Verificat de/

Verified by:

Nume/Name:

Director Sucursala / Branch

Manager

Semnatura /Signature:

In lipsa unor specificari exprese, se va intelege ca

persoanele din lista de mai sus vor avea dreptul de a

semna individual. In cazul in care se stipuleaza in mod

expres ca semnaturile sunt complementare, se va

intelege ca oricare doua persoane din prezenta lista

pot semna impreuna.

Clientul confirma ca persoanele imputerniciteidentificate mai sus au luat cunostinta si sunt de acord

ca relatiile de afaceri cu banca sunt supuse Conditiilor

Generale de Afaceri ale Bancii, cu toate modificarile si

adaugirile ulterioare.

We acknowledge the provisions of the law no.

677/2001 regarding handling and diffusion of Client's

personal information and the rights provided by this

law (access right, data modification, opposition right,

the right of not submitting a individual decision, rightto call the court) and I deliberately agree that my

personal data can be processed by the bank and/or

bank's partners and representatives.

Certificam prin prezenta ca informatiile din acest

formular sunt corecte si ca semnaturile ce se regasesc

in lista de mai sus au fost verificate in baza

documentelor de identitate mentionate.

The Annex hereto constitutes itself part of theAccount Opening Application- Corporate no.

.., dated ..

Prezenta Anexa este parte integranta a Cererii dedeschidere de cont - Persoane Juridice nr. .,

din data de ..

Declaram ca am luat la cunostinta de prevederile Legii

677/2001 privind prelucrarea datelor cu caracter

personal si libera circulatie a acestor date si de

drepturile conferite de aceasta (dreptul de acces,

dreptul de interventie asupra datelor, dreptul deopozitie, dreptul de a nu fi supus unei decizii

individuale, dreptul de a ma adresa justitiei) si consimt

in mod expres la prelucrarea datelor mele cu caracter

personal de catre banca si/sau partenerii si

im uternicitii acesteia.Sunt de acord ca Banca poate folosi datele mele cu

caracter personal in scopuri statistice si de marketing.

I agree that the Bank may use my personal data for

statistic and marketing purposes.

Unless otherwise specified, it will be assumed that

each person listed on list above will have the right to

sign singly. If joint signature authorization is expressly

stipulated, it will be assumed that any two persons

listed above may sign jointly.

The client confirms that the empowered personsmentioned above have duly noted and agreed that his

business relations with the Bank are governed by

General Business Conditions of the Bank as amended

from time to time and handed to us.

We hereby certify that the information contained

herein is correct and the signature(s) affixed above

have been verified on the basis of the official

identification documents mentioned above.