DATA THAT ARE ENTERED INTO THE SYSTEM WHEN MAKING POLICIES FOR ALL NON-LIFE INSURANCE CLASSES

GENERAL POLICY DATA FOR ALL CLASSES:

BRANCH OFFICE POLICYHOLDER INSURED INSURER SALE SPOT NUMBER CLASS COMMERCIAL INSURANCE HOUSEHOLDS INSURANCE INDUSTRY INSURANCE LIVESTOCK INSURANCE CROPS INSURANCE GOODS-IN-TRANSIT INSURANCE CREDIT INSURANCE MOTOR HULL INSURANCE MTPL INSURANCE FILIJALA UGOVARA OSIGURANIK OSIGURAVA PRODAJNO MESTO GRANA COMMERCIAL INSURANCE HOUSEHOLDS INSURANCE INDUSTRY INSURANCE LIVESTOCK INSURANCE CROPS INSURANCE TRANSPORT INSURANCE CREDIT INSURANCE MOTOR HULL INSURANCE MOTOR TPL INSURANCE

RAILWAY INSURANCE GENERAL LIABILITY INSURANCE ACCIDENT INSURANCE LIFE INSURANCE HEALTH INSURANCE PENSION INSURANCE FOREIGN TERMS FINANCIAL LOSS UNKNOWN INSURANCE CLASS

RAILWAY INSURANCE GENERAL LIABILITY INSURANCE ACCIDENT INSURANCE LIFE INSURANCE HEALTH INSURANCE PENSION INSURANCE FOREIGN TERMS FINANCIAL LOSSES UNKNOWN INSURANCE CLASS

TARIFF TARIFF GROUP OLD POLICY NUMBER BASIC POLICY NUMBER COVER NOTE REPLACEMENT MANUAL OR AUTOMATIC NUMBER ASSIGNMENT PLACE OF INSURANCE POLICY TYPE SEGMENT 99 100 101 102 103 104 105 106 LEGAL ENTITIES PERSONS - CITIZENS PERSONS - COLLECTIVELY PERSONS - COOPERATION PERSONS - FOREIGNER PERSONS - ENTREPRENEUR PERSONS - COLLECTIVELY, INVOICED PERSONS - COLLECTIVELY, WITHOUT INVOICEMENT

TARIFA TARIFNA GRUPA BROJ STARE POLISE BROJO OSNOVNE POLISE ZAMENA LISTA POKRIA RUCNA ILI AUTOMATSKA DODELA BROJA MESTO OSIGURANJA VRSTA POLISE SEKTOR LEGAL ENTITIES PERSONS - CITIZENS PERSONS - COLLECTIVELY PERSONS - COOPERATION PERSONS - FOREIGNER PERSONS - ENTERPRENEUR PERSONS - COLLECTIVELY, INVOICED PERSONS - COLLECTIVELY, WITHOUT INVOICEMENT

DATE OF POLICY INCEPTION DATE OF POLICY EXPIRY DATE OF INSURANCE INCEPTION DATE OF INSURANCE EXPIRY DATE OF POLICY UNDERWRITING PLACE OF UNDERWRITING METHOD OF INSURANCE FIXED AGREED VALUE FLOATING VALUE FIRST LOSS REAL VALUE OF VEHICLE FIRST LOSS TAXED VALUE OTHER

DATUM POCETKA OBRACUNA DATUM ISTEKA OBRACUNA VREME POCETKA OSIGURANJA VREME ISTEKA OSIGURANJA DATUM ZAKLJUENJA POLISE MESTO ZAKLJUENJA TEHNIKI NAIN OSIGURANJA FIKSED AGREED VALUE FLOATING VALUE FIRST LOSS REAL VALUE OF VEHICLE FIRST LOSS TAXED VALUE OTHERS

METHOD OF PREMIUM CALCULATION 1 2 3 4 ANNUAL PRO-RATA PRO-SCALE WITHOUT CORRECTION

NAIN OBRAUNA PREMIJE ANNUAL PRO-RATA PRO-SCALE WITHOUT CORRECTION

CONTRACT NUMBER CONTRACT PERIOD CONTRACT INCEPTION DATE CONTRACT EXPIRY DATE CLAUSES

BROJ UGOVORA TRAJANJE UGOVORA DATUM POETKA UGOVORA DATUM ISTEKA UGOVORA KLAUZULE

MOTOR CASCO SPECIFIC DATA

GEOGRAPHICAL AREA LEASING OR NO MORE THAN 5 VEHICLES OR NO GEOGRAFSKO PODRUCJE LIZING ILI NE VISE OD 5 VOZILA ILI NE

NUMBER OF VEHICLES INSURED NUMBER OF CLAIMS-FREE YEA RS BONUS EXTRA BONUS NUMBER OF ACCIDENT POLICY SYISTEM BONUS MALUS NUMBER OF YEARS OF DRIVING EXPERIENCE

BROJ VOZILA NA POLISI BROJ GODINA BEZ STETE BONUS EKSTRA BONUS BROJ POLISE NEZGODE SISTEMSKI BONUS MALUS BROJ GODINA VOZAKOG STAA

Picture 1 FORM REPRESENTING NEW CASCO POLICY (the form contains all general data common for all classes)

AGRICULTURE CROPS, LIVESTOCK SPECIFIC DATA

CULTURE GROUP CROP CULTURE INSURED AREA (HA) INSURED AREA (ARE) TERRITORIAL UNIT TYPE OF ANIMAL CODE OF PURPOSE OF LIVESTOCK PURPOSE NUMBER OF LIVESTOCK GRUPA KULTURE POLJOPRIVREDNA KULTURA OSIGURANA POVRINA (HA) OSIGURANA POVRINA (AR) TERITORIJALANA JEDINICA VRSTA ZIVOTINJA SIFRA NAMENE IVOTINJA NAMENA BROJ IVOTINJA

Picture 2. FORM USED FOR ENTRY OF SPECIFIC DATA REQUIRED FOR LIVESTOCK INSURANCE

Picture 3. FORM USED FOR ENTRY OF SPECIFIC DATA REQUIRED FOR CROPS INSURANCE

ACCIDENT - SPECIFIC DATA

NUMBER OF INSURED PERSONS TYPE OF BENEFICIARY NAME AND SURNAME OF THE BENEFICIARY RELATIONSHIP OF THE BENEFICIARY BIRTHDATE OF THE BENEFICIARY ADDITIONAL CONDITIONS SPECIAL CONDITIONS NAME OF THE INSURED BROJ OSIGURANIH LICA VRSTA KORISNIKA NAKDNADE IME I PREZIME KORISNIKA NAKNADE SRODSTVO KORISNIKA NAKNADE DATUM ROENJA KORISNIKA NAKDNADE DOPUNSKI USLOVI POSEBNI USLOVI NAZIV OSIGURANIKA

GOODS-IN-TRANSIT - SPECIFIC DATA

DOMESTIC OR INTERNATIONAL EXPORT IMPORT TRANSPORT FROM TRANSPORT TO CURRENCY CODE CARRIERS ORDER NUMBER REFERENCE NUMBER IDENTIFICATION NUMBER OF THE MEANS OF TRANSPORTATION SHIPS FLAG SHIPS CODE NAME OF THE SHIP DISTANCE DISTANCE VIA DISPATCH OF SHIPMENT DOMACI ILI MEDJUNARODNI UVOZ IZVOZ RELACIJA OD RELACIJA DO SIFRA VALUTE BROJ POZICIJE SPEDITERA BROJ ZAKLJUCKA OZNAKA PREVOZNOG SREDSTVA ZASTAVA BRODA SIFRA BRODA IME BRODA VRSTA RELACIJA RELACIJA PREKO POLAZAK POSILJKE

MEANS OF TRANSPORTATION MAR POLICY (ENGLISH SYMBOL) REPORT ISSUED BY INSURANCE TERMS AND CONDITIONS TYPE OF GOODS WEIGHT OF GOODS NUMBER OF PIECES OF FREIGHT RISKS COVERED PREMIUM PERCENTAGE IN SERBIA

PREVOZNO SREDSTVO MAR POLISA (ENGLESKA OZNAKA) ZAPISNIK OD USLOVI OSIGURANJA VRSTA ROBE TEZINA ROBE BROJ KOLETA ILI KOMADA OSIGURANI RIZICI PROCENAT PREMIJE U SRBIJI

HEALTH SPECIFIC DATA

NUMBER OF INSURED PERSONS TYPE OF VISA REGION OF TRAVEL COUNTRY OF TRAVEL METHOD OF INSURANCE HEALTH PASSPORT NO. CONDITIONS SURGICAL INTERVENTIONS CONDITIONS SERIOUS ILLNESSES BROJ OSIGURANIK LICA VRSTA VIZE VARIJANTA PUTOVANJA PODVARIJANTA PUTOVANJA NAIN OSIGURANJA ZDRAVSTVENO BROJ PASOA USLOVI HIRUSKE INTERVENCIJE USLOVI TEE BOLESTI

MTPL SPECIFIC DATA

TECHNICAL RESULT NUMBER OF CLAIMS-FREE YEARS BONUS DATE OF BONUS TEHNIKI REZULTAT BROJ GODINA BEZ TETE BONUS DATUM BONUSA

INFORMATION ON THE BUSINESS PARTNER, WHETHER HE IS A FOREIGNER, NATURAL PERSON, ENTREPRENEUR, OR LEGAL ENTITY

Picture 4. FORM USED FOR ENTRY OF GENERAL DATA REQUIRED FOR NEW BUSINESS PARTNER IDENTIFICATION NUMBER NAME FORM OF REGISTRATION STREET NUMBER PLACE ADDITIONAL PLACE EIN (EMPLOYER IDENTIFICATION NUMBER) NOTE LEASING COMPANY REGISTERED NUMBER SIC CODE TYPE OF CONTACT CATEGORY OF CONTACT UNIQUE MASTER CITIZEN NUMBER GENDER PHONE NUMBER EXTENSION DESCRIPTION BANK CURRENCY ACCOUNT NO. ACCOUNT BATCH NUMBER VALID FROM VALID TO DESCRIPTION MATINI BROJ NAZIV OBLIK REGISTROVANJA ULICA BROJ MESTO DODATNO MESTO PIB NAPOMENA LIZING KUCA REGISTARSKI BROJ SIFRA DELATNOSTI VRSTA KONTAKTA KATEGORIJA KONTAKTA JMBG POL LOKAL OPIS BANKA VALUTA BROJ RACUNA BROJ PARTIJE POCETAK VAZENJA ISTEK VAZENJA OPIS MATINI BROJ

BUSINESS PARTNER DETAILS NATURAL PERSON

DDOR EMPLOYEE OR NOT IDENTIFICATION NUMBER CONTACT PERSON AT DDOR MARITAL STATUS SPOUSES OCCUPATION CHILDREN / BIRTH DATE EDUCATION HOBBY MEMBERSHIP HOUSE/FLAT PETS SPORTS HOUSEHOLD TRAVELS VEHICLE YEAR OF MANUFACTURE OWNED LAND POLICY TYPE NUMBER OF POLICIES PREMIUM POTENTIAL OR NOT DATE OF LAST MEETING COMMENTS COMPUTER RADNIK DDORA ILI NE MATINI BROJ DDOR KONTAKT OSOBA BRANO STANJE ZANIMANJE BRANOG DRUGA DECA/DATUMI ROENJA OBRAZOVANJE HOBIJI LANTVA KUA/STAN KUNI LJUBIMCI SPORT DOMAINSTVO PUTOVANJA VOZILO GODITE ZEMLJA U POSEDU VRSTA POLISE BROJ POLISA PREMIJA POTENCIJALNI ILI NE DATUM POSLEDNJEG SASTANKA KOMENTARI KOMPJUTER

Picture 5. FORM USED FOR ENTRY OF SPECIFIC DATA REQUIRED FOR BUSINESS PARTNER - NATURAL PERSON

BUSINESS PARTNER DETAILS LEGAL ENTITY

DDOR EMPLOYEE OR NOT IDENTIFICATION NUMBER CONTACT PERSON AT DDOR POLICY TYPE NUMBER OF POLICIES PREMIUM POTENTIAL OR NOT DATE OF LAST MEETING COMMENTS DESCRIPTION OF BUSINESS NAME OF CONTACT PERSON SURNAME OF CONTACT PERSON POLE OF CONTACT PERSON REGISTERED AS NATURAL PERSON INCOME IN PREVIOUS YEAR PROFIT IN PREVIOUS YEAR TOTAL ASSETS REAL ESTATE/PROPERTY (QUANTITY AND VALUE OF PROPERTY IN RSD MIL.) COMPUTER EQUIPMENT (RSD MIL.) BALANCE OF ASSETS IN PREVIOUS YEAR LIABILITIES IN PREVIOUS YEAR CREDIT STANDING TECHNIAL RESULT CONTRACT ON INSURANCE OF EMPLOYEES INFORMATION ON INSURANCE OF EMPLOYEES NOTES RADNIK DDORA ILI NE MATINI BROJ DDOR KONTAKT OSOBA VRSTA POLISE BROJ POLISA PREMIJA POTENCIJALNI ILI NE DATUM POSLEDNJEG SASTANKA KOMENTARI OPIS DELATNOSTI IMA KONTAKT OSOBE PREZIME KONTAKT OSOBE ULOGA KONTAKT OSOBE REGISTROVAN KAO FIZIKO PRIHOD PRETHODNE GODINE PROFIT PRETHODNE GODINE UKUPNA SREDSTVA NEPOKRETNOSTI/IMOVINA(BROJ I VREDNOST IMOVINE U MIL. RSD) KOMPJUTERSKA OPREMA(MILIONA RSD) STANJE SREDSTAVA PRETHODNE GODINE DUGOVANJA PRETHODNE GODINE KREDITNA SPOSOBNOST TEHNIKI REZULTAT UGOVOR OSIGURANJA ZAPOSLENIH PODACI O OSIGURANJU ZAPOSLENIH NAPOMENE

Picture 6. FORM USED FOR ENTRY OF SPECIFIC DATA REQUIRED FOR BUSINESS PARTNER LEGAL ENTITY

VEHICLE INFORMATION

GENERAL VEHICLE INFORMATION

VEHICLE TYPE REGISTRATION PLATE FOREIGN PLATES OR NOT OWNERS IDENTIFICATION NUMBER SURNAME OF OWNER NAME OF OWNER CATALOGUE REFERENCE MAKE VEHICLE MAKE VEHICLE TYPE CATALOGUE REFERENCE TYPE CHASSIS NUMBER CAR BODY (OBLIK KAROSERIJE) YEAR OF MANUFACTURE ENGINE NUMBER ENGINE POWER ENGINE CUBAGE TECHNIAL CAPACITY NUMBER OF SEATS NUMBER OF STANDING PLACES DATE OF FIRST REGISTRATION VRSTA VOZILA REGISTARSKA OZNAKA STRANE TABLICE ILI NE MATICNI BROJ VLASNIKA PREZIME VLASNIKA IME VLASNIKA KATALOSKA MARKA MARKA VOZILA TIP VOZILA KATALOSKI TIP BROSJ SASIJE OBLIK KAROSERIJE GODINA PROIZVODNJE BROJ MOTORA SNAGA MOTORA ZAPREMINA MOTORA TEHNIKA NOSIVOST BROJ MESTA ZA SEDENJE BROJ MESTA ZA STAJANJE DATUM PRVE REGISTRACIJE

Picture 7. FORM USED FOR ENTRY OF GENERAL DATA ON VEHICLE

ADDITIONAL VEHICLE INFORMATION

WEIGHT OF EMPTY VEHICLE REGISTERED CAPACITY BASIC COLOR ADDITIONAL COLOR NUMBER OF AXLES NUMBER OF DRIVING SHAFTS NUMBER OF DOORS NUMBER OF WHEELS TOW HOOK OR NOT TYPE OF FUEL GENERAL PURPOSE REGISTRATION CARD NUMBER PLACE OF FIRST REGISTRATION ORIGINAL REGISTRATION PLATE (FIRST REGISTRATION) IDENTIFICATION NUMBER OF PREVIOUS OWNER SURNAME OF PREVIOUS OWNER NAME OF PREVIOUS OWNER COUNTRY OF MANUFACTURE NUMBER OF REGISTRY AT THE SECRETARIAT OF PUBLIC SECURITY MASA PRAZNOG VOZILA DOZVOLJENA NOSIVOST BOJA OSNOVNA BOJA DODATNA BROJ OSOVINA BROJ POGONSKIH OSOVINA BROJ VRATA BROJ TOKOVA KUKA ZA VUU ILI NE VRSTA GORIVA OSNOVNA NAMENA BROJ SAOBRAAJNE DOZVOLE MESTO PRVE REGISTRACIJE REG. OZNAKA PRVE REGISTRACIJE MATINI BROJ PRETHODNOG VLASNIKA PREZIME PRETHODNOG VLASNIKA IME PRETHODNOG VLASNIKA ZEMLJA PROIZVODNJE BROJ REGISTRA U SUP-U

Picture 8. FORM USED FOR ENTRY OF SPECIFIC DATA ON VEHICLE