LSS ExhibitsLSSS-eng.doc

Payment received in the Payer’s bank Debited to the Payer's account

PAYMENT ORDER NO. 1

Date Type of payment

Exhibit H 0401060

Indicate an amount in words

US Embassy

Payer

Commercial Bank Citibank CJSC, Moscow

Payer’s Bank

Branch 1, Moscow Regional Department of the Bank of Russia in Moscow 705 Receiver’s Bank

Account No.

Federal Treasury Department in Moscow (for Main Office – Branch of the Pension Fund of Russia in Moscow and Moscow region)

Receiver

Name of payment

Priority of payment

Code

Res. field

{V070010} Federal Fund of Obligatory Medical Insurance, Reg. No. MC-38-16822, INN 9909075049 (US Embassy) Purpose of payment

Signatures Notes of the bank

Stamp here Payment received in the Payer’s bank

PAYMENT ORDER NO. 2

Exhibit H, page 2

Indicate an amount in words

US Embassy

Commercial Bank Citibank CJSC, Moscow

Payer’s Bank

Branch 1, Moscow Regional Department of the Bank of Russia in Moscow 705 Receiver’s Bank

Account No.

Federal Treasury Department of the Ministry of Finance of the Russian Federation in Moscow (for Interdistrict Inspection No. 47 in Moscow)

Name of payment

Priority of payment

Code

Res. field

Income tax, INN 9909075049 (US Embassy)

Stamp here

Payment received in the Payer’s bank

PAYMENT ORDER NO. 3

Exhibit H, page 3

Indicate an amount in words

US Embassy

Commercial Bank Citibank CJSC, Moscow

Payer’s Bank

Branch 1, Moscow Regional Department of the Bank of Russia in Moscow 705 Receiver’s Bank

Account No.

Federal Treasury Department in Moscow (for Main Office – Branch of the Pension Fund of Russia in Moscow and Moscow region)

Name of payment

Priority of payment

Code

Res. field

Pension Fund of Russia (funded component), Reg. No. 087-121-080044, INN 9909075049 (US Embassy)

Stamp here

Payment received in the Payer’s bank

PAYMENT ORDER NO. 4

Exhibit H, page 4

Indicate an amount in words

US Embassy

Commercial Bank Citibank CJSC, Moscow

Payer’s Bank

Branch 1, Moscow Regional Department of the Bank of Russia in Moscow 705 Receiver’s Bank

Account No.

Federal Treasury Department in Moscow (for Main Office – Branch of the Pension Fund of Russia in Moscow and Moscow region)

Name of payment

Priority of payment

Code

Res. field

Pension Fund of Russia (insurance component), Reg. No. 087-121-080044, INN 9909075049 (US Embassy)

Stamp here

Payment received in the Payer’s bank

PAYMENT ORDER NO. 5

Exhibit H, page 5

Indicate an amount in words

US Embassy

Commercial Bank Citibank CJSC, Moscow

Payer’s Bank

Branch 1, Moscow Regional Department of the Bank of Russia in Moscow

Receiver’s Bank

Account No.

Federal Treasury Department in Moscow (Main Office – Moscow Regional Office of the Social Insurance Fund of the Russian Federation)

Name of payment

Priority of payment

Code

Res. field

Social Insurance Fund, Reg. No. 7730004971, INN 9909075049 (US Embassy)

Stamp here

Payment received in the Payer’s bank

PAYMENT ORDER NO. 6

Exhibit H, page 6

Indicate an amount in words

US Embassy

Commercial Bank Citibank CJSC, Moscow

Payer’s Bank

Branch 1, Moscow Regional Department of the Bank of Russia in Moscow

Receiver’s Bank

Account No.

Federal Treasury Department in Moscow (Main Office – Moscow Regional Office of the Social Insurance Fund of the Russian Federation)

Name of payment

Priority of payment

Code

Res. field

Social Insurance Fund – traumatism (0.4%), Reg. No. 7730004971, INN 9909075049 (US Embassy)

Stamp here

Exhibit I To be submitted before or on 15th day of a calendar month, following the reporting period, to a territorial office of the Russian Federation Social Insurance Fund

Appendix 1 To Order of the Ministry of Health and Social Development of Russia dated 28.02.2011 No. 156н Form-4 SIF RF

Insurant's registration number

Subordination code

CALCULATION

of accrued and paid insurance fees on account of obligatory social insurance in the event of temporary disability and maternity, and obligatory social insurance for job-related injuries and occupational diseases, as well as of expenses connected with payment of insurance coverage

Reporting period (code)

(full name of an organization, independent unit / full name, individual entrepreneur, individual)

Code according to OKATO

INN

Code according to OKVED

KPP

Code according to OKPO

OGRN (general state registration number) (OGRNIP-general state registration number of an individual entrepreneur)

Code according to OKOPF

Contact phone

Code according to OKFS

building (block) flat (office)

Average number of employees

including:

women

Originals or copies of supporting documents are attached on pages working invalids employees working in hazardous and (or) harmful environment

I do confirm authenticity and completeness of information contained in this calculation

To be filled in by an officer of the Fund

Information on calculation

2 – authorized representative of an insurant

This calculation is issued (code)

Originals or copies of supporting documents are attached on pages

(surname, name, patronymic)

Signature

Stamp here

Power of Attorney issued to a representative

Date of calculation

(Full name)

(Signature)

Exhibit J To be compiled and submitted on a quarterly basis (progressive total) before or on 15th day of a calendar month, following the reporting period, to a territorial office of the Russian Federation Pension Fund (further – PFR) in the place of registration

Appendix to Order of the Ministry of Health and Social Development of Russia dated November 12, 2009 No. 894н

Form PCB-1 PFR

Registration number in PFR

CALCULATION

of accrued and paid insurance fees for obligatory pension insurance in the Pension fund of the Russian Federation, insurance fees for obligatory medical insurance in the Federal Fund of Obligatory Medical Insurance* and territorial funds of obligatory medical insurance** by payers of insurance fees who make payments and other considerations to individuals

Correction number

Reporting period (code)

Calendar year

(full name of an organization, independent unit / full name, individual entrepreneur, individual)

TFOMS registration number (territorial fund of obligatory medical insurance)

Code according to OKATO

INN

Code according to OKVED

KPP

Code according to OKPO

OGRN (general state registration number) (OGRNIP-general state registration number of an individual entrepreneur)

Code according to OKOPF

Contact phone

Code according to OKFS postal code

Registration address:

region district city town street house building (block) flat (office)

Number of insurants

Average number of employees

Code of tariff

pages

I do confirm authenticity and completeness of information contained in this calculation

To be filled in by an officer of the PFR Information on calculation

1 – insurant

2 – authorized representative of an insurant

This calculation is issued (code) on pages

(surname, name, patronymic)

Signature

Originals or copies of supporting documents are attached on pages

Stamp here

Power of Attorney issued to a representative

Date of calculation***

(Full name)

(Signature)

* further – FFOMS

** further – TFOMS

*** Date of submission of calculation in person or by proxy, if sent by post – date of posting of a letter with a list of contents, if sent by e-mail – date of sending as recorded by a transport (postal) server of a certification center

Form АДВ-6-2 Code according to OKUD

Code according to OKPO

LIST OF INFORMATION to be provided by an insurant to PFR

PFR registration number

Number of correction (cancellation) packages of documents

Name (short)

INN

KPP

Reporting period:

1 quarter ( 6 months ( 9 months ( year: ( Calendar year

Reporting period 2010: 6 months ( year:

Original information:

Insurant's total:

Correction (cancellation) information:

Insurant's total:

Chief's position Signature Print name

Date Stamp here

Exhibit K, page 2 Form СЗВ-6-1 Code according to OKUD

Code according to OKPO

INFORMATION ON ACCRUED AND PAID INSURANCE FEES

FOR OBLIGATORY PENSION INSURANCE

AND INSURANT'S PENSIONABLE SERVICE

Insurant's details:

PFR registration number

Name (short)

INN

Code of insured's category

Date of submission to PFR "_____" ______________ ______

Reporting period:

1 quarter 6 months 9 months year:

Calendar year

Reporting period 2010: 6 months

Type of information:

- original

- correction for reporting period: 1 quarter 6 months 9 months

-cancellation Calendar year

Information on insurant:

Period of work for the past three months (six months in 2010) of a reporting period:

Print name

Stamp here

Form СЗВ-6-2 Code according to OKUD

Code according to OKPO

REGISTRY

ON INFORMATION ON ACCRUED AND PAID INSURANCE FEES FOR OBLIGATORY PENSION INSURANCE

AND INSURANT'S PENSIONABLE SERVICE

Calendar year

Reporting period 2010: 6 months ( year

Number of insurants according to the registry

PFR registration number

INN

Name of organization (short)

Code of insured's category

Date of submission to PFR "____" ______________ ___________

Type of information: ( - original

( - correction

( - cancellation For reporting period: 1 quarter ( 6 months ( 9 months ( year ( Calendar year

Insurance fees for the past three months (six months in 2010) of a reporting period by each insurant

(day/month/year)

Total according to the registry:

Print name

Date Stamp here

Exhibit L Form АДВ-6-4 Code according to OKUD

Code according to OKPO

List of documents containing information on amounts of fees and other considerations, insurance fees accrued by payers of insurance fees - insurants in favor of an individual Details of payer of insurance fees - insurant:

Registration number in PFR

Name (short)

INN

KPP

Code of insured's category

Contract (type of contract) with insured:

( - Employment contract

( - Civil law contract

Reporting period: year

Type of information:

( - original ( - corrections

Notes:

Information on amount of fees and other considerations paid by payers of insurance fees - insurants in favor of an individual (Form СЗВ-6-3)

To be completed for a package of documents accompanied by documents in electronic form:

Number of a package of documents assigned by an insurant ___ · ___ · ___ · ___ · ___ Number of a package of documents in the territorial office of PFR ___ · ___ · ___ · ___ · ___ · ___ · ___ · ___

Number/year

Information on amount of fees and other considerations

Total amount accrued

Print name

Date Stamp here

Exhibit L, page 2 Form СЗВ-6-3 Code according to OKUD

Code according to OKPO

Information on the amount of fees and other considerations, insurance fees accrued by payers of insurance fees - insurants in favor of an individual

Surname

Name

Patronymic

Insurance number

Reporting period: year

Code of insured's category

Contract (type of contract) with insured:

( - Employment contract

( - Civil law contract Type of information:

( - original ( - corrections

Information on payer of insurance fees - insurant:

Registration number in PFR

INN

KPP

Name of organization (short)

Information on amount of fees and other considerations

accrued in favor of an individual Including: insurance fees accrued for obligatory pension insurance

January

February

March

April

May

June

July

August

September

October

November

December

Total

Print name

Date Stamp here

Exhibit M Company: US Embassy

Period: January 2011 – December 2011

Withholdings applicable to various categories of employees

TOTAL

Exhibit N

REGISTRY

OF INFORMATION ON PERSONAL INCOME FOR 2011

in

Tax agent:

INN/KPP of tax agent:

Sender: Occupation Full name

Number of submitted documents (Certificate of income):

SUBMITTED DOCUMENTS:

Total:

Signature of tax agent

Date of submission to tax authority

Date of acceptance by tax authority

Signature of an officer of tax authority

Exhibit O Appendix 1 Approved by the Order of the Federal Tax Service of Russia

dd. 17/11/2010 No. MMB-7-3/611@

2-NDFL Form

Form Code as per KND 1151078

1.1. Individual Tax Number / Company Code for the organization or Individual Tax Number for the individual

1.2. Name of the organization / Family name, given name, patronymic of the individual

1.3. OKATO Code

2. Information on the individual - income receiver

2.1. Individual Tax Number

2.2. Family name, given name, patronymic

2.3. Taxpayer’s status

2.4. Date of birth

2.5. Citizenship (country code)

2.6. ID document code

2.7. Document number and series

region code district city location street no.

section apartment

2.9. Address in the country of residence: Country code

Address

3. Income tax at the rate of ___ %

4. Standard, Social and Property Tax Deductions

4.1. Sum of deductions the taxpayer is eligible for

4.2. No. of document confirming property-related tax deduction

4.3. Date confirmation was issued

4.4. Code of the tax authority issuing the confirmation

5. Total amount of income and income tax at the close of the taxable period

5.1. Total amount of income

5.2. Total taxable amount

5.3. Total assessed tax amount

5.4. Amount of tax withheld

5.5. Amount of tax transferred*

5.6. Amount of tax overwithheld by the tax agent

5.7. Amount of tax not withheld by the tax agent

Tax Agent

(position)

(signature)

(family name, given name, patronymic)

Stamp here

* Clause to be filled out in relation to tax amounts assessed from income received since 2011.

Exhibit P

INN

Appendix to the Order of the Federal Internal Revenue Service of the Russian Federation dated 29.03.2007 No. ММ-3-25/174@

Page

Form according to KND 1110018

Information on average number of employees for the previous calendar year

To be submitted to

Code

(tax authority)

(full name of organization / surname, name, patronymic of an individual entrepreneur)

Average number of employees as of

(day/month/year)* is equal to employees

* In the event of submission of information on average number of employees for the previous calendar year, specify 1st of January of a current year, in case of establishment (reorganization) of an organization, specify the first day of a month following a month in which an organization is established (reorganized).

I do confirm authenticity and completeness of information presented:

To be filled in by an officer of a tax authority

For organization

Director

Date of submission

(Surname, name, patronymic (in full))

Registration number

Signature

Date

Stamp here

For individual entrepreneur

(Surname, initials)

(signature)

Signature

Date

Representative

(full name of organization / (surname, name, patronymic))

Signature

Date

Stamp here

(document confirming powers of a representative, copy of such document is attached)

Exhibit Q Appendix 2

To the Procedure for approval of the main economic activity of an insurant under obligatory social insurance plan in respect of job-related injuries and occupational diseases – legal entity, and types of economic activities of subdivisions of an insurant, which are independent classification units, as approved by the Order of the Ministry of Health and Social Development of Russia dated January 31, 2006 No. 55

Confirmation of main economic activity

1. Name of organization

2. INN

3. Date and place of registration, registration number (according to the Unified State Register of Legal Entities)

4. Date of commencement of business activity

5. Legal address

6. Full name of the director

7. Full name of the chief accountant

8. Average number of employees in the previous year

9. Distribution of profits and revenues in the previous financial year1:

Total:

100%

To be completed based on financial statements for previous year

To be completed by non-commercial organizations

10. Description of the main type of economic activity

OKVED code

Director

(signature) (print name)

Chief Accountant

(signature) (print name)

Exhibit K

Exhibit K, page 3