Annex V

010

Legal entity name

Bank A

020

Legal idenfier

111

030

Governing law of the liabilities

EEA

040

Date

12/31/2013

Counterparties

Debt with a legal subordination qualifying as additional tier 1

Debt with a legal subordination qualifying as tier 2

Debt with a legal subordination

Senior unsecured debt

Deposits

Secured debt

Other liabilities excluded by Article 44(2) of BRRD

Derivatives

TOTAL

< 1 month

< 1 year

> 1 year

< 1 month

< 1 year

> 1 year

< 1 month

< 1 year

> 1 year

Total

of which eligible deposits

of which covered deposits

Exposure after prudential netting

Exposure after deducting margin and collateral

010

020

030

040

050

060

070

080

090

100

110

120

130

140

150

160

170

180

050

Natural persons

055

of which eligible liabilities

060

Micro, small and medium-sized enterprises

065

of which eligible liabilities

070

Large non-financial enterprises

075

of which eligible liabilities

080

Institutions

085

of which eligible liabilities

090

Insurance firms and pension funds

095

of which eligible liabilities

100

Other financial undertakings

105

of which eligible liabilities

110

Intragroup

115

of which eligible liabilities

120

Government, central banks and supranationals

125

of which eligible liabilities

130

Others/non-identified

140

of which eligible liabilities

150

TOTAL

160

Total eligible liabilities