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ANNEX 3a: MODEL III – ADVERTISING OF ORGANISED TRAVEL PROGRAMMES BY STRATEGIC PARTNERS Application form 1 – General information about the strategic partner Name of the strategic partner Registered Head office of the strategic partner E-mail address of the strategic partner Tax number of the strategic partner Person authorised to represent the strategic partner (name, surname, position) E-mail address of the person authorised to represent the strategic partner Share in nominated Media plan in the absolute amount (without VAT) Name of the bank Address of the bank Giro account number/IBAN/SWIFT Number of beds in hotels Number of beds in camping sites Number of beds in other types of accommodation premises Estimated total number of achieved tourist arrivals in 2015 Estimated total number of achieved overnight stays in 2015 Planned total number of tourist arrivals in 2016 (organised – airline) Planned total number of tourist overnight stays in 2016 (organised – airline) Signature of the person authorised Stamp of the strategic partner to represent the strategic partner 1

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Page 1: croatia.hr · Web viewAll data are subject to the control of the State Inspectorate of the Republic of Croatia Signature of the person authorised to represent The Consolidator of

ANNEX 3a: MODEL III – ADVERTISING OF ORGANISED TRAVEL PROGRAMMES BY STRATEGIC PARTNERS

Application form 1 – General information about the strategic partner

Name of the strategic partner

Registered Head office of the strategic partner

E-mail address of the strategic partner

Tax number of the strategic partner

Person authorised to represent the strategic partner (name, surname, position)E-mail address of the person authorised to represent the strategic partnerShare in nominated Media plan in the absolute amount (without VAT)

Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

Number of beds in hotels

Number of beds in camping sites

Number of beds in other types of accommodation premisesEstimated total number of achieved tourist arrivals in 2015Estimated total number of achieved overnight stays in 2015Planned total number of tourist arrivals in 2016(organised – airline)Planned total number of tourist overnight stays in 2016(organised – airline)

Signature of the person authorised Stamp of the strategic partnerto represent the strategic partner

________________________________

Place ___________________________

Date ___________________________

1

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Application form 2 – Information about organised travel programmes in 2016 by strategic partner for CroatiaIndicator Total

Croatia Istria Kvarner region Zadar Šibenik Split Dubrovnik City of

Zagreb Inland

Expected number of travellers in 2015TotalWith organised charter transportWith organised bus transportTotal number of leased beds in all commercial accommodation premises in 2015Planned number of travellers(for organised applied programmes)201620172018Total number of leased beds in all commercial accommodation premises in 2016TotalIn hotelsIn rooms and apartments in private accommodationIn camping sitesOn boatsIn other accommodationAirline charter transport in 2016Planned total number of seatsPlanned number of rotations and starting date and end of charter programmes for each departure airport (please list departure and arrival airports)

With financial and legal liability, we confirm the accuracy of the above stated information. All data are subject to the control of the State Inspectorate of the Republic of Croatia

Signature of the person authorised to represent the strategic partner Stamp of the strategic partner________________________________Place ___________________________Date____________________________

2

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Application form 3 – List of key partners (hotels and other companies) with the number of leased beds in Croatia

No. Exact name and address of the hotel or other company where the strategic partner has leased beds in Croatia

Number of leased beds

Number of travellers

2015 Plan for

2016

2015 Plan for

20161.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

With financial and legal liability, we confirm the accuracy of the above stated information. All data are subject to the control of the State Inspectorate of the Republic of Croatia

Signature of the person authorised to represent the strategic partner Stamp of the strategic partner

_________________________________

Place ___________________________

Date ___________________________

3

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Application form 4 – Certificate about the number of leased beds

CERTIFICATE ABOUT THE NUMBER OF LEASED BEDS IN 2016

I_______________________(name and surname) from__________________________, as a person authorised to represent the holder of the accommodation offer __________________________(company) with the Head office in______________________ declare that_______________________(strategic partner) in the registered hotel accommodation premises of our company, in 2016, has leased in total____________________beds.

In __________________, _________2015Place date

Stamp

________________________________________(Signature of the person authorised to represent

the holder of the accommodation offer)

4

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Application form 5 – Media plan

5

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Application form 6 – General information about the promotional Agency

Name of the promotional Agency

Registered Head office of the promotional Agency

E-mail address of the promotional Agency

Tax number of the promotional Agency

Person authorised to represent the promotional Agency (name,surname,position)E-mail address of the person authorised to represent the promotional agency

Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

6

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Application form 7 – Declaration about paid dues

DECLARATION ABOUT PAID DUES

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the strategic partner____________________________(company) with the Head office in____________________, declare that____________________________(company) at the moment of giving this declaration has no unpaid dues such as tourist tax, tourist membership fees or any other financial debts to the CNTB, as well as no unpaid dues arising from business with Croatian legal entities and individuals based on enforceable court judgments.In________________________,_________,________2015Place Date

Stamp

_________________________________(Signature of the person authorised to

represent the strategic partner)

7

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Application form 8 – Declaration of the undertaking that he is not in difficulty

DECLARATION OF THE UNDERTAKING THAT HE IS NOT IN DIFILCUTIY

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the strategic partner____________________________(company) with the Head office in____________________, declare that____________________________(company) at the moment of giving this declaration is not in difficulty.

Further, I declare that I agree with the obligation to provide CNTB with additional documentation if asked, to determine with certainty that ____________________________(company) is not in difficulty

In________________________,_________,________2015Place Date

Stamp___________________________________

(Signature of the person authorised to represent the strategic partner)

8

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Application form 9 – Declaration of the undertaking about all entities controlled by the undertaking on a legal or de facto basis

D E C L A R A T I O N OF T H E U N D E R T A K I N G ABOUT A L L E N T I T I E S CO N T R O L L E D B Y T H E U N D E R T A K I N G

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the strategic partner____________________________(company) with the Head office in____________________, declare that the____________________________(company) is associated with following entities:

No NAME AND ADRESS OF THE UNDERTAKING PERSON AUTHORISED TO REPRESENT THE UNDERTAKING

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

In________________________,_________,________2015Place Date

Stamp________________________________________

(Signature of the person authorised to represent the strategic partner)

9

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Application form 10 – Declaration of the undertaking about all received de minimis aid in the current and previous two fiscal years

DECLARATION OF THE UNDERTAKING ABOUT ALL RECEIVED STATE AID IN THE CURRENT AND PREVIOUS TWO FISKAL

I, ________________________________(name and surname) from______________________________, as a person authorised to represent strategic partner____________________________(company) with the Head office in____________________, declare that the____________________________(company) received in the current and previous two fiscal years, regardless of the level of the aid provider (national, regional, local), following de minimis aid:

No STATE AID PROVIDER 2013. 2014. 2015.AMOUNT IN KUNA AMOUNT IN KUNA AMOUNT IN KUNA

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

In________________________,_________,________2015Place Date

Stamp________________________________________

(Signature of the person authorised to represent the strategic partner)

10

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ANNEX 3b: MODEL III – ADVERTISING OF ORGANISED TRAVEL PROGRAMMES BY MARKET LEADERS

Application form 1 – General information about the market leader

Name of the Leader

Registered Head office of the Leader

E-mail address of the Leader

Tax number of the LeaderPerson authorised to represent the Leader (name, surname, position)E-mail address of the person authorised to represent the LeaderShare in the nominated Media plan in its absolute amount (without VAT)Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

Number of beds in hotels

Number of beds in camping sitesNumber of beds in other types of accommodation premisesEstimated total number of achieved tourist overnight stays in 2015Estimated total number of achieved tourist overnight stays in 2015Planned total number of tourist arrivals in 2016 – in organised air transportPlanned total number of tourist overnight stays in 2016 – in organised air transportPlanned total number of tourist arrivals in 2016 – in organised bus transportPlanned total number of tourist overnight stays in 2016 – in organised bus transport

Signature of the person authorised to represent the Leader Stamp of the Leader

_________________________________

Place___________________________

Date___________________________

11

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Application form 2 – Information about organised travel programmes by the market leader for Croatia in 2016

IndicatorTotal

Croatia Istria Kvarner Region

Zadar Šibenik Split Dubrovnik City of Zagreb Inland

Expected number of travellers in 2015TotalWith organised charter transportWith organised bus transportTotal number of leased beds in all commercial accommodation premises in 2015Planned number of travellers201620172018Total number of leased beds in all commercial accommodation premises for 2016TotalIn hotelsIn rooms and apartments in private accommodationIn camping sitesOn boatsIn other accommodationAirline charter transport in 2016Planned total number of seatsPlanned total number of travellersPlanned number of rotations in starting date and end of charter programmes for each departure airport

12

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Specially organised transport by bus in 2016Planned total number of travellersPlanned number of rotations and date of departure and end of bus programmes for each country from where tourists arrive

With financial and legal liability, we confirm the accuracy of the above stated information. All data are subject to the control of the State Inspectorate of the Republic of Croatia

Signature of the person authorised to represent the Leader Stamp of the Leader_________________________________

Place ___________________________

Date ___________________________

13

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Application form 3 – List of key partners (hotels, other companies) with the number of leased beds in Croatia

No. Exact name and address of the hotel or company where the Leader has leased beds in Croatia

Number of leased beds

Number of travellers

2015 Plan for

2016

2015 Plan for

20161.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

With financial and legal liability, we confirm the accuracy of the above stated information. All data are subject to the control of the State Inspectorate of the Republic of Croatia

Signature of the person authorised to represent the Leader partner Stamp of the Leader

_________________________________

Place ___________________________

Date ___________________________

14

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Application form 4 – Certificate about the number of leased beds

CERTIFICATE ABOUT THE NUMBER OF LEASED BEDS IN 2016

I_______________________(name and surname) from__________________________, as a person authorised to represent the holder of the accommodation offer __________________________(company) with the Head office in______________________ declare that_______________________(leader) in the registered hotel accommodation premises of our company, in 2016, has leased in total____________________beds.

In___________________,___________2015Place Date

Stamp

_________________________________ (Signature of the person authorised to represent

the holder of the accommodation offer)

15

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Application form 5 – Media plan

16

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Application form 6 – General information about the promotional Agency

INFORMATION ABOUT THE PROMOTIONAL AGENCY

Name of the promotional Agency

Registered Head office of the promotional Agency

E-mail address of the promotional Agency

Tax number of the promotional Agency

Person authorised to represent the promotional Agency (name, surname, position)E-mail address of the person authorised to represent the promotional Agency

Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

17

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Application form 7 – Declaration about paid dues

DECLARATION ABOUT PAID DUES

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the leader____________________________(company) with the Head office in____________________, declare that____________________________(company) at the moment of giving this declaration has no unpaid dues such as tourist tax, tourist membership fees or any other financial debts to the CNTB, as well as no unpaid dues arising from business with Croatian legal entities and individuals based on enforceable court judgments.

In________________________,_________,________2015Place Date

Stamp

_______________________________(Signature of the person authorised

to represent the Leader)

18

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Application form 8 – Declaration of the undertaking that he is not in difficulty

DECLARATION OF THE UNDERTAKING THAT HE IS NOT IN DIFILCUTIY

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the leader____________________________(company) with the Head office in____________________, declare that____________________________(company) at the moment of giving this declaration is not in difficulty.

Further, I declare that I agree with the obligation to provide CNTB with additional documentation if asked, to determine with certainty that ____________________________(company) is not in difficulty

In________________________,_________,________2015Place Date

Stamp

________________________________________(Signature of the person authorised to

represent the leader)

19

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Application form 9 – Declaration of the undertaking about all entities controlled by the undertaking on a legal or de facto basis

D E C L A R A T I O N OF T H E U N D E R T A K I N G ABOUT A L L E N T I T I E S CO N T R O L L E D B Y T H E U N D E R T A K I N G

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the leader____________________________(company) with the Head office in____________________, declare that the____________________________(company) is associated with following entities:

No NAME AND ADRESS OF THE UNDERTAKING PERSON AUTHORISED TO REPRESENT THE UNDERTAKING

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

In________________________,_________,________2015Place Date

Stamp

________________________________________(Signature of the person authorised to

represent the leader)

20

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Application form 10 – Declaration of the undertaking about all received de minimis aid in the current and previous two fiscal years

DECLARATION OF THE UNDERTAKING ABOUT ALL RECEIVED STATE AID IN THE CURRENT AND PREVIOUS TWO FISKAL

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the leader____________________________(company) with the Head office in____________________, declare that the____________________________(company) received in the current and previous two fiscal years, regardless of the level of the aid provider (national, regional, local), following de minimis aid:

No STATE AID PROVIDER 2013. 2014. 2015.AMOUNT IN KUNA AMOUNT IN KUNA AMOUNT IN KUNA

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

In________________________,_________,________2015Place Date

Stamp________________________________________

(Signature of the person authorised to represent the leader)

21

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ANNEX 3c: MODEL III – ADVERTISING OF ORGANISED TRAVEL PROGRAMMES BY THE CHARTER CONSOLIDATOR

Application form 1 – General information about the charter consolidator

Name of the charter consolidator

Registered Head office of the charter consolidator

E-mail address of the charter consolidator

Tax number of the charter consolidator

Person authorised to represent the charter consolidator (name, surname, position)

E-mail address of the person authorised to represent the charter consolidator

Share in the nominated Media plan in the absolute amount (without VAT)

Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

Number of beds in hotels

Number of beds in camping sites

Number of beds in other types of accommodation premises

Estimated total number of achieved tourist arrivals in 2015

Estimated total number of achieved tourist overnight stays in 2015

Planned total number of tourist arrivals in 2016

Planned total number of tourist overnight stays in 2016

Signature of the person authorised to represent the Charter consolidator Stamp of the Charter consolidator

_________________________________

Place ___________________________

Date ___________________________

22

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Application form 2 – Information about the programme by the consolidator of organised travel to Croatia in 2016

No. List of departure airports abroadList of arrival airports in Croatia

Time period of operations in 2016

(starting and end date)

Planned number of rotations in 2016

Total number of planned seats in the charter to Croatia2015 2016 2017 2018

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.TOTAL NOMINATED NUMBER OF PLANNED SEATS TO CROATIA IN 2016

TOTAL NOMINATED NUMBER OF PLANNED TRAVELLERS TO CROATIA IN 2016

With financial and legal liability, we confirm the accuracy of the above stated information. All data are subject to the control of the State Inspectorate of the Republic of Croatia

Signature of the person authorised to represent the Charter consolidator Stamp of the Consolidator

_________________________________

Place ___________________________

Date ___________________________

23

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Application form 3 – List of TO/TA that the charter consolidator nominates in 2016

No.Exact name and address of the

TO/TA which has leased seats at the consolidator

Country of the TO/TA that

consolidator nominates

Number of leased seats at the consolidator for

Croatia

Number of travellers

2015 Plan for 2016

2015 Plan for 2016

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

TOTAL NUMBER OF PLANNED SEATS FOR CROATIA IN 2016TOTAL NOMINATED NUMBER TRAVELLERS FOR CROATIA IN 2016

With financial and legal liability, we confirm the accuracy of the above stated information. All data are subject to the control of the State Inspectorate of the Republic of Croatia

Signature of the person authorised to represent the Charter consolidator Stamp of the Consolidator

_________________________________

Place ___________________________

Date ___________________________

24

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Application form 4 – Media plan

25

Page 26: croatia.hr · Web viewAll data are subject to the control of the State Inspectorate of the Republic of Croatia Signature of the person authorised to represent The Consolidator of

Application form 5 – General information about the promotional Agency

INFORMATION ABOUT THE PROMOTIONAL AGENCY

Name of the promotional Agency

Registered Head office of the promotional Agency

E-mail address of the promotional Agency

Tax number of the promotional Agency

Person authorised to represent the promotional Agency (name, surname, position)E-mail address of the person authorised to represent the promotional Agency

Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

26

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Application form 6 – Declaration about paid dues

DECLARATION ABOUT PAID DUES

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the charter consolidator____________________________(company) with the Head office in____________________, declare that____________________________(company) at the moment of giving this declaration has no unpaid dues such as tourist tax, tourist membership fees or any other financial debts to the CNTB, as well as no unpaid dues arising from business with Croatian legal entities and individuals based on enforceable court judgments.

In________________________,_________,________2015Place Date

Stamp

_________________________________ (Signature of the person authorised to

represent the Charter consolidator)

27

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Application form 7 – Declaration of the undertaking that he is not in difficulty

DECLARATION OF THE UNDERTAKING THAT HE IS NOT IN DIFILCUTIY

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the charter consolidator____________________________(company) with the Head office in____________________, declare that____________________________(company) at the moment of giving this declaration, is not in difficulty.

Further, I declare that I agree with the obligation to provide CNTB with additional documentation if asked, to determine with certainty that ____________________________(company) is not in difficulty

In________________________,_________,________2015Place Date

Stamp

________________________________________(Signature of the person authorised to

represent the charter consolidator)

28

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Application form 8 – Declaration of the undertaking about all entities controlled by the undertaking on a legal or de facto basis

D E C L A R A T I O N OF T H E U N D E R T A K I N G ABOUT A L L E N T I T I E S CO N T R O L L E D B Y T H E U N D E R T A K I N G

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the charter consolidator____________________________(company) with the Head office in____________________, declare that the____________________________(company) is associated with following entities:

No NAME AND ADRESS OF THE UNDERTAKING PERSON AUTHORISED TO REPRESENT THE UNDERTAKING

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

In________________________,_________,________2015Place Date

Stamp

________________________________________(Signature of the person authorised to

represent the charter consolidator)

29

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Application form 9 – Declaration of the undertaking about all received de minimis aid in the current and previous two fiscal years

DECLARATION OF THE UNDERTAKING ABOUT ALL RECEIVED STATE AID IN THE CURRENT AND PREVIOUS TWO FISKAL

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the charter consolidator____________________________(company) with the Head office in____________________, declare that the____________________________(company) received in the current and previous two fiscal years, regardless of the level of the aid provider (national, regional, local), following de minimis aid:

No STATE AID PROVIDER 2013. 2014. 2015.AMOUNT IN KUNA AMOUNT IN KUNA AMOUNT IN KUNA

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

In________________________,_________,________2015Place Date

Stamp

________________________________________(Signature of the person authorised to

represent the charter consolidator)

30

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ANNEX 3d: MODEL III – THE ADVERTISING OF ORGANISED TRAVEL PROGRAMMES BY THE CONSOLIDATOR OF ORGANISED TRAVELApplication form 1 – General information about the consolidator of organised travel programmes

Name of the consolidator of organised travel

Registered Head office of the consolidator of organised travel

E-mail address of the consolidator of organised travel

Tax number of the consolidator of organised travel

Person authorised to represent the consolidator of organised travel (name, surname, position)E-mail address of the person authorised to represent the consolidator of organised travelShare in the nominated Media plan in its absolute amount (without VAT)

Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

Number of beds in hotels

Number of beds in camping sites

Number of beds in other types of accommodation premisesEstimated total number of achieved tourist arrivals in 2015Estimated total number of achieved tourist overnight stays in 2015

Planned total number of tourist arrivals in 2016

Planned total number of tourist overnight stays in 2016

Signature of the person authorised to represent the Consolidator of organised travel Stamp of the Consolidator of organised travel

_________________________________

Place___________________________

Date ___________________________

31

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Application form 2 – Information about the programme by the consolidator of organised travel to Croatia in 2016

Indicators Total Croatia Istria Kvarner

Region Zadar Šibenik Split Dubrovnik City ofZagreb Inland

Expected number of travellers in 2015TotalWith organised airline transportWith organised bus transportTotal number of leased beds in all commercial accommodation premises in 2015Planned number of travellers201620172018Total number of leased beds in all commercial accommodation premises for 2016TotalIn hotelsIn rooms and apartments in private accommodationIn camping sitesOn boatsIn other accommodationAirline charter transport in 2016Total planned number of seatsTotal planned number of travellersPlanned number of rotations and starting and end date of charter programmes for each departure airport

32

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Specially organised bus transport in 2016Total planned number of travellersPlanned number of rotations and starting and end date of the bus programme for each country from where tourists come

With financial and legal liability, we confirm the accuracy of the above stated information. All data are subject to the control of the State Inspectorate of the Republic of Croatia

Signature of the person authorised to representThe Consolidator of organised travel Stamp of the Consolidator of organised travel

_________________________________

Place ___________________________

Date ___________________________

33

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Application form 3 – List of TO/TA that the charter consolidator of organised travel programmes nominates in 2016

No. Exact name and address of TO/TA that the consolidator of organised travel nominates

Country of TO/TA that the

consolidator nominates

Number of travellers to Croatia

2015 Plan for 2016

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

TOTAL NOMINATED NUMBER OF TRAVELLERS TO CROATIA IN 2016

With financial and legal liability, we confirm the accuracy of the above stated information. All data are subject to the control of the State Inspectorate of the Republic of Croatia

Signature of the person authorised to represent Stamp of the Consolidator of organised programmesThe Consolidator of organised programmes

_________________________________

Place ___________________________

Date ___________________________

34

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Application form 4- Certificate about the number of leased beds

CERTIFICATE ABOUT THE NUMBER OF LEASED BEDS IN 2016

I_______________________(name and surname) from__________________________, as a person authorised to represent the holder of the accommodation offer __________________________(company) with the Head office in______________________ declare that_______________________(consolidator) in the registered hotel accommodation premises of our company, in 2016, has leased in total____________________beds.

In _________________,__________2015(Place) (date)

Stamp

_________________________________

(Signature of the person authorised to represent the holder of the accommodation offer)

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Application form 5 - Media plan

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Application form 6 - General information about the promotional Agency

INFORMATION ABOUT THE PROMOTIONAL AGENCY

Name of the promotional Agency

Registered Head office of the promotional Agency

E-mail address of the promotional Agency

Tax number of the promotional Agency

Person authorised to represent the promotional Agency (name, surname, position)E-mail address of the person authorised to represent the promotional Agency

Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

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Application form 7 – Declaration about paid dues

DECLARATION ABOUT PAID DUES

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the consolidator of organised travel____________________________(company) with the Head office in____________________, declare that____________________________(company) at the moment of giving this declaration has no unpaid dues such as tourist tax, tourist membership fees or any other financial debts to the CNTB, as well as no unpaid dues arising from business with Croatian legal entities and individuals based on enforceable court judgments.In________________________,_________,________2015Place Date

Stamp

_________________________________ (Signature of the person authorised to represent

the Consolidator of organised travel)

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Application form 8 – Declaration of the undertaking that he is not in difficulty

DECLARATION OF THE UNDERTAKING THAT HE IS NOT IN DIFILCUTIY

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the consolidator of organised travel____________________________(company) with the Head office in____________________, declare that____________________________(company) at the moment of giving this declaration, is not in difficulty.

Further, I declare that I agree with the obligation to provide CNTB with additional documentation if asked, to determine with certainty that ____________________________(company) is not in difficulty

In________________________,_________,________2015Place Date

Stamp________________________________________

Signature of the person authorised to represent theconsolidator of organised travel

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Application form 9 – Declaration of the undertaking about all entities controlled by the undertaking on a legal or de facto basis

D E C L A R A T I O N OF T H E U N D E R T A K I N G ABOUT A L L E N T I T I E S CO N T R O L L E D B Y T H E U N D E R T A K I N G

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the consolidator of organised travel____________________________(company) with the Head office in____________________, declare that the____________________________(company) is associated with following entities:

No NAME AND ADRESS OF THE UNDERTAKING PERSON AUTHORISED TO REPRESENT THE UNDERTAKING

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

In________________________,_________,________2015Place Date

Stamp________________________________________

Signature of the person authorised to represent theconsolidator of organised travel

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Application form 10 – Declaration of the undertaking about all received de minimis aid in the current and previous two fiscal years

DECLARATION OF THE UNDERTAKING ABOUT ALL RECEIVED STATE AID IN THE CURRENT AND PREVIOUS TWO FISKAL

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the consolidator of organised travel____________________________(company) with the Head office in____________________, declare that the____________________________(company) received in the current and previous two fiscal years, regardless of the level of the aid provider (national, regional, local), following de minimis aid:

No STATE AID PROVIDER 2013. 2014. 2015.AMOUNT IN KUNA AMOUNT IN KUNA AMOUNT IN KUNA

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

In________________________,_________,________2015Place Date

Stamp________________________________________

Signature of the person authorised to represent theconsolidator of organised travel

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ANNEX 4: MODEL IV – ADVERTISING OF SPECIAL PROGRAMMES BY DESTINATIONApplication form 1 – General information about the County Tourist Board

Name of the County Tourist Board

Registered Head office of the County Tourist Board

E-mail address of the County Tourist Board

Tax number of the County Tourist Board

Person authorised to represent the County Tourist Board (name,surname,position)E-mail address of the person authorised to represent the County Tourist BoardShare in the nominated Media plan in its absolute amount (without VAT)

Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

Number of beds in hotels

Number of places in camping sites

Number of beds in other types of accommodation premisesEstimated total number of achieved tourist arrivals in 2015Estimated total number of achieved tourist overnight stays in 2015

Planned total number of tourist arrivals in 2016

Planned total number of tourist overnight stays in 2016

Signature of the person authorised to represent the County Tourist Board Stamp of the County Tourist Board

_________________________________

Place ___________________________

Date ___________________________

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Application form 2 - General information about the carrier, TO/TA or organiser

Name of the carrier, TO/TA or organiser

Registered Head office of the carrier, TO/TA or organiser

E-mail address of the carrier, TO/TA or organiser

Tax number of the carrier, TO/TA or organiser

Person authorised to represent the carrier, TO/TA or organiser (name, surname, position)E-mail address of the person authorised to represent the carrier, TO/TA or organiserShare in the nominated Media plan in its absolute amount (without VAT)

Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

Number of beds in hotels

Number of places in camping sites

Number of beds in other accommodation premises

Estimated total number of achieved tourist arrivals in 2015Estimated total number of achieved overnight stays in 2015

Planned total number of tourist arrivals in 2016

Planned total number of tourist overnight stays in 2016

Signature of the person authorised to Stamp of the carrier, TO/TA or organiserrepresent the carrier, TO/TA or organiser

_________________________________

Place ___________________________

Date ___________________________

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Application form 3 – Declaration about the planned number of travellers

DECLARATION ABOUT THE PLANNED NUMBER OF TRAVELLERS

I__________________________(name and surname) from _____________________________, as a person authorised to represent the carrier, TO/TA or organiser _________________________(company) with the Head office in ________________________declare that, on the basis of advertising the nominated programme, __________________________(company), plans to bring in the area of ________________________________(CTB), ________________travellers.

In ____________________,____________2015(Place) (Date)

Stamp

_________________________________ (Signature of the person authorised to represent

the carrier, TO/TA or organiser)

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Application form 4 – Media plan

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Application form 5 – General information about the promotional Agency

INFORMATION ABOUT THE PROMOTIONAL AGENCY

Name of the promotional Agency

Registered Head office of the promotional Agency

E-mail address of the promotional Agency

Tax number of the promotional Agency

Person authorised to represent the promotional Agency (name, surname, position)E-mail address of the person authorised to represent the promotional Agency

Name of the bank

Address of the bank

Giro account number/IBAN/SWIFT

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Application form 6 – Declaration about paid dues

DECLARATION ABOUT PAID DUES

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the carrier, TO/TA or organiser____________________________(company) with the Head office in____________________, declare that____________________________(company) at the moment of giving this declaration has no unpaid dues such as tourist tax, tourist membership fees or any other financial debts to the CNTB, as well as no unpaid dues arising from business with Croatian legal entities and individuals based on enforceable court judgments.In________________________,_________,________2015Place Date

Stamp

_________________________________(Signature of the person authorised to represent

the carrier, TO/TA or organiser)

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Application form 7 – Declaration of the undertaking that he is not in difficulty

DECLARATION OF THE UNDERTAKING THAT HE IS NOT IN DIFILCUTIY

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the carrier, TO/TA or organiser ____________________________(company) with the Head office in____________________, declare that____________________________(company) at the moment of giving this declaration is not in difficulty.

Further, I declare that I agree with the obligation to provide CNTB with additional documentation if asked, to determine with certainty that ____________________________(company) is not in difficulty

In________________________,_________,________2015Place Date

Stamp

________________________________________Signature of the person authorised to represent the

carrier, TO/TA or organiser

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Application form 8 – Declaration of the undertaking about all entities controlled by the undertaking on a legal or de facto basis

D E C L A R A T I O N OF T H E U N D E R T A K I N G ABOUT A L L E N T I T I E S CO N T R O L L E D B Y T H E U N D E R T A K I N G

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the carrier, TO/TA or organiser ____________________________(company) with the Head office in____________________, declare that the____________________________(company) is associated with following entities:

No NAME AND ADRESS OF THE UNDERTAKING PERSON AUTHORISED TO REPRESENT THE UNDERTAKING

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

In________________________,_________,________2015Place Date

Stamp

________________________________________Signature of the person authorised to represent the

carrier, TO/TA or organiser

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Application form 9 – Declaration of the undertaking about all received de minimis aid in the current and previous two fiscal years

DECLARATION OF THE UNDERTAKING ABOUT ALL RECEIVED STATE AID IN THE CURRENT AND PREVIOUS TWO FISKAL

I, ________________________________(name and surname) from______________________________, as a person authorised to represent the carrier, TO/TA or organiser ____________________________(company) with the Head office in____________________, declare that the____________________________(company) received in the current and previous two fiscal years, regardless of the level of the aid provider (national, regional, local), following de minimis aid:

No STATE AID PROVIDER 2013. 2014. 2015.AMOUNT IN KUNA AMOUNT IN KUNA AMOUNT IN KUNA

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

In________________________,_________,________2015Place Date

Stamp

________________________________________Signature of the person authorised to represent the

carrier, TO/TA or organiser

50