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Basic identification number To be filled by legal entity - entrepreneur Activity code Tax identification number

1 2 3 Name: Head office ( town; street and number):

To be filled by the Serbian Business Registers Agency Type of activity Codes 19 20 21 22 23 24 25

26

BALANCE SHEET On ___________________ in 000 RSD

Account group, account 1

ITEM 2 ASSETS A. PERMANENT ASSETS (002+003+004+005+009) I. SUBSCRIBED CAPITAL UNPAID II. GOODWILL III.INTANGIBLE ASSETS IV. IMMOVABLES, PLANTS, EQUIPMENT AND BIOLOGICAL RESOURCES (006+007+008) 1. Immovables,plants and equipment 2. Investment immovables

ADP 3

Remark number 4

Current year 5

Amount Previous year 6

001 002 003 004 005

0 12 01 without 012

020, 022, 023, 026, 027(part), 028(part), 029 024, 027(part), 028(part) 021,025, 027(part), 028(part)

006 007

3. Biological resources V. LONG-TERM FINANCIAL INVESTMENTS (010+011)

008

009 010 011 012 013 014

030 to 032, 039 (part) 033 to 038, 039 (part) minus 037 10 to 13, 15 14

1. Investments in capital 2.Other long-term financial investments B. CURRENT ASSETS (013+014+015) I. INVENTORIES II. PERMANENT ASSETS FOR SALE AND ASSETS OF BUSINESSES TO BE CEASED III. SHORT-TERM RECEIVABLES, INVESTMENTS AND CASH (016+017+018+019+020) 1. Receivables 2. Recivables for overpaid tax on profit 3. Short-term financial investmets 4. Cash and cash equivalents 5. VAT and accrued expenses V. DEFERRED TAX ASSETS G. OPERATING ASSETS (001+012 +021) D. LOSS ABOVE EQUITY . TOTAL ASSETS (022+023)

015 016 017 018 019 020 021 022 023 024

20, 21 and 22, except 223 223 23 minus 237 24 27 and 28 except 288 288

29

in 000 RSD Account group, account 1 88 ITEM 2 E. OFF-BALANCE SHEET ASSETS LIABILITIES A.EQUITY (102+103+104+105+106107+108-109-110) I. CAPITAL II. SUBSCRIBED CAPITAL UNPAID III. RESERVES IV. REVALUATION RESERVES V. UNREALIZED PROFITS FROM SECURITIES VI. UNREALIZED LOSSES FROM SECURITIES VII. RETAINED EARNINGS VIII. LOSS IX. TREASURY SHARES B. LONG-TERM PROVISIONS AND LIABILITIES(112+113+116) I. LONG-TERM PROVISIONS II. LONG-TERM LIABLITIES (114+115) 1. Long-term loans 2. Other long-term liabilities III. SHORT-TERM LIABILITIES (117+118+119+120+121 +122) 1. Short-term financial liabilities 2. Liabilities derived from assets for sale and assets of businesses to be ceased 3. Operating liabilities 4. Other short-term liabilities 5. Liabilties derived from VAT and other public revenues and deferred expenses 6.Liabilities derived from tax on profit V. DEFERRED TAX LIABILITIES G. TOTAL LIABILITIES (101+111 +123) D. OFF-BALANCE SHEET LIABILITIES ADP 3 025 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 Remark number 4 Current year 5 Amount Previous year 6

30 31 32 330 and 331 332 333 34 35 037 and 237

40 41 414,415 41 without 414 and 415

42, except 427 427 43 and 44 45 and 46 47, 48 except 481 and 49 except 498 481 498

89

In _____________________ on ____,____ 20__

Person authorized to compose Financial Statement S.P. _______________________

Legal representative

__________________________

The form is prescribed by Rule on contents and form of Financial Statements for legal entities, cooperatives, other legal entities and entrepreneurs ( Official Journal of RS, no. 114/06, 5/07, 119/08, 2/10, 101/12 and 118/12 )