Data update

Based on Law No. 06/L-082 on “Personal Data Protection,” I declare that I agree that the Bank and its representatives may use, process, and transfer my personal data to related companies in accordance with the applicable legislation, for the purpose of providing quality services.

Client’s consent for the processing of his/her personal data for statistical reporting purposes:

(For more information on the processing of personal data by Banka Ekonomike, please read the general terms and conditions. At any time during your visit to one of the bank branches, you may request that your personal data not be processed; however, this will affect the provision of services and products.)

Declaration of Consent for Communication/Direct Marketing

I declare that I agree to be contacted and to receive offers and/or notifications related only to products and services offered by Banka Ekonomike Sh.A.

YesNo

For the purpose of this communication, the primary method I choose for communication is through:

I declare that I agree to receive offers and/or notifications related to products and services offered by Banka Ekonomike Sh.A. which are related to Siguria Insurance Company Sh.A.

For the purpose of this communication, the primary method I choose for communication is through:

FSDK declaration

fsdk

Banka Ekonomike is a member of the Deposit Insurance Fund of Kosovo (FSDK). FSDK will compensate insured depositors if the bank is unable to meet its financial obligations, up to €5,000. Insured depositors are individuals and legal entities that are not otherwise excluded from the scheme. For further information regarding the deposit insurance scheme, please ask at your local bank branch or visit the FSDK website: www.fsdk.org.

*The insurance limit will increase as follows: €3,000 (from 01.01.2014), €4,000 (from 01.01.2016), €5,000 (from 01.01.2018).

Identification Form for Politically Exposed Persons (PEP)

Politically exposed person – individuals who are or have been entrusted with prominent public functions

YesNo

Close family members – spouses/equivalent to spouses, children, spouses/equivalents of children, parents.

YesNo

Close associate – means any individual who is a joint owner of legal entities, or has any close business relationship, and any individual who is the beneficial owner of a legal entity which is known to have been established for the de facto benefit of the PEP.

YesNo

*If you answered YES to any of the above questions, please complete the PEP form

PEP Form

Declaration on the Origin of Funds and Determination of the Beneficial Owner

Based on Law No. 05/L-096 on the Prevention of Money Laundering and Combating the Financing of Terrorism, specifically Article 19.6 (Customer Due Diligence), and CBK Regulation on the Prevention of Money Laundering and Combating the Financing of Terrorism, Article 18.5 (Enhanced Due Diligence), the person involved in this activity must provide the bank or financial institution in writing that:

The person involved in this activity declares that:

Acts on his/her own behalf as the owner and holder of the ownership right over any property subject to the transactionActs as an authorized agent (or as an independent third party) of one or more persons or entities

FATCA (Foreign Account Tax Compliance Act) Declaration for Individuals

Based on Law No. 05/L-013 on “Ratification of the Agreement between the Government of the Republic of Kosovo and the Government of the United States of America,” to improve international tax compliance and implement FATCA regulations, I declare that I am a US citizen or US resident. IRS Form W9

YesNo