Formularze

Appendix 2 to:

The Rules of providing current and periodic reports in the alternative trading system on NewConnect and on Catalyst and providing listed companies’ reports of compliance with the detailed principles of corporate governance.

Form No.

,on

Management Board
Warsaw Stock Exchange

Application
for of access to the Electronic Information Base (EBI)

NEW APPLICATION CORRECTION OF THE APPLICATION

NewConnect – Alternative Trading System

CATALYST – Alternative Trading System

CORPORATE GOVERNANCE – Regulated Market

Issuer details:

Name:

Address:

VAT number:

LEI:

Telephone:

E-mail:

Proposed abbreviated name:

Acting on behalf of the Issuer

of access to the Electronic Information Base (EBI):

granting access to EBI:

First name:

Surname:

Add

revoking access to EBI:

First name:

Surname:

Add

List of all EBI operators of the Issuer including changes defined in this application:

First name:

Surname:

Job position or legal relationship:

Telephone:

E-mail:

Add

Date:

Additional information:

First names, surnames and signatures of the Issuer’s duly authorised representatives:

The personal data controller is the Warsaw Stock Exchange (GPW), ul. Książęca 4, 00-498 Warsaw, Poland, phone +48 22 628 32 32, gpw@gpw.pl.

The Data Protection Officer may be contacted at iodgkgpw@gpw.pl..

Business contact details including in particular: first name, surname, business e-mail, business telephone number, job position, identification and contact details of the entity represented by the person, will be processed in accordance with Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation). Business contact details will be processed for the purposes of granting access to the Electronic Information Database (EBI) and the performance of actions of EBI Operator.

The processing is necessary to get access to EBI and to perform actions of EBI Operator as defined in the Rules of providing current and periodic reports in the alternative trading system on NewConnect and on Catalyst and providing listed companies’ reports of compliance with the detailed principles of corporate governance (Article 6(1)(f) of the General Data Processing Regulation).

Disclosure of data is a condition of getting access to EBI. Failure to disclose data will prevent access and performance of actions of EBI Operator. Data will be processed for the duration of access to EBI and until the expiry of claims, if any. Every person has the right to access their personal data, the right to rectification, erasure, restriction of processing, and data portability. Every person has the right to lodge a complaint with the President of the Personal Data Protection Office and the right to object to the processing of his or her personal data. Every person has the right to object to the processing of his or her personal data on the basis of legitimate interest pursued by the controller.

Attachment to the Application for Granting Access
to the Electronic Information Base (EBI) This is to represent that I

EBI Operator details:

First name:

Surname:

Job position or legal relationship:

Telephone:

E-mail:

This is to represent that the Rules of providing current and periodic reports in the alternative trading system on NewConnect and on Catalyst and providing listed companies’ reports of compliance with the detailed principles of corporate governance, defined in Resolution No. 646/2011 of the Exchange Management Board dated 20 May 2021 (as amended), and I shall comply with the Rules.

Date:

EIB operator’s signature

Date:

Signatures of the Issuer’s representatives

Add

Disclosure of data is a condition of getting access to EBI. Failure to disclose data will prevent access and performance of actions of EBI Operator. Data will be processed for the duration of access to EBI and until the expiry of claims, if any. Every person has the right to access their personal data, the right to rectification, erasure, restriction of processing, and data portability. Every person has the right to lodge a complaint with the President of the Personal Data Protection Office and the right to object to the processing of his or her personal data. Every person has the right to object to the processing of his or her personal data on the basis of legitimate interest pursued by the controller.

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