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Ministry of Economy and Finance Directorate of Public Financing Public Auction of Public Debt Instruments Panama, Mrs. Katyusca Correa de Jimenez Director of Public Financing Ministry of Economy and Finance E. S. D. I, _________________________, in my capacity as authorized representative of __________, hereby present irrevocable application for the acquisition of Public Debt Instruments denominated Treasury Bonds in the authorized Public Auction to be held on November 20, 2013, for which I declare under oath severity the following: 1. That this application is submitted on behalf of: Own behalf Third party PRIVATE ENTITY GOVERNMENT ENTITY 2. That subject to the terms, conditions and procedures established in the Ministerial Resolution No. 017-2013DdCP of November 14, 2013 my proposal is the following: ISIN Code Maturity PAL634445OA2 Requested amount Letters and numbers (US $) Price (Expressed in two (2) decimal places) ISIN Code Maturity Requested amount Letters and numbers (US $) Price (Expressed to two (2) decimal places) 3. That, in case the Ministry of Economy and Finance selects my application, I commit to pay the entire amount acquired in 'PUBLIC DEBT INSTRUMENTS' within a T+3 period, through CENTRAL LATINOAMERICANA DE VALORES, S.A. (LATINCLEAR). ____________________________ Signature of the Authorized Agent Position no. ______ License no. ______