APPLICABLE DATA SHEET

1. Company name:

2. Single registration code:

3. Form of legal formation:

4. Establishment Date / Trade Registry Number:

5. Address, telephone / fax, e-mail of the company:

6. The CAEN Code activity that AFN is requested to do is:

10. Associates, shareholders:

Name and surname of the CNP Domicile Share in Share Capital%

100%

11. Administrators

Name and surname Domicile Numeric Personal Code

Number of employees you take and keep for 2 years:

Total employees 3 of which _____ Gr. (graduates 2013 or unemployed)

For a maximum score of 100 pp it is necessary to assume at least 2 employees, both of the
disadvantaged categories.