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Membership Application Form (For the FIC internal use only) I Company Name: _____________________________________________________ II Details about the Member Company Headquarters’ Contact Details: City and Postal Code: Street: ___________________ ____________________________ Phone No: Fax No: ________________________ ________________________ Corporate e-mail: ____________________________ Web-Site (local): ______________________ Web-site (global): _____________________ Please define your alternate headquarters if any, i.e. branch of your company apart from your primary HQ: ______________________________________________________ Business Details: (This information will be treated as confidential and will be used for internal purposes only) PIB (or PIN): _________________________ Commercial Bank: Auditors: Commerce Registry No: _______________ ______________________________________________________ _____________________________________________________________ Law Office: ___________________________________________________________ PR and Marketing Agency: ________________________________________________ III Contacts Chief Executive1: Phone: ____________________________ Financial Director: Phone: ____________________________________________________ ____________________________ (name and function) ___________________________ ____________________________________________________ Marketing/Communication Director: 1 E-mail: E-mail: ___________________________ _______________________________________ Phone: ____________________________ HR Director: Phone: E-mail: ___________________________ _________________________________________________________ ____________________________ E-mail: ___________________________ Head of Corporate & Regulatory Affairs/Legal Department: _____________________ ___________________________________________________________________ Phone: ____________________________ E-mail: Personal Assistant to the Managing Director: ___________________________ _______________________________ ___________________________________________________________________ Phone: ____________________________ E-mail: ___________________________ Please Name Your Company’s Liaison Officer for the FIC: ___________________________________________________________________ Phone: ____________________________ E-mail: ___________________________ IV Type of Business: [ ] Production [ ] Law/Consultancy [ ] Banking/ Leasing/ Insurance [ ] Audit/Consultancy [ ] Services [ ] Rep. Office [ ] Media/PR [ ] Other _____________________ V Type of membership: Membership in the Council is open to: A. domestic companies established with substantial portion of foreign capital B. domestic company which in significant way represents foreign business interest C. domestic companies that provide consulting services to the FIC membership under specified conditions D. natural persons performing registered professional activity in Serbia (registered for the performance of consulting and legal activities) under specified conditions The above gain the title of FIC member. An institutional member of the Council may be any foreign association, representative or educational institution, which contributes to the development of international economic co-operation and has an understanding of the goals of the Council. Honorary members can be natural persons, such as prominent public figures, scientists, diplomats or politicians from Serbia or other countries, who are able to contribute to the development of international economic co-operation and agree with the goals of the Council, selected by the Board of Directors as honorary members based on their distinguished services for the Council. Please indicate the appropriate type of membership: [ ] Member by criteria A [ ] Member by criteria B [ ] Member by criteria D [ ] Institutional Member [ ] Member by criteria C VI Additional Information: Total investment of your company in Serbia (EUR): ___________________________________ Number of employees in Serbia: _____ Percentage of clients - domestic companies established with substantial portion of foreign capital: _______ Percentage of clients - foreign legal entities with interest to invest in Serbia: _______ VII FIC Committees: The mission of the Council is to contribute together with the Authorities to a better investment environment for foreign and domestic companies on the market, through open, formal and informal dialogue between the willing stakeholders. In order to achieve the goals efficiently, the Foreign Investors Council has formed relevant cross functional and sector based working committees. There are two categories of membership in a Working Committee: Active member and Observer member. The active member of a Working Committee has the full scope of rights and obligations, including but not limited to: to actively participate in committee work, control the activities of the committee and execute other rights in accordance with statutory and committee acts. The observer member has the right to be informed about the activities of the Working Committee. FIC members can, at any given time, enter into committee membership, as well as change membership category. Please indicate the FIC committees of interest, in which representatives of your company would participate in as well as preferred category of membership per each chosen Working Committee: Legal Active member [ ] or Observer member [ ] Human Resources Active member [ ] or Observer member [ ] Taxation Active member [ ] or Observer member [ ] Anti-Illicit Trade Active member [ ] or Observer member [ ] Digital& E-Commerce Active member [ ] or Observer member [ ] Industrialization& Infrastructure Active member [ ] or Observer member [ ] Food & Agriculture Active member [ ] or Observer member [ ] Leasing & Insurance Active member [ ] or Observer member [ ] Real-Estate Active member [ ] or Observer member [ ] Telecommunications & IT Active member [ ] or Observer member [ ] VIII Fees*: One time entry fee: 550.00 EUR Annual membership fee: Board Members: 6,000.00 EUR Members: 1,850.00 EUR Institutional Members: 1,000.00 EUR IX References: Please list representatives of the top management in seven FIC member companies Name of the Company: __________________________________________________ Name and position of the Contact Person: ______________________________________ Phone: ____________________________ Name of the Company: _____________________________ _____________________________________ ____________________________ Name of the Company: E-mail: __________________________________________________ Name and position of the Contact Person: Phone: _____________________________ _____________________________________ ____________________________ Name of the Company: E-mail: __________________________________________________ Name and position of the Contact Person: Phone: _____________________________________ ____________________________ Name of the Company: _____________________________ __________________________________________________ Name and position of the Contact Person: Phone: E-mail: E-mail: _____________________________ __________________________________________________ Name and position of the Contact Person: _____________________________________ Phone: ____________________________ Name of the Company: E-mail: _____________________________ __________________________________________________ Name and position of the Contact Person: Phone: _____________________________________ ____________________________ Name of the Company: _____________________________ __________________________________________________ Name and position of the Contact Person: Phone: E-mail: _____________________________________ ____________________________ E-mail: _____________________________ X Please, supplement this Application Form with the recent Annual Report and/ or other record documenting that your company meets the criteria for FIC membership. The applicant hereby submits a written request for admission into FIC membership, stating that it is informed and agrees with the Statute and all other general acts of the Council. On behalf of the Company ____________________________ Place, date: _____________________