Print-out date: 2023-12-19 hour.

14:38

Date Description Amount

Transaction date PRZELEW EXPRESS ELIXIR -100,00 PLN

2023-12-19
From account: 91 1090 2066 0000 0001 1973 2242
Booking date HASAN EREN AGIR UL. KOŚCIUSZKI 52A/9 59-220 LEGNICA
2023-12-19
To account: 82 1870 1045 2078 1016 8867 0001
Anna Kosmider

Reference: Przelew #Oplata sadowa od wniosku o zabezpiecznie.

The document is a computer printout and does not require any additional signatures or the bank's seal.

Santander Bank Polska S.A. with its registered office in Warsaw, al. Jana Pawła II 17, 00-854 Warsaw, registered in
the District Court for the capital city of Warsaw, 13th Commercial Division of the National Court Register,
under KRS no. 0000008723, NIP 896-000-56-73, REGON 930041341. Share capital: PLN 1 021 893 140.
Paid up share capital: PLN 1 021 893 140. Page 1/1