The Open Dialog Foundation ul. 3-go Maja 18/4

BALANCE SHEET 20-078 Lublin, Poland NIP: 712-32-0&-033

THE OPEN DIALOG FOUNDATION REGON: 060466097

(name of entity) as of the 31th of December, 2011 (state statistical number)

The balance sheet is drawn up in accordance with the annex to the decree of the Minister of Finance of the 15

th of November, 2001 (Polish Journal of Laws 'Dziennik Ustaw' 137, position 1539)

Line ASSETS As of 2011 Line LIABILITIES As of 2011

1 2 beginning of the

year

end of the year 1 2 beginning of the

year

end of the year

A Fixed assets - - A Equity - 168,82 - 23 246,28

I Intangible fixed assets - - I Statutory fund 10, 000 15 000,00

II Tangible fixed assets - - II Revaluation reserve -

III Long-term receivables - - III Net profit for the fiscal year - 10 168.82 - 38 246,28

IV Long-tern investments - - 1 Excess of revenues over

expenses (positive value)

-

V Long-term prepayments and

accruals

- - 2 Excess of expenses over

revenues (negative value)

- 10 168,82 - 38 246,28

B Current assets 7 436,84 38 057,01 B Liabilities and provisions

for liabilities

- 61 303,29

I Tangible current assets

(stock)

- - I Long-term liabilities due to

credits and loans

- -

II Short-term receivables - 2 322,97 II Short-term liabilities and

special funds

7 605,66 61 303,29

1 Credits and loans - -

2 Other liabilities 7 605,66 61 303,29

3 Special funds - -

III Short-term investment 7 436,84 35 734,04 III Provisions for liabilities - -

1 Cash 7 436,84 35 734,04 IV Accruals of expenses - -

2 Other financial assets - - 1 Deffered income - -

C Short-term prepayments

and accruals

- - 2 Other accruals of expenses

and deferred income

- -

Total assets 7 436,84 38 057,01 Total liabilities - 168,82 38 057,01

Date Prepared Signatures: Paweł Świderski, Lyudmyla Kozlovska

The Open Dialog Foundation ul. 3-go Maja 18/4

INCOME STATEMENT 20-078 Lublin, Poland NIP: 712-32-0&-033

THE OPEN DIALOG FOUNDATION REGON: 060466097

(name of entity) of the 31th of December, 2011 (state statistical number)

The balance sheet is drawn up in accordance with the annex to the decree of the Minister of Finance of the 15

th of November, 2001 (Polish Journal of Laws 'Dziennik Ustaw' 137, position 1539)

Position Specification Amount for the previous

year

Amount for the fiscal year

2010 2011

1 2 3 4

A. Income from statutory activities 10 600,00 156 255,71

I Gross contributions as specified in the statute

II Other income as specified in the statute 10 600,00 156 255,71

B. Expenses resulting from statutory activity 20 252,13 168 475,16

C. The financial result from the statutory activity (positive or negative

value) (A-B)

- 9 652,13 - 12 219,45

D. Administrative expenses 457,37 12 825,63

1 Consumption of materials and energy 294,99 102,00

2 External services 24,28 5 354,28

3 Taxes and fees 122,50 30,00

4 Remuneration, social insurance and other benefits 1 000,00

5 Amortisation and depreciation

6 Other 15,60 6 339,35

E. Other income (not listed in items A and G)

F. Other expenses (not listed in items B,D and H ) 10 168,82

G. Financial income 0,65 4,58

H. Financial expenses 59,97 3 036,96

I. The financial result from the total activity (positive or negative) (C-D + E +

F + G-H)

- 10 168,82 - 38 246,28

J. Profit/loss on extraordinary activities - -

I. Profit on extraordinary activities – positive value

II. Loss on extraordinary activities - negative value

K. Total financial result (I + J) - 10 168,82 - 38 246,28

I. Difference increasing the balance of expenses of the following year

increasing difference in costs next year (negative value)

10 168,82 - 38 246,28

II. Difference increasing the balance of revenues of the following year (positive

value)

Date Prepared Signatures: Paweł Świderski, Lyudmyla Kozlovska

The Open Dialog Foundationul. 3-go Maja 18/4

BALANCE SHEET 20-078 Lublin, PolandNIP: 712-32-0&-033

THE OPEN DIALOG FOUNDATION REGON: 060466097(name of entity) of the 31th of December, 2011 (state statistical number)Date Prepared Signatures

ADDITIONAL INFORMATION REGARDING FINANCIAL STATEMENT

Fiscal year: 1 January, 2011- 31

December, 2011

Additional data regarding assets and liabilities 1. Short-term receivables 2 322,97

2. Current assets:

Cash in hand: 5 107,45

Cash at bank: 30 626,59

Total: 38 057,01

3. Revenues realised:

No.

SpecificationSurplus revenues from the result in 2010 Receipts in 2011 Revenues altogether:

Total revenues:

0,00

156 260,29

256 260,29

I

Revenues from the statutory activity,

including:

0,00 156 255,71 156 255,711. Membership fees

0,00 0,00

2. Funds from grants / general donations

0,00 94 270,60

94 270,60

3. Statutory activity

- other payments (organisation of

conferences - reimbursement of expenses)

0,00 61 985,11

61 985,11

II

Financial income 0,00

4,58 4,58

III

Other income, including:- in-kind donations

0,00 0,00

0,00

Monetary donations, exceeeding 15 000,00 PLN at one time, received from legal persons- no such donations were made

4. Breakdown of expensesNo. Specification Amounts for the year 2011

Total expenses, including:

I Expenses resulting from statutory activity

1. cash benefits

1. non-cash benefits

II Administrative expenses

III Other expenses (expenses increased by the financial result of the previous year)

IV Financial expenses

5. Short-term liabilities as of the 31st of December, 2011

- liabilities due to taxes and social insurance fees (ZUS): 1 818,00

- payroll liabilities 0,00- liabilities due to outstanding advances 33 534,27- liabilities to suppliers 25 951,02Total: 61 303,29

6. Transformation of the balance sheet result to the tax result:

accounting surplus of revenues over expenses as of the 31st of December, 2011 -38 246,28decrease of the result by the surplus of expenses over revenues as of the 31st of December, 2011 - (-10 168,82)

– tax result: (-28 077,46)

7. Data dor CIT-8 declaration for the year 2011

- income in 2011 156 260,29Deductible expenses in 2011: 184 337,75- gross income in 2011 including exempted income: 0,00

8. Employment as of the 31st of December, 2011 – 0 persons.

Lublin, [date]The Open Dialog Foundationul. 3-go Maja 18/4

20-078 Lublin, Poland

NIP: 712-32-0&-033[Signatures:] Paweł Świderski, Lyudmyla Kozlovska