Private Sector Investment Survey 2010
Transcription
Private Sector Investment Survey 2010
Private Sector Investment Survey (PSIS) 2010 QUESTIONNAIRE To coordinate the development and maintenance of a National Statistical System To foster price stability and a sound financial system To promote and facilitate investment projects, provide serviced land, and advocate for a competitive business environment FOR COMMERCIAL BANKS ONLY Please help us monitor economic development and formulate better policies. AUGUST 2010 Private Sector Investment Survey (PSIS) 2010 A. Background 1. Introduction: Bank of Uganda (BOU), in conjunction with Uganda Bureau of Statistics (UBOS) and Uganda Investment Authority (UIA), are conducting the ninth survey on Private Sector Investment in Uganda. The survey will collect data on private capital, which includes stocks and flows (transactions) for the calendar years 2008 and 2009 and Investor Perceptions for the year 2010. The results of the previous eight surveys; Private Capital Flows Survey (PCF) 2001, Private Sector Investment Survey (PSIS) 2003, Foreign Private Capital (FPC) 2004, PSIS 2005 FPC 2006, PSIS 2007, PSIS 2008 and PSIS 2009 can be accessed from the following websites: http://www.bou.or.ug, http://www.ugandainvest.com and http://www.ubos.org; or by obtaining hard copies from the following; Director, Statistics Department, BOU; Executive Director, UIA; and Executive Director UBOS. 2. How do you benefit? Uganda has actively promoted the private sector as an engine of economic growth and development. The private sector continues to benefit from the overall macroeconomic stability resulting from formulation of appropriate domestic and external sector policies. However, information for formulating national macroeconomic policies requires accurate data from the private sector, which can only be obtained through administrative sources and regular surveys. The regular PSIS are intended to fill this information gap by: • Collecting vital information from the private entities on each sector’s performance in the economy. • Availing to the public and policymakers information in aggregate form for research and informed/prudent decision-making. • Facilitating effective planning and policies formulation, which benefit both the public and private sectors. • Enhancing dialogue and cooperation between the public and private sectors. It is important to note that conducting the surveys jointly under the Working Group arrangement caters for the data requirements of all stakeholder institutions, thus; reduces respondents’ fatigue and maximises the use of available resources. 3. Why do we need to collect this information? i) Following the enactment of the Investment Code 1991 and the freeing of the current and capital accounts in 1993 and 1997 respectively, both the domestic and external sectors were fully liberalized. As a result, private investment has increased tremendously to benefit our country by way of economic growth and development. However, this has also meant that the government is less able to monitor these flows for purposes of formulating i policies that would sustain and increase the current levels of economic growth and development. Therefore, by quantifying inward and outward investments we assess confidence in the economy to design policies to promote private sector investments. ii) Globalisation has meant that countries are more prone to external effects of market failures arising from external shocks such as the ones that hit South East Asian economies in the late 1990s, Latin America from 1998 to 2002 and the global financial crises 2007 2009. Such crisis can lead to foreign private capital reversal and negative consequences on the economy. In the absence of exchange controls, there is need for timely and reliable data on foreign assets and liabilities in order to formulate effective policies to mitigate any potential destabilizing effects. iii) The information sought is essential for financial sector management and planning for aversion of potential economic crises to foster stable and sustainable economic growth. It is also vital in Uganda’s investment promotion, facilitation and retention efforts. iv) Good quality economic statistics are necessary for better decision-making and to meet international standards and codes in reporting which include General Data Dissemination System (GDDS)1, System of National Accounts (SNA), External Debt Guide (EDG), etc. v) The information is required for the compilation of Uganda’s Balance of Payments (BOP) and the International Investment Position (IIP) statistics. vi) To assess how private cross border capital supplement domestic resources for investment and provide feedback from the private entities. The feedback is critical for policy fine tuning that benefits all stakeholders in the economy. vii) To assess the perceptions of the private sector investors on the investment climate in Uganda in order to evaluate the impact of the existing policies. 1 IMF (2009), Balance of Payments and International Investment Position Manual (BPM 6) ii B. Guidelines 1. Who should complete this questionnaire? The Chief Executive Officer or a representative of the targeted bank shall fill the questionnaire. 2. Which parts of the questionnaire does your bank have to fill? While the questionnaire might look long, please note that it is unlikely that all questions will be relevant to you, and you will not need to fill them in. Please complete Part 1 and 5, which are compulsory, and refer to the five (5) filtering questions in Table 1.13 (page 7 of 19) to identify those questions that will be relevant to your bank in order to save your valuable time. 3. What is the Legal Mandate to collect this data? The stakeholder institutions are empowered to collect this data by the Investment Code 1991, the Uganda Bureau of Statistics Act. 1998 and Foreign Exchange Act. 2004. We wish to re-assure you that all information provided by your Bank will be treated with strict confidentiality and will only be used in aggregated statistical format for analysis and policy formulation purposes. The interviewers and staff involved in the PSIS 2010 are under oath of secrecy not to disclose any Bank specific information to any third party individual/bank. The data/information collected will only be published in aggregate form. 4. Why are Financial Statements required? Much of the information required for this survey can be obtained from your annual financial statements for the years 2008, and 2009. Please provide a copy of your financial statements covering calendar years 2008, and 2009 along with the duly completed questionnaire. While this may not provide all the information we need, it may help us answer some questions we might have, in which case we would not need to come back to you for clarifications. In case, your audited financial statements are not ready the required data can be obtained from your bank’s interim financial statements, working estimates or management accounts. 5. Do you need assistance? Our interviewers are available to guide you on how to complete this questionnaire. In addition, the following offices are open for any further inquiries or clarifications; Title Department/Institution Telephone E-mail address Director (Coordinator) Statistics Department, 0414-231036 mkatarikawe@bou.or.ug Deputy Director F Commercial Banks Supervision Department, 0414-303215 gndyareeba@bou.or.ug BANK OF UGANDA. P.O. BOX 7120, Kampala. BANK OF UGANDA. iii 6. Completed questionnaire. The questionnaire can be filled promptly with assistance from our interviewers. The duly filled questionnaire will be collected by the interviewer or can be returned to the office of the Director, Statistics Department, Bank of Uganda, Plot 37/43, Kampala Road, P.O. Box 7120 Kampala before or within fourteen (14) days from the date of delivery. Otherwise, the interviewer will collect the duly filled questionnaire on the due date or earlier as agreed. 7. Will there be any feedback? Yes! As a way of promoting dialogue we will share with you the results of this survey in aggregate form and seek your further involvement in this exercise, as was the case in the earlier surveys. Aggregated results will also be posted on the following websites: http://www.bou.or.ug or http://www.ubos.org or http://www.ugandainvest.com THANK YOU FOR YOUR CONTINUED COOPERATION iv PLEASE READ THE FOLLOWING INSTRUCTIONS AND DEFINITIONS BEFORE COMPLETING THE QUESTIONNAIRE C. Instructions 1. Part 1 and Part 5 - Should be completed by ALL respondents. 2. Reporting period This questionnaire requests for stock position data on a calendar year basis (i.e., from 1st January to 31st December) as at 31st December 2008 and 2009 and flows/transactions during 2009 for Parts 1, 2, 3 and 4. If your bank’s financial statements are prepared on any other financial year basis other than on the calendar year, please take one of the following steps. If you produce: • quarterly or semi-annual accounts, please consolidate these so that the data you submit is consistent with the calendar year basis. • annual accounts and your reporting period is not calendar year, then please indicate this period to us on the questionnaire and provide estimates from 1st January to 31st December, based on your previous experience with the bank. Your best estimates, whether audited or not, are perfectly acceptable to us. For Investors’ Perception questions (Part 5), we request the current perception for the year 2010. 3. Currency of reporting Please provide all data in Uganda Shillings (UShs) except if you have foreign debts or credits denominated in foreign currencies applicable to Parts 3 and 4. 4. Units of Reporting Please report all data in actual amounts (to the last unit). For example, enter six million seven hundred eighty five thousand seven hundred forty one as 6,785,741 (and not as 6.786m). Please report all data in units (DO NOT ROUND OFF THE FIGURES). v D. Definitions of technical terms This questionnaire contains technical words, which are explained below in the context in which they are used. However, if you still encounter problems, and/or are uncertain of any terms or questions, please do not hesitate to call or email us for clarification (please refer to contacts under Guideline No.5, Page iii for any assistance). 1. Turnover The turnover of the Bank recorded during 2009 is requested for in Table 1.4. These figures reflect the bank’s total turnover inclusive of other income as recorded in the bank’s income statement. 2. Actual employment (number of jobs) Actual employment constitutes the number of permanent or temporary labour force employed in a given bank as at the end of the period. The data requested for are broken down by the nature of employment, local or foreign and by gender (sex) as shown in Table 1.5 as at 31 December 2009. Foreign employees are further disaggregated into those with short-term (less than 12 months and long-term (more than 12 months) periods of stay within Uganda. 3. Compensation of employees Compensation of employees by a bank includes salaries and wages, fringe benefits, pension funds, Directors’ fees and any other as requested for in Table 1.6 during 2009. Please note that, compensation of foreign employees is required to be detailed into short-term and long-term for BOP purposes. 4. Imports and exports Total Imports and Exports during 2009 are requested for in Table 1.7 and require values as per the market prices of an entity’s total imports and exports of goods and services, broken down by imports and/or exports from/to foreign affiliates/parent entity or unrelated entity. Imports of merchandise should be reported at Cost Insurance and Freight (CIF) value and Exports at Free on Board (FOB) value. 5. Actual Investments Actual investments are requested for in Table 1.8 and require book-value figures of the capital position/stock of the bank as at 31 December 2009. These figures can be obtained from the Bank’s audited financial statements or management accounts. 6. Corporate Social Responsibility Corporate Social Responsibility contributions are requested for in Table 1.11 as at 31 December 2009. This information can be obtained from the bank’s audited financial statements or management accounts. These may include donations, financing of environmental, infrastructure, educational programs, social and community services that benefit the country. Please do not include expenses incurred on promotional activities. vi 7. Filtering questions Table 1.12 consists of five (5) questions to help the respondent know which parts of the questionnaire are relevant to a particular bank. This table should be discussed verbally and completed by both the respondent and the interviewer during their first meeting for purposes of guidance and saving valuable time. 8. Residency In this questionnaire, Parts 1, 2, 3 and 4 are interested in operations between residents and nonresidents only (Residency considers the centre of the economic/business interest). You are a resident individual or bank if you have lived or operated (or intend to live or operate) in Uganda for a year or more, regardless of your nationality. Non-resident individuals or banks are basically the rest of the world i.e. they have lived or operated (or intend to live or operate) outside Uganda’s territory for a year or more (even if they are Ugandan). In Parts 2, 3 and 4, the focus is on residency and NOT the nationality. International Organisations (A Special Case of Residency) International Organisations have shareholders who are governments. They are thus not considered residents of any country, including the country in which they are located. If you have transactions with international organisations such as the East African Development Bank (EADB), African Development Bank (AfDB), International Finance Corporation (IFC) etc then, for Questions in Parts 2, 3 and 4 please treat all of them as non-residents. 9. Financial Derivatives Financial derivatives are financial instruments whose values are derived from the value of an underlying specific financial asset or index or commodity, and through which specific financial risks can be traded in financial markets in their own right. 10. Financial Instruments Financial instruments consist of Equity and Non-equity i) Equity refers to all shares held in entities or the equivalent ownership interest in your bank. ii) Non-equity refers to all other financial instruments including loans, trade credits (for goods and services), bonds, debentures, notes, money market instruments, shareholder and intercompany loans, arrears of debtor interest, currency, deposits etc. vii 11. Time of Recording of a Transaction Transactions in financial items are recorded on the day when there is a change of ownership. So, for instance, commitments to provide funds do not count as transactions for recording purposes until the necessary funds have actually been disbursed. If debt is exchanged for equity or other debt, then a transaction is recorded whereby principal is repaid and a new liability created. For positions in financial items, ownership is considered as the key. The positions are only recorded if the creditor owns a claim on the debtor. For other transactions, when goods are provided, a service is paid, interest accrues, or an event occurs that creates a transfer of claim, a debt liability is created and exists until payment is made or forgiven. 12. Dividends Declared and paid/received and Profits Remitted This data is requested for in Table 1.10 for all entities and Table 4.1 (row 12) for entities with foreign equity assets. Dividends are earnings distributed to shareholders or equivalent equity holdings for incorporated private entities, cooperatives and public corporations. Dividend Paid/Profits remitted Profits remitted/paid apply to branches (unincorporated entities) and dividends are declared returns on a shareholders’ equity. The payment of the dividends may be executed in the following financial year depending on the bank’s policy and cash flow. In practice, we find that the dividends are declared but paid/remitted later. The survey requests for both dividends declared and paid/remitted during 2009. 13. Net Profits and Retained (Reinvested) Earnings Net profits are the gross profits less corporation tax. Retained (reinvested) earnings are undistributed profits that are capitalised in the bank. Retained earnings/loss are computed by taking the net profit/loss less dividends declared for the period. Net profit and retained earnings are requested for in Tables 1.10 (row 1 and 4) for all entities. 14. Gains/loss from the sales of fixed assets and foreign exchange translation Gains/losses from the sales of fixed assets and foreign exchange translation are requested for in Table 1.9 for all entities. Gains/losses can be obtained from the bank’s income statement and associated notes to the accounts. 15. Investment relationship A direct investment relationship arises when an investor resident in one economy makes an investment that gives control or a significant degree of influence on the management of an enterprise that is resident in another economy. Control is determined to exist if the direct investor owns more than 50 per cent of the voting power in the direct investment enterprise (also called a subsidiary). A significant degree of influence is determined to exist if the direct investor owns from 10 to 50 percent of the voting power in the direct investment enterprise (also called associate). Therefore, Direct Investment is defined as any ownerships stake held by a non-resident in your Bank that is 10% or more of total equity and results into a Consolidated Direct Investment (CDI) relationship. The control or influence of the CDI may be immediate (through ownership of voting viii power) or indirect (through ownership of enterprises that in turn have voting power). Ownership in your bank by non-residents that is less than 10% of the total equity is reflected as Portfolio Investments (PI). However, there are other investment relationships that are also of interests. These include your bank owning more than 10% of the total equity of an investor that in turn holds less than 10% of your equity stake. This is referred to as reversed investments and the non-resident investing enterprise as a Direct Investment Enterprise (DIE). In addition the survey is interested in obtaining information about investors who have less than 10% of your bank’s equity but are also owned by another entity that has interest in your bank. Your bank and the investing entity with less than 10% of total equity are referred to as Fellow Enterprises (FE). These relationships are required in Table 1.3. 16. Foreign Equity Investment i) Foreign Direct Equity Investment (FDEI) This term is referred to in Tables 2.1 and 4.1. FDEI reflects having influence or control in the management decisions by a non-resident in your bank, or by your bank in a nonresident entity (Table 4.1). For the purpose of this survey, FDEI is defined as a shareholding of 10% or more. Therefore: • If a non-resident holds 10% or more of the ordinary shares, voting rights or equivalent in your bank, please complete Table 2.1 • If your bank own 10% or more of the ordinary shares, voting rights or equivalent in a non-resident entity, please complete Table 4.1 (Column A). ii) Foreign Portfolio Equity Investment (FPEI) This term is referred to in Tables 2.2 and 4.1 (Column B). FPEI refers to shareholding either by a non-resident in your bank (Table 2.2), or by your bank in a non-resident entity (Table 4.1 (Column B)). It does not however entail having influence in management decisions. For the purpose of this survey, FPEI is defined as a shareholding of less than 10%. Therefore: • If a non-resident holds less than 10% of the ordinary shares, voting rights or equivalent in your bank, please complete Table 2.2 • If your bank own less than 10% of the ordinary shares, voting rights or equivalent in a non-resident entity, please complete Table 4.1 (Column B) 17. Book Value (Nominal) and Market Value Tables 2.1, 2.2 and 4.1 require both book values and market values. i) Book Value of Equity Investment Book value comprises of paid up share capital (at historical cost), share premium reserves, accumulated retained earnings, revaluation and any other financing item of your bank. ix These items should be readily available from your bank’s financial statements. Accountants and financial managers refer to this as ‘shareholders’ funds’ or ‘owners equity’. ii) Market Value Market value is simply what you would be willing to pay to acquire something from a willing seller based on commercial consideration only at arms length. For example, think of building a house to sell; altogether the cost of land and construction was UShs100,000,000 (its book value), if you have built this house in an area where there is high demand for housing, you may estimate that you could obtain UShs150,000,000 from a willing buyer (its market price). If your bank is not listed on the stock exchange the market value should be assumed to be equal to the book values. However, if the book value is negative, then a financial officer/ accountant can estimate the possible sale value based on commercial consideration or market value of similar Bank in the same sector. In order to meet international best practices, codes and standards and to assess what the investment is truly worth, you are required to estimate market value of your bank regardless of the book value. 18. Methods of estimating market value The questionnaire requires the respondent to provide an estimate of the market value (the equity value of the bank in the stock market) of the investment both on the liability side (Tables 2.1, 2.2) and on the asset side (Table 4.1). So, Table 2.0 and Table 4.0 require the respondent to indicate the estimation method and also the person who carried out this estimation. The respondent is required to provide an estimate of the market value of their equity investment for Part 2.1, 2.2 and 4.1 of this questionnaire. So how do you estimate the market value for your bank? a) You can base it on your auditor’s estimate, or request your accountant or financial manager, or use a director’s estimate. b) You may base it on a recent sale of shares between the bank owners (assuming it was based on commercial considerations at arm’s length). c) Alternatively, you could compare it to a trading for a similar sized bank in Uganda or the region. 19. Shareholder and inter-company transactions This is requested for in Tables 3.1 and 3.2 for foreign borrowings (foreign liabilities), and Tables 4.2 for external lending (foreign assets) by resident entities. These are borrowings or lending between your bank, and affiliated (i.e., not independent) non-resident entities where FDEI equity / shareholding relationship exists (e.g., head offices, branches, associate entities, subsidiaries). Note this would include trade credits (buyers’ and suppliers’ credit) if the transaction were between related entities. x 20. Trade Credits from / to Unaffiliated Entities Trade credits are commercial credits extended by exporters to importers (suppliers’ credit) and prepayments made by importers to exporters (buyers’ credit). Trade Credits between unrelated entities are requested for in Tables 3.1 and 3.2 for foreign borrowings and Tables 4.2 for foreign lending. 21. Other Claims other than Equity and Loans These include: Deposits, Currency, Bonds & Notes, Money Market Instruments, Portfolio Debt Assets etc. a) Deposits are transferable (with unrestricted exchange on demand at par) in any currency and commonly used to make payments, or other (such as savings or time deposits). These are requested for in Tables 3.3 for the foreign liabilities. b) Currency consists of notes and coins in circulation, commonly used to make payments. c) Bonds and Notes include bonds, debentures, commercial paper, promissory notes, certificates of deposit, and other tradable non-equity securities. Bonds and Notes are long-term with original maturities of more than one year. d) Money Market Instruments are short-term with original maturities of one year or less. 22. Investor Perceptions (IP) This is requested for in Part 5. Investors’ perceptions, which are the assessment of the views of the private investors on the effects of selected variables and institutions on business operation. Policy makers are concerned about improving the private investments environment in Uganda. As such, the questionnaire requests you to rate the effects of a number of selected factors on your business operations. Please, note that these IP questions seek for your current perceptions (in 2010) on the identified factors. xi Acknowledgement of Receipt of Questionnaire I, _____________________________________ of ______________________________ (Name of recipient) (Name of Bank) Acknowledge Receipt of the Private Sector Investment Survey (PSIS) 2010 Questionnaire. Title: Signature: Date & Stamp of your bank: Name of Interviewer: Date agreed for collection of duly filled questionnaire and financial statements Thank you for receiving and accepting to fill the questionnaire. This page should be filled-in by the person who is receiving the questionnaire on behalf of the bank at the time of delivery of this questionnaire by the interviewer. After it is signed, the interviewer should retain the original copy of this page. xii Q/MPSI/08/09 CONFIDENTIAL QUESTIONNAIRE FOR SURVEY ON PRIVATE SECTOR INVESTMENT 2010 Issued under authority of the Investment Code (1991) Section 35(1), the Foreign Exchange Act (2004) Section 9 (5) and the Uganda Bureau of Statistics Act. 1998 Section 16, 19 PART 1 General Information (All respondents should complete Part 1 & 5, while for Parts 2, 3 and 4, the filtering questions on Page 7 (Table 1.13) will guide you on which parts to fill) 1.1 Name, Contacts and other information 1.1a Name of the bank: ___________________________________________________________________________ 1.1b Contact Person and Position ___________________________________________________________________ 1.1c Alternative Contact Person and Position _________________________________________________________ 1.1d Physical Address:_______________________________ Postal Address: _______________________________ Tel: _______________________________________________________________ Fax:__________________ E-mail: _____________________________________Website: _______________________________________ 1.1e Date of Commencement of Operation: ___________________________________________________________ 1.1f UIA Investment License Number (if any): ________________________________________________________ 1.2 Shareholding Structure of the Bank as at 31st December 2008 and 2009. Table 1.2: Shareholding Structure as at 31st December 2008 and 2009 Ownership Stake (% Shareholding) Name of Shareholder* Nationality Country of Residence as at: 31-12-2008 31-12-2009 1. 2. 3. 4. 5. 6. 7. 8. *name of shareholders includes both the entity and individual investor ownership. Please attach additional sheet in case you have more than eight (8) shareholders in your bank. Page 1 of 17 Q/MPSI/08/09 CONFIDENTIAL 1.3 Investment Relationship with other entities in 2009 Please fill out table 1.3 below for entities reported in 1.2 that own less than 10% of the equity in your bank. (Please record YES or NO for questions 3 and 4 in this Section). [see definition 17 (iii) page ix] Table 1.3: Investment relationship with companies owning less than 10% of your equity No 1. Name of Shareholder (this should be the same as that mentioned in Table 1.2) 2. Ownership stake (percentage shareholding should be the same as reported in Table 1.2 for entity with less than 10% equity in your bank) 3. Does your bank own 10% or more equity in this nonresident entity investors? (YES / No) 4. Does any of the investor with more than 10% equity in your bank also own more than 10% in this nonresident entity investor who own less than 10% of your equity? (YES/NO). 5. Provide the name of common shareholders if your response to No 4 is YES (should be the same as in Table 1.2) Bank 1 Bank 2 Bank 3 Bank 4 1.4 The bank’s turnover during 2009 in Ushs Please enter the total turnover of your bank during the calendar year 2009. Table 1.4: Total Turnover during 2009 in Ushs No Item 1. Total Turnover including Other Income 2009 1.5 Actual employment as at 31st December 2009 (record exact numbers) Please enter the exact number of employees for each nature of employment or category. Table 1.5: Actual employment as at 31st December 2009 Nature of Employment Duration of the employee(s) stay in Uganda Number of Managerial/Supervisory Local Permanent resident Foreign Short term Long term ( less than 12 months) ( more than 12 months) Number of Administrative/ Accounts Number of Skilled Technicians Number of Casual labourers TOTAL Males Females Page 2 of 17 Q/MPSI/08/09 CONFIDENTIAL 1.6. Compensation of Employees during 2009 in UShs Please enter the values (in Ushs) of compensation of employees during 2009. Table 1.6: Compensation of Employees during 2009 (Ushs) Type of Compensation Duration of the employee(s) stay in Uganda Salaries and Wages Fringe Benefits NSSF/Pension Directors Fees Other (specify) TOTAL Local Permanent resident Foreign Short term Long term ( less than 12 months) ( more than 12 months) Males Females 1.7. Total Values of Imports and Exports during 2009 in Ushs Please enter the values of imports and Exports of goods or services during 2009 in Ushs. Table 1.7: Values of Imports (CIF) and Exports (FOB) during 2009 in Ushs No 1. Imports/Exports 2009 Total Import of goods and Services (a) o/w Merchandise Services 2. Total exports of goods and services (b) o/w Merchandise Services 3. Total imports of goods and services from foreign affiliate or parents 4. Total exports of goods and services to foreign affiliate or parents 1.8 Actual Investment as at 31st December 2009 in Ushs Please enter the Net Book Values (in Ushs) of actual investment under each type of investment. Table 1.8: Actual investment as at 31st December 2009 in Ushs No 1. Type of investment 31st December 2009 Land 2. Building and Civil Works 3. Plant and Machinery 4. Vehicles 5. Computers and accessories 6. Furniture and Fittings 7. Intangible Assets (e.g. operations software) 8. Research and Development 9. Other (specify) Total Page 3 of 17 Q/MPSI/08/09 CONFIDENTIAL 1.9 Gains/Loss from Foreign Exchange and sales of Fixed Assets during 2009 Please enter the net gains/losses from foreign exchange translation and sales of fixed assets recorded by your bank during 2009 in Ushs. Table 1.9: Gains/Loss from Foreign Exchange translation and sales of Fixed Assets during 2009 in Ushs No Item 1. Gain/Loss in Foreign Exchange 2. Gain/Loss on the sale of Fixed Assets 2009 Total 1.10. Net profit/Loss, Dividends and Retained Earnings during 2009 Please enter the values (in Ushs) of the net profit/dividends/retained earnings. Table 1.11 Net Profits/Loss, Dividends and Retained Earnings during 2009 in Ushs No. Item 1. 2. 3. Net profit/loss (after tax) for the year Total dividends declared for the year Total dividends paid / profits remitted during the year Total retained earnings for the year 4. 2009 1.11. Corporate Social Responsibility during 2009 in UShs Please enter the values (in Ushs.) of your Bank’s Corporate Social Responsibility. Table 1.12: Corporate Social Responsibility activities during 2009 (in Ushs.) No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Item Amount Spent (Ushs) 2009 Education Health and welfare Safety and Security Arts and Culture Sports Development Environment Water Road Religious Donation to other charity org. Other (Specify) Total Page 4 of 17 Q/MPSI/08/09 CONFIDENTIAL 1.12. Please, indicate which parts (2 or 3 or 4) of this questionnaire are relevant to you by answering the five questions below. The table below provides filtering questions that will help you to identify the relevant parts for your Bank to answer, please tick in the appropriate box. Table 1.12: Filtering Questions (FQ) FQ1 FQ2 FQ3 FQ4 FQ5 Filtering Questions (FQ) Do non-resident entities, governments or individuals hold shares (equity or other equity) in your bank? If yes, please complete Tables 2.1, and 2.2. Does your bank borrow from non-resident entities/individuals or have outstanding loan commitments? If yes, please complete Tables 3.1 and 3.2 Do non-resident entities, governments or individuals have any other monetary claims against your bank other than shares and loans? If yes, please complete Table 3.3. Does your bank own shares (equity or other equity) in non-resident entities? If yes, please complete Table 4.1. Has your bank extended or lent money to non-resident entities or individuals or does it have unpaid amounts outstanding? If yes, please complete Tables 4.2 and 4.3. Yes No NB: If you ticked ‘no’ for every question, please proceed to Part 5 (Investor’s Perceptions). Page 5 of 17 Q/MPSI/08/09 CONFIDENTIAL PART 2 Foreign Equity Investment (shares) in this Bank (Liabilities) Methods of Estimating Market Value Please indicate (by ticking) the method(s) used in estimating the Market Value (MV) of equity. Indicate also the designation of person/office carrying out the estimation of the market value of equity. Table 2.0 (a): Methods of Estimating Market Value No. 1. 2. 3. 4. 5. Method Valuation Approach Income Stock exchange/securities Net Asset Value Other Valuation approach (specify) Tick (9) Table 2.0 (b): Estimation carried out by No. 1. 2. 3. 4. 5. Title CEO Director Accountant Finance Manager Auditor Tick (9) Please complete this PART if your bank in Uganda had non-resident shareholders during years ended 2008 and 2009. Report all values of foreign equity investments to the lowest units and in Uganda shillings. In case you report in foreign currency, then please use average exchange rates for conversion of transactions (or flows) and end-period exchange rates for conversion of outstanding balances (or stocks). Exchange rates can be provided on request. 2.1 Equity (10% or more) held in your bank by non-residents as at end of 2008 and 2009. Please complete this section if non-resident entities hold 10% or more shares in your bank: In Table 2.1, please enter aggregate data by country, for all non-resident entities each owning 10% or more of the equity or equivalent voting rights in your bank (Foreign Direct Equity Investment). To ensure we do not have to get back to you for clarification, enter “N/A” where the question is not applicable to your bank. Table 2.1 Equity held in your bank by non-residents (each owning 10% or more) and transactions in Ushs No. Item 1. 2. 3. Country of residence/ International Organisation Percentage shareholding (%) Book Value of Equity as at 31st December 2008: O/w: Paid-up Share Capital: Share Premium: Accumulated retained earnings/loss Revaluations: ** Others: Estimated Market Value as at 31st December 2008 Purchases of shares by non-residents in your bank during 2009 (inwards) Sales of shares by non-residents in your bank during 2009 (outwards) Retained Earnings/Loss during 2009 Other equity changes during 2009 (inwards)* Other equity changes during 2009 (outwards) Exchange rate translation gains/loss Book Value of Equity as at 31st December 2009: 4. 5. 6. 7. 8. 9. 10. 11. Amounts in UShs = (3 + 5 − 6 ± 7+ 8 – 9 ± 10) O/w: 12. Paid-up Share Capital: Share Premium: Accumulated retained earnings/loss Revaluations: ** Others: Estimated Market Value as at 31st December 2009 * These should include any transactions related to: new equity issues (Greenfield investment), rights issue of shares, net value from mergers and acquisitions and additional capital contribution by shareholders. ** Others - any other equity component e.g. unremitted dividend, debt equity swaps, deposits by shareholders etc Note: In case you have more than three countries investing in your bank, please provide data on separate page(s) or sheet(s) Page 6 of 17 Q/MPSI/08/09 2.2 CONFIDENTIAL Equity (less than 10%) held in your bank by non-residents as at end-2008 and 2009 and associated transactions during 2009. Please complete this section if non-resident entities or individuals hold less than 10% equity in your bank: • In the Table 2.2, please enter aggregate data by investor and their country, for all non-resident entities each owning less than 10% of the shares or equivalent voting rights in your bank (Foreign Portfolio Equity Investment). To ensure we do not have to get back to you for clarification, enter “N/A” where the question is not applicable. Table 2.2 Equity held in your bank by non-residents (each owning less than 10%) and transactions in Ushs No. Item 1. Country of residence/ International Organisation Percentage shareholding (%) Type of investor i.e. Direct Investments Enterprise (DIE), Fellow Enterprise (FE), or Portfolio Investment (PI) Book Value of Equity as at 31st December 2008: O/w: Paid-up Share Capital: Share Premium: Accumulated retained earnings/loss Revaluations: ** Others: Estimated Market Value as at 31st December 2008 Purchases of shares by non-residents in your bank during 2009 (inwards) Sales of shares by non-residents in your bank during 2009 (outwards) Retained Earnings/Loss during 2009 Other equity changes during 2009 (inwards)* Other equity changes during 2009 (outwards) Exchange rate translation gains/loss Book Value of Equity as at 31st December 2009: 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Amounts in UShs = (4 + 6 − 7 ± 8 + 9 – 10 ± 11) O/w: 13. Paid-up Share Capital: Share Premium: Accumulated retained earnings/loss Revaluations: Others**: Estimated Market Value as at 31st December 2009 * These should include any transactions related to: new equity issues (Greenfield investment), rights issue of shares, net value from mergers and acquisitions and additional capital contribution by shareholders. ** Others - any other equity component e.g. unremitted dividend, debt equity swaps, deposits by shareholders etc Note: In case you have more than three countries investing in your bank please provide data on separate page or sheet Page 7 of 17 Q/MPSI/08/09 CONFIDENTIAL PART 3 Non-Equity Liabilities from Non-Residents 3.0 Borrowings from non-resident(s) by your bank Please complete Tables 3.1 and 3.2 for long-term and short-term debt (including any arrears) respectively, if your Bank borrows from non-resident entities, individuals or organizations (external borrowings). • Exclude domestic borrowings (resident-to-resident) in both foreign and local currencies. • To ensure we do not trouble you for clarification, enter “N/A” where not applicable. • In case of recipient sector specify the sector using options provided on pages 2 and 3 of this questionnaire i.e. Table 1.4. 3.1 Long-term external liabilities of loans, trade credits, and debt security (bonds, notes, bills etc) Long-term debt liabilities constitute loans and debt securities with original maturity of 12 months or more. Please supply total outstanding balances for the years as at end-December 2008 and 2009 and transactions during 2009 for each individual non-equity external obligations. Table 3.1: Long-term external debt liabilities of loans, trade credits, and debt securities No Debt Debt Debt Debt Instrument 1 Instrument 2 Instrument 3 Instrument 4 Particulars 1. Creditor institution group* 2. 3. 4. Debt type** Recipient Industrial Classifications Creditor country/International organization 5. Original currency of liability 6. Total debt amount (original contracted) 7. Interest rate (in % terms) 8. Outstanding balance as at 31st December 2008♠ O/w: Balance of principal 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Balance of principal arrears Balance of interest arrears Debt received from non-residents during 2009 (Disbursements) Debt repaid to non-residents during 2009 (Principal repayments) Principal arrears created during 2009 Principal arrears paid during 2009 Interest paid during 2009 Interest arrears created during 2009 Interest arrears paid during 2009 Other changes during 2009 (debt forgiveness, write-off, debt-equity swaps etc) Please specify… Fees and commission paid in 2009: Exchange rate translation gains/loss Outstanding balance as at 31st December 2009 = (8 + 9 − 10 − 12 + 14 − 15 ± 16 ± 18) O/w: Balance of principal Balance of principal arrears Balance of interest arrears All bold fields are mandatory * Creditors institution group include; Direct Investor (parent), Subsidiary or Associate, DIE, Other related (FE) ** Debt type includes; trade credits, loans and debt security (e.g. bonds, notes etc) ♠ Not applicable if loan was contracted in 2009 2 In case the terms of the debt instruments loan change during the period under review please provide data on separate page or sheet Page 8 of 17 Q/MPSI/08/09 CONFIDENTIAL 3.2 Short-term External liabilities of loans, trade credits, and Debt securities Short-term debt liabilities constitute loans, trade credits, and debt securities with original maturity of less than 12 months. Please supply total outstanding balances for the years as at end-December 2008 and 2009 and transactions during 2009 for each individual debt contracted. Table 3.2: Short-term External debt liabilities of loans, trade credits, and debt securities No 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Particulars Debt Instrument 1 Debt Instrument 2 Debt Instrument 3 Debt Instrument 4 Creditor institution group* Debt type** Recipient Industrial Classifications Creditor country/International organization Original currency of liability Total debt amount (original contracted) Interest rate Outstanding balance as at 31st December 2008*** O/w: Balance of principal Balance of principal arrears Balance of interest arrears Debt received from non-residents during 2009 (Disbursements) Debt repaid to non-residents during 2009 (Principal repayments) Principal arrears created during 2009 Principal arrears paid during 2009 Interest paid during 2009 Interest arrears created during 2009 Interest arrears paid during 2009 Other changes during 2009 (debt forgiveness, write-off, debt/equity swaps etc) Please specify… Fees and commission paid in 2009: Exchange rate translation gains/loss Outstanding balance as at 31st December 2009 = (8 + 9 − 10 + 11 − 12 + 14 − 15 ± 16 ± 18 ) O/w: Balance of principal Balance of principal arrears Balance of interest arrears All bold fields are mandatory * Creditors institution group include; parent company (i.e. Direct Investor – DI), Subsidiary or Associates (i.e. DIE), other related party and unrelated party ** Debt type includes; trade credits, loans and debt security (e.g. bills etc) ***Not applicable if loan was contracted in 2009 Note: In case the terms of the debt instrument (i.e. loan, etc) changes during the period under review, please provide additional information on a separate page or sheet and attach to this questionnaire. Page 9 of 17 Q/MPSI/08/09 3.3 CONFIDENTIAL Other liabilities acquired from non-residents other than equity and borrowings Other liabilities acquired from non-residents may include namely; standardised guarantee scheme, employee stock option, management fees payable, financial derivatives, custody accounts, administered funds, franchise costs outstanding, currency and deposits, outstanding insurance and reinsurance premiums and claims etc. Please supply total outstanding balances for the years as at end-December 2008 and 2009 and transactions during 2009 for each individual liability. Please complete Table 3.3 below if your bank acquired liabilities (excluding sales of shares, loans, trade credits and debt securities) from non-resident entities or individuals Table 3.3: Other liabilities acquired from non-residents other than shares and borrowings Item Other liabilities from non-residents Type of liability (namely; standardised guarantee scheme, employee stock option, management fees, financial derivatives, custody accounts, administered 1. funds, franchise costs outstanding, currency and deposits, outstanding insurance and reinsurance premiums and claims etc.) 2. Currency (e.g. GB£, US$, Euro (€), KHS etc.)* 3. Creditor country / International Organization of counterpart 4. Outstanding balance as at 31st December 2008 5. Value of liability received from non-residents during 2009 6. Settled liabilities during 2009 7. Interest paid on liability holding during 2009 (please provide this if applicable to the liabilities held) 8. Other changes (e.g. exchange rate ) during 2009 9. Outstanding balance as at 31st December 2009 = (4 + 5 − 6 ± 8) O/w Amount due from related party Page 10 of 17 Q/MPSI/08/09 CONFIDENTIAL PART 4 Investment (Assets) Abroad by this Bank Methods of Estimating Market Value Please indicate (by ticking) the method(s) used in estimating the Market Value (MV) of equity. Indicate also the designation of person/office carrying out the estimation of the MV of foreign equity owned by your bank. Table 4.0 (a): Methods of Estimating Market Value No. 1. 2. 3. 4. 5. Tick (9) Method Valuation Approach Income Stock/ Securities market Net Asset Value Other (specify) Table 4.0 (b): Estimation carried out by No. 1. 2. 3. 4. 5. Title Tick (9) CEO Director Accountant Finance Manager Auditor 4.1 Holdings of shares by your bank in non-resident entities Please complete Table 4.1 as follows: • In Column A, please enter aggregate data for your holdings of shares in non-resident entities that are each 10% or more. • In Column B, please enter aggregate data for your holdings of shares in non-resident entities that are each less than 10%. To ensure we do not have to get back to you for clarification, enter “N/A” where it’s not applicable to your Bank. Table 4.1 Holdings of equity by your bank in non-resident entities equivalent in UShs. No 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Item Equity held by your bank A. Holdings (each 10% or more) B. Holdings (each less than 10%) Country of investment /International Organisations* Book value of equity as at 31st December 2008 O/w: Paid-up Share Capital: Share Premium: Accumulated Retained earnings Revaluations: Others: Estimated market value as at 31 December 2008 Purchases of shares in non-resident entities by your Bank during 2009 (inwards) Sales of shares in non-resident entities during 2009 (outwards) Retained Earnings/Loss during 2009 Other equity transactions during 2009 (inwards) Other equity transactions during 2009 (outwards) Exchange rate translation gains/loss Book value of equity as at 31st December 2009 = (2 + 4 − 5 ± 6 + 7 − 8 ± 9) O/w: 11. Paid-up Share Capital: Share Premium: Accumulated Retained earnings Revaluations: Others: Estimated market value as at 31 December 2009 12. Dividends received during 2009 *In case you hold equity in more than one entity please provide data on separate page or request for additional sheet from the interviewer. Page 11 of 17 Q/MPSI/08/09 CONFIDENTIAL 4.2. External debt assets in form of loans, debt securities and trade credits Long-term debt assets constitute loans, trade credits, and debt securities (bonds, notes, bills etc) with original maturity of 12 months or more while short-term have original maturity of less than 12 months. Please supply total outstanding balances for the years as at end-December 2008 and 2009 and transactions during 2009 for each individual debt in original contract agreement currencies. Please complete the table below if you had asset claims on non-residents in form of trade credits, loans, debt securities in 2008 and 2009. Table 4.2 External assets in terms of; loans, trade credits, and debt securities (bonds, notes, bills etc) No Items 1. Debtor institution group* 2. 3. 4. Debt type* Tenure [ST – short term or LT – long term] Debtor country of residence/ International Organization Original debt currency Original Principal Amount Interest rate 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. Assets 1 Asset 2 Asset 3 Assets 1 Outstanding balance as at 31st Dec 2008*** O/w: Balance of principal Balance of principal arrears Balance of interest arrears Debt extended to non-residents during 2009 (Disbursements) Debt repaid by non-residents during 2009 (Principal repayments) Principal arrears created during 2009 Principal arrears paid during 2009 Interest due and paid during 2009 Interest arrears created during 2009 Interest arrears paid during 2009 Fees and commissions received in 2009: Exchange rate translation gains/loss Outstanding balance as at 31st Dec 2009 = (8 + 9 −10 −12 + 14 −15 ± 16) O/w: Balance of principal Balance of principal arrears Balance of interest arrears All rows in bold must be completed * Creditors institution group include; parent company, subsidiary other related party (fellows, directors etc) and unrelated party ** Debt type includes; trade credits, loans and debt security (e.g. bonds, notes, bills etc) *** Not applicable if credits was extended in 2009 Note: a) In case your Bank lent to non-residents in more than one country please provide data on separate page or sheet b) Short term in case the maturity period of the asset is less than 12 months otherwise it should be considered long-term. Page 12 of 17 Q/MPSI/08/09 CONFIDENTIAL 4.3 Other assets acquired from non-residents other than equity and debt securities Other assets acquired from non-residents may include; standardised guarantee scheme, employee stock option management fees receivable, financial derivatives, custody accounts, administered fund, franchise costs, currency and deposits, outstanding insurance and reinsurance premiums and claims etc. Please supply total outstanding balances for the years as at December 2008 and 2009 and transactions during 2009 for each individual asset in original currency. Please complete Table 4.3 below if your bank acquired assets (excluding sales of shares, loans, trade credits and debt securities) from non-resident entities or individuals Table 4.3: Other assets acquired from non-residents other than shares, loans, trade credits and debt securities Item 1. Assets 1 Asset 2 Asset 3 Type of asset (namely; standardised guarantee scheme, employee stock option, management fees receivable, financial derivatives, custody accounts, administered funds, franchise costs, currency and deposits, outstanding insurance and reinsurance premiums and claims etc.) 2. Currency (e.g. KHS, US$, Euro €, GBP₤ etc.)* 3. Creditor Country / International Organization of counterpart 4. Outstanding balance as at 31 December 2008 5. Value of asset acquired from non-residents during 2009 6. Settlement s (repayments) during 2009 7. Interest received on other assets during 2009 (please provide amounts for applicable assets) 8. Other changes (e.g. exchange rate changes) 9. Outstanding balance as at 31 December 2009 = (4 + 5 − 6 ± 8) O/w To related party * Indicate amount in space provided in the original tranche currency. In case you have more than three currencies please provide the extra data on separate page(s) or sheet(s) Page 13 of 17 Q/MPSI/08/09 CONFIDENTIAL PART 5 Investor Perceptions (All respondents should complete this part) Instructions for Questions in Table 5.1 – 5.5 In tables 5.1 – 5.5 please rate the effect (on your business activities) of each factor on a scale of -2 to +2 where: +2 = “Strong positive effect”, +1 = “Limited positive effect”, 0 = “No effect”, -1 = “Limited negative effect” and -2 = “Strong negative effect” Please indicate your rating in the space provided ( Table 5.1 ) Effect of Economic and financial factors to your business bank Rating 2010 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Factor 5.1.1 5.1.2 5.1.3 5.1.4 5.1.5 5.1.6 5.1.7 5.1.8 5.1.9 5.1.10 5.1.11 5.1.12 5.1.13 5.1.14 Domestic market size Smuggling Corruption Competition with imports Access to international markets Corporate tax Customs and excise duty Interest rate Exchange rate Inflation rate Access to local business finance/credit Access to regional business finance Access to international finance Others (specify) Table 5.2 Efficiency and cost of the following support services on your bank Factor 5.2.1 5.2.2 5.2.3 5.2.4 5.2.5 5.2.6 5.2.7 5.2.8 5.2.9 5.2.10 5.2.11 5.2.12 5.2.13 5.2.14 5.2.15 5.2.16 5.2.17 5.2.18 Electricity Road transport Railway transport Water transport Air transport Postal services Telecommunication Internet Customs services Internal revenue services Insurance services Banking services Water supply Immigration services/ work permits Municipal services (garbage, sewerage etc) Legal services Licenses/ permit fees Others (specify) Rating in 2010 Efficiency Cost ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) Page 14 of 17 Q/MPSI/08/09 CONFIDENTIAL Table 5.3 Effect of Labour, Environmental and Health factors to your business activities Factor 5.3.1 5.3.2 5.3.3 5.3.4 5.3.5 5.3.6 5.3.7 5.3.8 5.3.9 5.3.10 5.3.11 5.3.12 5.3.13 5.3.14 5.3.15 Restrictions regarding hiring expatriates Staff turnover Wage levels Availability of skilled labour locally Cost of skilled labour Productivity of skilled labour Productivity of unskilled labour Cost of un skilled labour NSSF/Pension contribution Malaria HIV/AIDS Climate changes Soil degradation Land and boarder conflicts Other Diseases (specify) Rating 2010 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 5.4 Did the global financial crises /economic slowdown affect your bank? YES [ ] NO [ ] 5.4.1 If YES, rate the business areas in the following Table 5.4.1 below Table 5.4.1 Effects of the global financial crises /economic slowdown on your bank 5.4.1 5.4.2 5.4.3 5.4.4 5.4.5 5.4.6 5.4.7 5.4.8 Table 5.5 Business areas Turnovers Investments flows Exports demands(if any) Imports cost Access to international credits Access to domestic credits Debt service Other effects (specify) Efficiency of Regulatory and Other government agencies to your business activities Factor 5.5.1 5.5.2 5.5.3 5.5.4 5.5.5 5.5.6 5.5.7 5.5.8 5.5.9 5.5.10 5.5.11 5.5.12 5.5.13 5.5.14 5.5.15 5.5.16 5.5.17 5.5.18 Rating 2010 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Electricity Regulatory Authority Uganda National Chamber of Commerce & Industry Privatization Unit Uganda National Bureau of Standards Uganda Revenue Authority Department of Immigration, Ministry of Internal Affairs Legal System (e.g. Uganda Law Reform Commission) National Environmental Management Authority Local Authorities (e.g. KCC) The Parliament of the Republic of Uganda Uganda Investment Authority Uganda Registration Services Bureau Bank Of Uganda Private Sector Foundation Uganda (PSFU) Judicial Services (e.g. Commercial Court) Uganda Communications Commission Uganda Bureau of Statistics Other (specify) Rating 2010 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Page 15 of 17 Q/MPSI/08/09 Table 5.6 CONFIDENTIAL Please indicate the direction of your investment in Uganda in the next 3 years. In this Table please indicate the direction of your investments in Uganda in the next 3 (three) years of each aspect on a scale of -1 to +1 where: +1 = “Expand”, 0 = “Maintain” and -1 = “ Scale Down” Please enter your score on each aspect in the space provided ( ) Score 2010 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Aspect 5.6.1 5.6.2 5.6.3 5.6.4 5.6.5 5.6.6 5.6.7 5.6.8 5.6.9 5.6.10 5.6.11 5.6.12 5.6.13 Table 5.7 Diversify in other sectors Diversify range of product and services Staff Training Recruitment of nationals Recruitment of expatriates Gender balance in recruitment Investment in Technology Import of Capital goods Export of the products Construction of New Building and Structure Improvement of existing facilities Mergers and Acquisition Others (specify) On a scale of 1 – 3 please rate the usefulness of the listed sources of information in your investment decisions where: +2 = “Very useful”, +1 = “Quite useful” and 0 = “Not useful” Please enter your score on each source in the space provided ( Source /Utility 5.7.1 5.7.2 5.7.3 5.7.4 5.7.5 5.7.6 5.7.7 5.7.8 5.7.9 5.7.10 Local and regional media International media Internet Government agency/ publications Donor and international agencies Business associates Competitors Workshops, Conferences, Trade fairs & International seminars Word of mouth Other (specify) ) Rating 2010 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ( ) ) Please indicate below any issue not discussed in this questionnaire that you may wish to bring to the attention of policy makers. _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ Page 16 of 17 Q/MPSI/08/09 CONFIDENTIAL Once again we wish to assure you that the information you have provided will be treated with strict confidentiality. Kindly certify this information. Name: ________________________________________________________________________________________ Address: ______________________________________________________________________________________ Signature: ________________________ Date: __________________ Stamp: ______________________________ THANK YOU FOR YOUR COOPERATION AND FOR PROVIDING YOUR FINANCIAL STATEMENTS. FOR OFFICIAL USE Name of Interviewer: _______________________ Signature: ___________________ Date: __________________ General remarks / comments ………………………………………………………………………………………………………… ………………………………………………………………………………………………………… ………………………………………………………………………………………………………… ………………………………………………………………………………………………………… Page 17 of 17