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ATTACHMENT NO.1 – INFORMATION ABOUT CLIENT'S FINANCIAL STATUS, INVESTMENT OBJECTIVES, EXPERIENCE AND READINESS TO UNDERTAKE RISKS, CATEGORIZATION AND RISK EVALUATION(1/4)

Why do you need to fill in the below questionnaire?

The Investment Intermediaries collect information about their clients in compliance with the requirements of the Bulgarian and European legilsation regarding the markets in financial instruments, the measures agains money laundering and terrorism fiancing and the automatic exchange of financial information for tax purposes. We understand that the confidentiality and the security of your organisation and personal data you provide are important. All data and documents provided by our clients are kept and/or destroyed strictly following the requirements of GDPR and the relevant Bulgarian legislation.

To be filled by::*

Firstname:*

Surname:*

Lastname:*

UCN/Other unique number:*

Date of birth:*

Place of birth:*

Id card/Passport No.:*

Valid till:*

Issued by:*

Address:*

Phone:*

E-mail:*

Citizenship:*

Other citizenship, if any:

Tax residence:*

Tax number issued by the tax authorities:*

*If the Client is a local taxable person in more than one jurisdiction, additional declaration is to be filled and signed. Declaration

Education (level):*

Professional sector:*

Current or previous profession:*

Job experience in years:*

Connection to the financial sector:*

Categories under Art. 36, para 2

I fall into the following category under article 36, paragraph 2 of MMLA I don't fall into the following category under article 36, paragraph 2 of MMLA

During last 12 months:

I fall into the following category under article 36, paragraph 2 of MMLA (specify the particular category 1): I do not fall into the categories under article 36, paragraph 2 of MMLA.

Categories under Art. 36, para 5

I fall into the following category under article 36, paragraph 5 of MMLA I don't fall into the following category under article 36, paragraph 5 of MMLA

During last 12 months:

I fall into the following category under article 36, paragraph 5 of MMLA (specify the particular category 2): I do not fall into the categories under article 36, paragraph 5 of MMLA.

I provide the following additional information in support to the fact that I belong to the abovementioned category(s):

Method of initial contact with FFBH: