Entity Designation :…………………………………………. Fin. year ended 31/12/…...

Identification number :………………………………….. Duration ( in months).…...

STATEMENT OF FINANCIAL POSITION AS AT DECEMBER 31 N
Year ended Year ended
31/12/N 31/12/N

Note
Ref.

ASSETS
Gross Amort & Net Net
Dep.
AD INTANGIBLE ASSETS 3

AE Prospection and Development cost

AF Patents, licences, Softwares, & similar rights
AG Goodwill and leasehold rights
AH Other intangible assets
AI PROPERTY, PLANT AND EQUIPMENT 3

AJ Land with Net investment………../………

AK Building with net investment…........./…...…

AL Fixtures, fittings and installations

AM Equipments, furniture & biological assets
AN Transport equipment 3
AP Advances & installments paid on acquisition of
fixed assets

AQ FINANCIAL ASSETS 4

AR Equity Securities
AS Other financial assets

AZ TOTAL ASSETS CAPITALISED

BA CURRENT ASSETS N.O.A 5

BB STOCK AND IN PROGRESS 6
BG RECEIVABLES AND ASSIGNED EMPLOYMENT
BH Supplier advnces paid 17
BI Customers 7
BJ Other receivables 8

BK TOTAL CURRENT ASSETS

BQ Investment Securities 9
BR Bills to be cashed 10
BS Banks, postal cheques, cash and equivalents 11

BT TOTAL TREASURY ASSET

BU Exchange conversion difference– Asset 12

BZ GENERAL TOTAL
Entity Designation :…………………………………………. Fin. year ended 31/12/…...
Identification number :………………………………….. Duration ( in months).…...
STATEMENT OF FINANCIAL POSITION AS AT DECEMBER 31 N
Year ended Year ended
31/12/N 31/12/N
Ref. LIABILITY Note
Net Net

CA Capital 13
CB Capital subscribers, uncalled(-) 13
CD Share premium 14
CE Revaluation differences 3e
CF Unavailable reserves 14
CG Free reserves 14
CH Retained earnings brought forward (+ ou -) 14
CJ Profit or Loss for the period (Profit + ou loss -)
CL Investment subsidies 15
CM Regulated provisions 15

CP TOTAL SHAREHOLDERS’ EQUITY & RELATED RE-

SOURCES

DA Loans and various financial liabilities 16

DB Leasehold acquisition liability 16
DC Provisions for risks and charges 16

DD TOTAL FIANACIAL LIABILITIES & RELATED RESOURCES

DF TOTAL STABLE RESOURCES

DH N.O.A current liabilities 5

DI Customer, advances received 7
DJ Trade suppliers 17
DK Fiscal and social liabilities 18
DM Other liabilities 19
DN Provisions for short-term risks 19

DP TOTAL CURRENT LIABILITIES

DQ Banks, discount credits 20

DR Banks, financial institutions and treasury credits 20

DT TOTAL TREASURY LIABILITY

DV Exchange conversion difference - liability 12

DZ GENERAL TOTAL
Entity Designation :…………………………… Fin. year ended 31/12/
Identification number :…………………… Duration ( in months)…
CASH FLOW STATEMENT
Year ended Year ended
DESCRIPTION 31/12/N 31/12/N

Net cash position as at January 1

ZA A
(Treasury asset N-1 - Treasury Liability N-1)

Cashflow from Operating activities

FA Working Capital Adjustments (CAFG)

FB -N.O.A Current asset Œ
FC -Change in stocks
FD -Change in Receivables
FE +Change in current liabilities Œ

Change in WC related to operating activities

(FB + FC + FD + FE) : ………....................................

Cash inflow/outflow from operating activities (sum FA to FE)

ZB B

Cash flows from investing activities

FF ¬Disbursements related to acquisitions of intangible assets

FG ¬Disbursements related to acquisitions of PPE
FH ¬Disbursements related to acquisitions of financial assets
FI + Proceeds from the disposal of intangible assets and PPE

FJ + Proceeds from the disposal of financial assets

Cash inflow/outflow from investing activities (sum FF to FJ)

ZC C

Cash flow from equity financing

FK +Capital increases by new contributions

FL +Investment subsidies received
FM ¬Appropriation of capital
FN ¬Dividends paid
Cash inflow/outflow from equity financing (sum FK to FN)
ZD D

Cash flow from foreign capital financing

FO Loans and borrowings

FP Other financial liabilities
FQ Loan repayments and other financial debts

ZE Cash inflow/outflow from foreign capital (sum FO to FQ) E

ZF Cash inflow/outflow from Financing activities (D+E) F

ZG NET CASHFLOW FOR THE PERIOD (B+C+F) G

Net cash position at December 31 (G+A)

ZH H
Control : Treasury asset N - Treasury liability N =
 excluding changes in receivables and payables related to investing activities (changes in receivables on disposal of
fixed assets and debts on the acquisition or production of fixed assets) and financing (e.g change in receivables from
investment grants) investments received)
 NOTES DESCRIPTION

NOTE 1 DEBTS GUARANTEED BY ACTUAL SURETIES

NOTE 2 MANDATORY INFORMATION
NOTE 3A ASSETS AT COST
NOTE 3B REAL ESTATE PROPERTIES ACQUISITION
NOTE 3C CAPITAL ASSETS : DEPRECIATION
NOTE 3D CAPITAL ASSETS : PROFIT OR LOSS ON DISPOSAL

NOTE 3E INFORMATION ON REVALUATION IN THE ENTITY

NOTE 3F AMORTISATION SCHEDULE OF CAPITALISED EXPENSES
NOTE 4 FINANCIAL ASSETS
NOTE 5 N.O.A CURRENT ASSETS
NOTE 6 STOCK & IN PROGRESS
NOTE 7 RECEIVABLES VALUES
NOTE 8 OTHER RECEIVABLES
NOTE 9 INVESTMENT SECURITIES
NOTE 10 BILLS TO BE CASHED
NOTE 11 AVAILABILITY
NOTE 12 CONVERSION GAP
NOTE 13 CAPITAL : NOMINAL VALUE OF SHARES
NOTE 14 PREMIUMS AND RESERVES
NOTE 15 REGULATED SUBSIDIES AND PROVISIONS
NOTE 15A OTHER EQUITY
NOTE 15B FINANCIAL DEBTS AND ASSIMILATED RESOURCES
NOTE 16A RETIREMENT COMMITMENTS AND ASSIMILATED BENEFITS (ACTUARIAL METHOD)

NOTE 16B RETIREMENT COMMITMENTS AND ASSIMILATED BENEFITS (ACTUARIAL METHOD)

NOTE 16C CONTINGENT ASSETS AND LIABILITIES

NOTE 17 TRADE SUPPLIERS
NOTE 18 FISCAL AND SOCIAL DEBTS
NOTE 19 OTHER DEBTS AND PROVISION FOR SHORT-TERM RISKS
NOTE 20 BANK, DISCOUNT CREDIT AND TREASURY
NOTE 21 SALES AND OTHER PRODUCTS
NOTE 22 PURCHASES
NOTE 23 TRANSPORT
NOTE 24 EXTERNAL SERVICES
NOTE 25 TAXES AND LEVIES
NOTE 26 OTHER CHARGES
NOTE 27A PERSONNEL EXPENSES
NOTE 27B EMPLOYEES, PAYROLL AND EXPATRAITES
NOTE 28 PROVISIONS AND DEPRECIATION IN BALANCE SHEET
NOTE 29 FINANCIAL INCOME AND EXPENSES
NOTE 30 OTHER N.O.A INCOME AND EXPENSES
NOTE 31 APPROPRIATION OF PROFITS AND OTHER ITEMS FOR THE LAST FIVE
PERIODS
NOTE 32 PRODUCTION FOR THE YEAR
NOTE 33 PURCHASES FOR PRODUCTION
NOTE 34 SUMMARY SHEET FOR THE MAIN FINANCIAL RATIOS /INDICATORS
NOTE 35 LIST OF SOCIAL, ENVIRONMENTAL AND SOCIETAL INFORMATION
TO BE PROVIDED
NOTE 36 CODE TABLES
Entity Designation :………………………………… Fin. year ended 31/12/..
Identification number :…………………………. Duration ( in months).….
NOTE 1  NOTE 1: DEBTS GUARANTEED BY ACTUAL SURETIES
Actual Sureties
Gross Gua-
Description Note Mort-
Amount Pledges rantee
gage
& Othe
Financial and related debts:
Convertible bonds
Other bonds
Borrowings & liabilities of credit institutions
Other financial debts
SUB TOTAL (1)
Capital Leases :
Real estate lease
Furniture lease
Lease liability on Sales and lease-back
Capital lease liability
SUB TOTAL (2)
Current Liabilities:
Account payable
Customer
Personnel
Social security & social organisation
State
International organisation
Associates and Group
Sundry creditors
SUB TOTAL (3)
TOTAL (1) + (2) + (3)
Com-
Commit-
mitme
FINANCIAL COMMITMENTS ments
nt re-
given
ceived
Commitments to related entities
Unpaid redemption premiums
Endorsements, garantees
Mortgages, pledges, guarantees and others
Effected discrepancies not yet due
Commercial and professional receivables due
Discontinued conditional receivables
TOTAL
Commentary :
Indicate the reason or motive of the suretee
Entity Designation :………………………………… Fin. year ended 31/12/
Identification number :…………………………… Duration ( in months)…
NOTE 2  REQUIRED INFORMATION

A - DECLARATION OF CONFORMITY WITH SYSCOHADA

B - ACCOUNTING RULES AND METHODS

C– EXCEPTIONS FROM POSTULATES AND ACCOUNTING POLICIES

D - ADDITIONAL INFORMATION RELATING TO THE BALANCE SHEET, IN-

COME STATEMENT AND CASH FLOW STATEMENT
 Entity Designation :………………………………… Fin. year ended 31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 3 A  ASSET AT COST
OPENING ASSETS TRANSFERS AS A RESULT OF DISPO- TRANS- CLOSING
BALANCE BROUGHT IN BETWEEN REVALUATION SALS, FERS BET- BALANCES
SITUATIONS AND MOVEMENTS OF FIXED DURING THE ACCOUNTS DIVESTME WEEN OF FIXED
ASSETS PERIOD NTS, OUT AC- ASSETS
HEADING
ACCS (AT OF SER- COUNTS AC-
COST) VICE COUNTS
(AT COST)

INTANGIBLE ASSETS
Prospection and development fees
Patents, licences, softwares and similar rights
Goodwil and lease contracts
Other intangible assets

PROPERTY, PLANT AND EQUIPMENT

Land outside investment property
Land within investment property
Building outside investment property
Building within investment property
Fixtures, fittings and installations
Equipment, furniture and biological assets
Transport equipment

ADVANCE & PAYMENTS ON ACC OF FIXED ASSETS

Intangible assets
Property, plant and equipment

FINANCIAL ASSETS
Investments in shares
Other financial assets
GRAND TOTAL
Comment: Indicate the group’s receivable, with nature and due date
All significant variation must be commented For banks, DAT indicate the the name of the bank amount and due date
Detail the elements of the commercial fund and indicate the date of acquisition.
For an intangible related to the concession , make a description of the agreement
Indicate :
●the nature of the claim ;
●the duration of the concession ;
●the deadline
 Entity Designation :………………………………… Fin. year ended 31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 3 B  REAL ESTATES ASSET ACQUISITION
NATURE OF A INCREASES - B DECREASES - C D=A+B-C
SITUATIONS AND MOVEMENTS CONTRACT
(I; M; A) OPENING ASSETS TRANSFERS AS A RESULT DISPO- TRANS- CLOSING BA-
 BALANCE BROUGHT BETWEEN OF REVALUA- SALS, FERS LANCES OF FIXED
HEADING OF FIXED IN DU- ACCOUNTS TION DIVESTME BETWEEN ASSETS AC-
ASSETS RING THE NTS, OUT AC- COUNTS (AT
ACCS (AT PERIOD OF SER- COUNTS COST)
COST) VICE

Patents, licences, softwares and similar

rights
Goodwil and lease contracts
Other intangible assets

SUB TOTAL : INTANGIBLE ASSETS

Land
Fixtures, fittings and installations
Equipment, furniture and biological ass-
Transport equipment

SUB TOTAL : PROPERTY, PLANT AND EQUIP-

MENT

GRAND TOTAL
 I : Real estate lease ; M : Furniture lease ; A : Other contracts (duplicate the items if there are significant amount)
Comment : Indicate the nature of the property, the name of the lessor and the lease duration
 Entity Designation :………………………………… Fin. year ended 31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 3 C  ASSET DEPRECIATION

A B C A = A + B—C
SITUATIONS AND MOVEMENTS
OPENING BALANCE INCREASES: DEPRE- DECREASES: DEPRE- CLOSING BA-
HEADING OF DEPRECIATION CIATION CHARGE CIATION RELATING TO LANCES OF DE-
ACCOUNT FOR THE PERIOD FIXED ASSETS WRITTEN PRECIATION AC-
(CUMULATIVE) OFF COUNTS
(CUMULATIVE)
Prospection and development fees
Patents, licences, softwares and similar rights
Goodwil and lease contracts
Other intangible assets
SUB TOTAL : INTANGIBLE ASSETS

Land outside investment property

Land within investment property
Building outside investment property
Building within investment property
Fixtures, fittings and installations
Equipment, furniture and biological assets
Transport equipment
SUB TOTAL : PROPERTY, PLANT AND EQUIPMENT

GRAND TOTAL
Comment :
Indicate
●the methods of depreciation used;
●the life span of the asset or the rates of depreciation used.
 Entity Designation :………………………………… Fin. year ended 31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 3D  CAPITAL ASSETS: PROFIT OR LOSS ON DISPOSAL

ORIGINAL ACCUMULATED NET BOOK VALUE PROCEEDS PROFIT OR LOSS

VALUE DEPRECIATION C= A—B FROM DIS- E = D—C
A B POSAL
D
Prospection and development fees
Patents, licences, softwares and similar rights
Goodwil and lease contracts
Other intangible assets

SUB TOTAL : INTANGIBLE ASSETS

Land
Fixtures, fittings and installations
Equipment, furniture and biological assTransport
equipment

SUB TOTAL : PROPERTY, PLANT AND EQUIPMENT

Investments in shares
Other financial assets

SUB TOTAL : FINANCIAL ASSETS

GRAND TOTAL
Comment:
Indicate the justification/reason for the disposal as well as the date of acquisition and the date of disposal.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)…
NOTE 3 A  INFORMATION ON REVALUATIONS MADE BY THE ENTITY

Nature and date of revaluations :

Revalued items by ba- Additional deprecia-

Historical cost
lance sheet accounts tion

Method of revaluation used :

Tax Treatment of the Revaluation Gap and additional depreciation :

Amount of imbedded capital difference

Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)...
NOTE 4  FINANCIAL ASSETS
Recei-
Recei-
Recei- vables
vables
Year Year Varia- vable above a
Description more
N N-1 tion in % within year but
than two
one year not more
years
two years
Equity securities
Loans and receivables
Loans to Personnel
Claims on the state
Fixed securities
Cautions and deposits
Accrued interest
GROSS TOTAL
Equity securities amortisation

Amortisation on other finan-

cial assets
TOTAL NET OF AMORTISATION
List of subsidiaries and shareholdings :
Location Amount of Subsidiary’s
Company Acquisition
(town/ coun- % detained subsidiary profit for last
name value
try) capital financial year

Comment:
Justify any significant variation .
Consider all brought forward or old receivables.
For receivables relating to the concession, make a description of the agreement.
Indicate:
●the nature of the receivable ;
●the duration of the concession ;
●The deadline
Indicate the number and date of shares acquisition.
Impairment : indicate the events and circumstances that motivated the impairmentor
write-down.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)…

NOTE 5  N.O.A.CURRENT ASSETS

Description Year N Year N-1 Variation in %

Receivables on disposal of fixed assets

Other N.O.A receivables

GROSS TOTAL

Impairment of N.O.A receivables

TOTAL NET OF IMPAIRMENT

Comment:
Consider any significant variation
Impairment: indicate the events and circumstances that motivated the impair-
ment or write-back

N.O.A CURRENT LIABILITIES

Description Year N Year N-1 Variation in %

Investment providers
Investment providers, notes payable

Balance payments on equity securities and

uncalled capital
Other N.O.A liabilities

TOTAL

Comment:
Indicate the date of sale and the nature of asset purchased and / or sold
Explain any significant variation.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)..
NOTE 6  STOCKS AND IN PROGRESS 

Year Variation
Description Year N
N-1 in %
Stock
Raw materials and related supplies

Other supplies
Products in progress

Services in progress
Finished products
Intermediate products
Stock in transit, on consignment or on deposit
TOTAL GROSS INVENTORY IN PROGRESS
Impairment of stock
TOTAL NET OF IMPAIRMENT

 N.O.A stock will be included in N.O.A current assets only when their total amount is signi-
ficant(greater than 5 % of total current assets).

Comment:
 Indicate the date of taking inventory and briefly describe the procedure, the accounting
methods adopted to eveluate the stock.
 Comment any significant chages in inventory.
 Indicate impaired inventory and the events and circumstances that led to the impairment
or write-down.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)..
NOTE 7  CUSTOMERS
Recei-
vables
Recei-
Recei- above a
Varia- vables
Year Year vable year but
Description tion in more
N N-1 within not
% than two
one year more
years
two
years
Customers (excluding group
ownership reserves)

Account receivables (excluding

group ownership reserves)

Customers and receivbles with

ownership reserves

Group customers and account

receivables

Receivables on disposal of fixed

assets

Customer discounted and unma-

tured
Contested and doubtful claims

Accrued income receivable

CUSTOMERS GROSS TOTAL
Impairment of customer accounts
TOTAL NET OF IMPAIRMENT
Customers, advances received
outside group

Customers, advances received

Other credit customers
TOTAL CREDIT CUSTOMERS
Comment:
Comment on any significant variation.
Indicate for group receivables, the name of the group company and the % of shares held.
Comment on old receivables.
Indicate the events and circumstances that led to the impairment or write-down.
Entity Designation :………………………………… Fin. year ended 31/12/

Identification number :…………………………. Duration ( in months)..

NOTE 8  OTHER RECEIVABLES
Recei-
vables
Recei-
Recei- above a
Varia- vables
Year Year vable year but
Description tion in more
N N-1 within not
% than two
one year more
years
two
years

Personnel
Social organisations
State and public collectivities
International organisations

Shareholders, associates and

group

Transitional special ajustement

account related to the revision of
SYSCOHADA
Other sundry receivables
Non-blocked permanent ac-
counts of establishment and
branches

Income and expense liaison ac-

counts

Join venture liaison accounts

GROSS TOTAL OTHER RECEIVABLES

Impairment of other receivables

TOTAL NET OF IMPAIRMENT

Comment:
Justify any significant variation.
Detail significant receivables amount.
Justify old receivables.
Indicate the events and circumstances that led to the impairment or write-down.
 Transitional special adjustment account, indicate the account detail and the time left for clea-
rance
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)..
NOTE 8 A  CAPITALISED EXPENSE AMORTISATION SCHEDULE

Expenses to be
Pre-incorporation Bond redemption
Libellés spread over seve-
expenses premium
ral financial years

Global amount amortised

as at January 1, 2018

Duration of retained morti-

sation
Account Amount Account Amount Account Amount

60… 60… 6714

Financial Year 2018 61… 61…

62… 62…
63… 63…
... ...
Total Financial Year 2018
Total Financial Year 2019
Total Financial Year 2020
Total Financial Year 2021
Total Financial Year 2022

GRAND TOTAL
Entity Designation :………………………………… Fin. year ended 31/12/
Identification number :…………………………. Duration ( in months)..
NOTE 9  INVESTMENT SECURITIES

Year Variation
Description Year N
N-1 in %

Treasury securities and short-term bills

Shares

Bonds

Subscription warrants

Negiciables securities outside the region

Accrued interes

Other assimilated amounts

GROSS TOTAL SECURITIES

Impairment of securities

TOTAL NET OF IMPAIRMENT

Comment:
Justify any significant variation.
For securities quote on the stock exchange market: indicate the number, the unit price
at acquisition and the price of the stock exchange at december, 31.
Remove the shares and indicate the date of acquisition and the number of shares held.
Indicate the events and circumstances that led to the impairment or write-down.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)...
NOTE 10  BILLS TO BE CASHED
Year Variation
Description Year N
N-1 in %

Bills to be cashed/collected

Bills on collection
Cheques to be cashed

Cheques on collection

Credit cards to be cashed

Other valuables to be cashed

GROSS TOTAL OF BILLS TO BE CASHED

Impairment of valuables to be cashed

TOTAL NET OF IMPAIRMENT

Comment:
Comment any significant variation ;
Indicate the events and circumstances that led to the impairment or write-down.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)..
NOTE 11  AVAILABILITIES
Year Variation
Description Year N
N-1 in %
Local banks
Banks, other states or regions

Banks, term deposit

Other Banks

Accrued bank interests

Postal cheques
Other financial institutions

Financial institutions interest accrued

Treasury instruments
Cash
Mobile electronic cash
Advance accounts and flow-through transfers

GROSS TOTAL AVAILABILITY

Impairment
TOTAL NET OF IMPAIRMENT
Comment:
Indicate the date of reconciliation of bank accounts.
Indicate the date of cash count and electronic money instrument inventory.
Comment any significant variation ;
Detail the elctronic money instrument if the amount is significant.
Indicate the events and circumstances that led to the impairment or write-down.

NB : Banks and accrued interest as well as financial institutions accrued interest are in-
cluded in this heading in negative if the principal account attached is debit.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)...
NOTE 12  CONVERSION GAP

Amoun
UML-
t in UML Ac- Change
Curren- Cours
Description foreign quisition in abso-
cy e
curren- year lute value
31/12
cy
Asset Translation differences :
Detail the receivables and debts concer-
ned

Liability Translation differences:

Detail the receivables and debts concer-
ned

Comment:
Make a comment

TRANSFER OF CHARGES
Year Variation
Description Year N
N-1 in %
Transfer of Operating Expenses :
Detail the nature of the charges transfered

Transfer of Financial charges:

Detail the nature of the charges transfered

Comment:
Make a comment
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)...
NOTE 13  CAPITAL
Nominal value of shares and units :

Nature of shares Total In-year

Nationali- Num-
Surname and name (ordinary or pre- Amou transfers or
ty ferences) ber repayments
nt

Subscribers, uncalled capital

TOTAL

Comment :
Indicate if possible the amount of capital in the constitution.
Indicate if possible the dates of the AGE and the amount of capital increased in case of capital
increase.
Indicate if possible the dates of the AGE and the amount of capital decreased in case of capital
reduction.
Indicate the advantages granted to preference shares.
Subscribers, uncalled capital : indicate the time left to call up the capital.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)..
NOTE 14  PREMIUMS AND RESERVES
Change in
Year
Description Year N absolute
N-1
value

Share premium
Issuance premium

Merger premium
Conversion premium
Other premium
TOTAL PREMIUM

Legal reserves
Statutory reserves

Reserves of long-term net capital gains

Reserves for the allocation of bonus shares to the

employees and directors

Other related reserves

TOTAL UNAVAILABLE RESERVES

Free Reserves
Retained earnings

Comment:
Indicate the dates of the AGE which decided on the contribution premium, the issue of mer
ger.
Indicate the details of the free reserves.
Indicate the amount remaining to be provided and the contribution rate of the legal reserve.
Indicate the date of the AGM that justifies the change in reserves and retained earnings.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)...
NOTE 15 A  TOTAL REGULATED SUBSIDIES AND PROVISIONS
Change in
Not Year Tax
Description Year N absolute Deadlines
e N-1 regime
value

State

Regions

Divisions

Municipalities and decentralised

public authorities

Public entities and parstatals

Entities and private organisations

International organisations
Others

TOTAL SUBSIDIES

Accelerated depreciation
Plus-value de cession à réinvestir
Special revaluation provision 3E
Regulated provisions for capital
assets

Regulated inventory provisions

Provisions for investment

Other provisions and regulated

funds

TOTAL REGULATED PROVISIONS

TOTAL REGULATED SUBSIDIES AND

PROVISIONS

Comment:
Indicate for the subsidies, the date of grant, the nature and possible obligations.
For regulated provisions, indicate the reference text, the obligations.
Comment on any significant variation.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months)...
NOTE 15 B  OTHER EQUITY RESOURCES 

Change in Varia-
Not Year
Description Year N absolute tion In Deadlines
e N-1
value %

Equity securities
Conditional advances
Subordinated securities of indefi-
nite duration (S.S.I.D.)

Bonds redeemable in shares

(B.R.S.)

Others
TOTAL OTHER EQUITY

 Where applicable, a ‘other equity’ heading (amount of equity securities, conditional advances,
etc.) on a separate line is inserted between the headings ‘TOTAL EQUITY AND LIABILITIES’ and
‘borrowings and financial debts’ if the amount of other equity is significant.

Comment :
Justify the recording of these debts in a specific section of the liabilities of the balance sheet
"other equity" (low probability of repayment, absence of debt schedule, etc.)
Justify the significance of the total amount of this heading
Comment on any significant variation
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 16 A  : FINANCIAL DEBT AND ASSIMILATED RESOURCES

Cha Liability
nge Liabili- above a Liabi-
in Va- ty year but lity
Description Yea Year ab- riatio within not abov
rN N-1 solut n in % one more e
e year than two
va- two years
lue years
Bond loans
Borrowings and liabilities from financial institutions
Advances received from state
Advances received and blocked current accounts
Deposits and surety bonds received
Accrrued interest
Advances with special conditions
Other borrowings and liabilities
Debts related to investments
Permanent blocked accounts of estalishments and
branches
TOTAL BORROWINGS AND FINANCIAL DEBTS
Real estate leasing
Furniture leasing
Sale and lease-back
Accrued interest
Other lease liabilities
TOTAL LEASE LIABILITIES
Provisions for disputes
Provisions for guarantees to be given to customers
Provisions for losses on future completion market
Provisions for exchange losses
Provisions for taxes
Provisions for pensions and asimilated bond
Pension plan asset
Provisions for restructuring
Provisions for fines and penalties
Provisions of own insurer
Provisions for dismantling and restoration
Provisions for rights to deduction
Other provisions
TOTAL PROVISIONS fOR RISKS AND CHARGES

Comment :
For each loan and acquisition lease debt: indicate the date of grant, the name of the financial institution, the initial
amount of the loan or debt, the term of the loan, the guarantees given by the company. Indicate the events and circum-
stances that led to the provision and resumption.
For pensions and retirement obligations indicate: ;State the method of evaluation used
For the assets of the regime, indicate the name of the insurance company or pension fund, the description of the
agreement signed with the organization, the periodicity of the payments, the amount and duration of the agreement;
indication of the value retained for the main actuarial assumptions at the balance sheet date and their basis of
determination.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 16 B  : RETIREMENT BENEFITS AND ASSOCIATED BENEFITS

ACTUARIAL ASSUMPTIONS

Description Year Year

N N-1
Rate of increase in wages
Discount rate
Inflation rate
Likelihood of being present in the entity at the date of retirement (past
experience)
Probability of being alive at retirement age (life span schedule)
Effective rate of return on assets scheme
Comment :
 Comment on the changes in actuarial assumptions used to calculate pension and other post-retirement it obligations.

CHANGE IN THE VALUE OF THE RETIREMENT COMMITMENT DURING THE YEAR

Description Year Year

N N-1
Obligation for early retirement commitments
Cost of services rendered during the year-financial cost
Actuarial losses/gains
Benefits paid during the year
Passed service cost
Obligation in respect of retirement commitments at balance sheet date
Comment :
Indicate the amount of the expense recognised by nature

SENSITIVITY ANALYSIS OF ACTUARIAL ASSUMPTIONS

Year N Year N-1
Description
Increase Decrease Increase Decrease
Discount rate (change of ...%)

Wage growth rate (change

of ...%)
Staff turnover rate ((change
of ...%)
Comment :
Indicate the impact of the changes obtained on the amount of pension commitments
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 16 B BIS : RETIREMENT BENEFITS AND ASSOCIATED BENEFITS

NET ASSETS / LIABILITIES RECOGNISED IN RESPECT OF FINANCIAL SCHEMES

Description Year Year

N N-1
Present value of obligations resulting from funded schemes
Present value of assets allocated to pension schemes
Surplus/deficit of scheme
Comment :
 Indicate the asset or liability amount reported at balance sheet date

CURRENT ASSET VALUE OF THE SCHEME

Year N Year N-1
Description Expected Actual value Expected Actual value
repayments of Asset repayments of Asset
Share
Bonds
Others
Total

Comment :
Explain how rates of return by asset class and global have been determined.
Indicate the amount of actual yields of assets allocated to the N and N-1 schemes.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 16 C  : CONTINGENT ASSETS AND LIABILITIES

Description Year N Year N-1

Contingent asset
Litigations
.............
.............
Contingent liabilities
Litigations

.............
.............

Comment:
 Describe the main characteristics of the contingent asset and liabilities, the time frame at which receipts
and disbursements are expected and any repayments to be received.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 17  : TRADE SUPPLIERS

Liability
Liability above a Liability
Year N- Varia- within one year but above
Description Year N 1 tion in % not more
year than two two years
years

Suppliers account (excluding

group)

Suppliers’ bill payable

(excluding group)
Suppkiiers liabilities and bills
payable –Group

Supplier invoice not received

(excluding group)

Supplier invoice not received -

Group

TOTAL SUPPLIERS

Suppliers’ advances and ins-

tallments (excluding group)

Suppliers’ advances and ins-

tallments -group

Other debtor suppliers

TOTAL DEBTOR SUPPLIERS

Comment :
Comment any significant variation.
Indicate for group debt; the name of the group company and the % of share held.
Consider old debts
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 18  : FISCAL AND SOCIAL LIABILITIES

Chang Liability
Liabili- above
e in Varia- ty a Liability
Description Year N Year abso- tion in year but
within not above
N-1 lute % one more two
value year than two
years
years

Personnel advances and

installments
Personnel remunerations
due
Other personnel
National Social Insurance
fund
Retirement fund
Other social organisations
TOTAL SOCIAL LIABILITIES
State, company tax on
profits
State, taxes and levies
State, VAT
State, taxes withheld at
source
Other fiscal liabilities
TOTAL FISCAL LIABILITIES
TOTAL FISCAL AND SOCIAL
LIABILITIES
Comment :
Comment any significant variation.
Comment any old liability
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 19  : OTHER LIABILITIES & PROVISIONS FOR SHORT TERM RISKS

Chang Liability
Liabili- above
e in Varia- ty a Liability
Description Year N Year abso- tion in year but
within not above
N-1 lute % one more two
value year than two
years
years

International organisations
Subscribers, capital tran-
sactions
Shareholders, current ac-
count
Shareholders dividend
payable
Group, current accounts
Other shareholder liabilities
TOTAL SHAREHOLDER LIABI-
LITY
Sundry creditors
Bondholders
Director’s remuneration

Factor account
Payments payable on unis-
sued investment securities

Transitional special ad-

justment account related
to the revision of SYS-
COHADA
Other sundry creditors
TOTAL SUNDRY CREDITORS
Unblocked permanent
accounts of establishments
and branches
Income and expenses joint
venture accounts
Joint venture liabilities

TOTAL JOINT VENTURE AC-

COUNTS
TOTAL OTHER LIABILITIES

Provisions for short-term

risks (see note 28)

Comment :
Consider any significant variation.
Indicate the rate of pay in case there are payments made to the current account.
Consider old debts.
For transitional special ajustement account, indicate the account detail and the time left for clearance.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 20  : BANKS, DISCOUNT CREDIT AND TREASURY

Year Variation
Description Year N
N-1 in %
Campaign credit discounts
Ordinary discount credit
TOTAL: BANKS, DISCOUNT CREDITS AND TREASURY
Local bank
Baks, other states and regions
Other banks
Bank accrued interest
Treasury credit
TOTAL: BANKS, TREASURY CREDITS
GRAND TOTAL

Comment :
Consider any significant variation.
Indicate the name of the organisation, the credit conditions, the interest rate, the duration of the
credit

NB : Banks and accrued interests are are included in this section if the principal account is a creditor account
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 21  : TURNOVER AND OTHER INCOME

Year Variation
Description Year N
N-1 in %
Sales within the region
Sales out of the region
Sales– by Group
E-Sales
TOTAL : SALES
Sales within the region
Sales out of the region

Sales– by Group
E-Sales
TOTAL : SALES OF PRODUCTS MANUFACTURED
Sales within the region
Sales out of the region
Sales– by Group
E-Sales
TOTAL : SALES OF WORKS AND SERVICES RENDERED
Accessory income
TOTAL : TURNOVER
Capitalised production
Operating subsidies
Other income
TOTAL : OTHER INCOME
GRAND TOTAL
Comment :
Consider any significant variation.
Detail out, income from product sales, intermediaries, residual products, accessory income, other significant income.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 22  : PURCHASES

Year Variation
Description Year N
N-1 in %
Purchases within the region
Purchases out of the region
Purchases– by Group
TOTAL : ACHATS DE MARCHANDISES
Purchases within the region
Purchases out of the region
Purchases– by Group

TOTAL : PURCHASE OF RAW MATERIALS AND RELATED SUPPLIES

Consumable material
Combustible material
Cleaning products
Workshop, factory and warehouse supplies
Water
Electricity
Other energies
Maintenance supplies
Office supplies
Small equipment and tools
Purchase of studies, services, materials and equipments

Packaging purchases
Purchase costs
Rebates, discounts and ristournes
TOTAL : OTHER PURCHASES

Comment :
Consider any significant variation.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 23  : TRANSPORT

Year Variation
Description Year N
N-1 in %
Transport on sales
Transport on account of third parties
Personnel transport
Transport of mails
Other transport
TOTAL
Comment :
Comment on any significant variation.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 24  : EXTERNAL SERVICES
Year Variation
Description Year N
N-1 in %
General sub-contracting
Rental charges
Acquisition lease payments
Repairs and maintenance
Insurance premiums
Studies, recherches and documentation
Advertising, publications, public relations
Telecommunications expenses
Bank charges
Intermidiary and consultancy fees
Staff training costs
Royalties for patents, licences, software, concessions, and
similar rights
Contributions
Other external charges
TOTAL
Comment :
Comment on any significant variation.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 25  : TAXES AND LEVIES

Year Variation
Description Year N
N-1 in %
Direct taxes and levies
Indirect taxes and levies
Registration rights
Penalties and fiscal fines
Other taxes and levies

TOTAL

Comment :
Comment on any significant variation.
 Detail the penalties and fines and indicate the reasons for such.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 26  : OTHER EXPENSES

Year Variation
Description Year N
N-1 in %
Loss on trade receivables
Losses on other receivables
Share of profit or loss on jointly made transactions
Book value of current asset disposed
Staff allowance and other director’s fees

Donations and patronage

Other miscellaneous expenses
Provision charges and provisions for short-term operating liabili-
ties (see note 28)

TOTAL

Commentaire :
Comment on any significant variation.
Indicate the date of the minutes of the AGM or the Board of directors, which sets the remu-
neration of directors.
Indicate the beneficiary bodies of the donations
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 27 A  : PERSONNEL EXPENSES

Year Variation
Description Year N
N-1 in %
Direct remuneration paid to staff
Flat-rate allowances paid to staff
Social expenses
Remuneration and social security contributions of each staff
Remuneration transferred from expatraits
Other social expenses
TOTAL

Comment :
Comment on any significant variation.
Indicate the nature and duration of the expatrait’s contract.
 Entity Designation :………………………………… Fin. year ended 31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 27B  EMPLOYEES, PAYROLL AND EXPATRAITS
EMPLOYEES AND PAYROLL EMPLOYEES PAYROLL

QUALIFICATIONS Other OHA- Non Other OHA- Non

National DA states OHADA National DA states OHADA
states TOTAL states TOTAL
M F M F M F M F M F M F
YA 1. Senior management
YB 2. Senior technicians and middle level management
YC 3. Technicians, formen and skilled workers
YD 4. Clerks, unskilled workers, manual labour and appren-
tices
YE TOTAL 
YF Permanent staff
YG Temporal staff
Billing to
2. Expatraits entity
YH 1. Senior management
YI 2. Senior technicians and middle level management
YJ 3. Technicians, formen and skilled workers
YK 4. Clerks, unskilled workers, manual labour and appren- M : Male
tices
YL TOTAL ‚ F : Female
YM Permanent staff
YN Temporal staff
YO TOTAL ‚ + ‚
Comment :
Make a comment if necessary in case of any significant change in personnel.
 Entity Designation :………………………………… Fin. year ended 31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 28  PROVISIONS AND DEPRECIATION REPORTED IN THE BALANCE SHEET
A B C D = A + B—C

SITUATIONS AND INCREASES : AMORTISATION DIMINUTIONS : WRITE-BACK

MOVEMENTS OPENING PROVISIONS
NATURE PROVISIONS OPERATIO- FNAN- OPERA- FNAN- AT YEAR END
N.O.A N.O.A
NAL CIAL TIONAL CIAL
1. Regulated provisions
2. Financial provisions for liabilities and
charges
3. Impairment of assets
TOTAL : DOTATIONS
4. Impairment of inventory
5. N.O.A current asset impairemnt
6. Impairment of suppliers
7. Impairment of customers
5. Impairment of suppliers
7. Other receivable impairment
8. Impairment of equity securities
9. Impairments to be borne
10. Availability impairment
11. Impairment and provisions for short-term
risks
12. Impairment and provisions for short =term
financial risks
TOTAL : EXPENSES FOR SHORT-TERM IMPAIR-
MENT AND PROVISIONS
TOTAL PROVISIONS AND IMPAIRMENT
Comment:
Indicate the events and circumstances that led to the formation and write-back of the impairment and the provision
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 29  : FINANCIAL INCOME AND EXPENSES
Year Variation
Description Year N
N-1 in %
Interest on borrowings
Interest on rental leases
Discounts granted
Other interests
Discount on commercial bills
Exchange losses
Losses on disposal of investment securities
Malis from bonus shares granted to employees and directors

Losses on financial risks

Financial amortisation and short-term provision (see note 28)

SUB TOTAL : FINANCIAL EXPENSES

Interest on loans and other receivables
Income from investments
Discounts obtained
Investment income
Exchange gains
Gains on sales of securities
Gains on financial risks
Write-back of financial amortisation and short-term provision
(see note 28)
SUB TOTAL : FINANCIAL INCOME

TOTAL
Comment :
Comment any significant variation.

In case of payment at maturity, indicate the amount of unrecognised interest.

Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 30  : OTHER N.O.A INCOME AND EXPENSE
Year Variation
Description Year N
N-1 in %
N.O.A Expenses recognised  to be detailed
……………………..
……………………..
N.O.A Losses on receivables
Donations and gifts
Forfeiture of receivables
Porvisions for N.O.A expenses
N.O.A provisions
Workers’ participation
Compensating subsidies
SUB TOTAL : OTHER N.O.A EXPENSES
N.O.A Income recognised  to be detailed
……………………..
……………………..
Donations and gifts
Forfeiture of receivables
Transfer of N.O.A expenses
Write-back of N.O.A impairment charges and short-term provi-
sions
N.O.A Write-backs
SUB TOTAL : OTHER N.O.A INCOME

Comment :
Comment any significant variation.
Entity Designation :………………………………… Fin. year ended 31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 31  APPROPRIATION OF PROFITS AND OTHER ITEMS FOR THE LAST FIVE PERIODS

Nature Financial Years 

N N-1 N-2 N-3 N-4
of indicators
CAPITAL STRUCTURE AT THE END OF FINANCIAL YEAR‚
Share capital
Ordinary shares
Preference shares (A.D.P) with no voting rights
New shares to be issued
- by convertible bonds
- by exercising subscription rights
OPERATIONS AND RESULTS FOR THE YEARS
Turnover excluding tax
N.O.A profit/loss excluding provision for depreciation and write-backs (operating and financial)
Employee participation in profits
Company income tax
Net profit/loss 
PROFIT OR LOSS AND DIVIDENDS DISTRIBUTED
Profit or loss distributed 
Dividend per share
PERSONNEL AND PAYROLL POLICY
Average number of employees during financial year 
Average number of expatraits
Payroll distributed during the year 
Employee benefits paid during the year 
[Social security, social welfare]
Expatraits billed to the entity 

Including the financial year in which the financial statements are submitted for the  When there is a loss, it must be enclosed in parenthenses ‚ Total accounts 661, 662, 663
approval of the assembly
 Indication, in case of partial release of capital, the amount of uncalled capital  Year N corresponds to the proposed dividend for the last financial ‚ Total des accounts 664, 668
year
 The items under this heading are those shown in the income statement  Own staff ‚ Account 667
 Entity Designation :………………………………… Fin. year ended 31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 32  PRODUCTION FOR THE YEAR
PRODUCT UNITS PRODUCTION PRODUCTION SOLD IN PRODUCTION SOLD PRODUCTION CAPI- OPENING STOCK CLOSING STOCK
DESCRIPTION SOLD IN THE OTHER OHADA STATES OUT OF THE OHADA TALISED FOR THE YEAR FOR THE YEAR
COUNTRY

Quantity Value Quantity Value Quantity Value Quantity Value Quantity Value Quantity Value

NOT VENTI-
LATED

TOTAL
 Entity Designation :………………………………… Fin. year ended 31/12/…
Identification number :…………………………. Duration ( in months).….
NOTE 33  PURCHASES FOR PRODUCTION

PURCHASES MADE DURING THE YEAR

DESCRIPTION OF MA- VARIATION IN
UNIT OF QUAN- PRODUCTS OF THE IMPORTED PRODUCTS
TERIALS AND PRO- STOCK
TITY CHOSEN COUNTRY BOUGHT IN THE COUNTRY BOUGHT OUT OF THE COUNTRY
DUCTS
Quantity Value Quantity Value Quantity Value (in value)

NOT VENTILATED

TOTAL
 (IN MILLIONS OF FRANCS Year N Year N-1 Variation in %
OPERATIONS ANALYSIS
INTERMEDIATE MANAGEMENT BALANCE

TURNOVER (SALES)
COMMERCIAL MARGIN
VALUE ADDED
GROSS PROFIT
PROFIT OR LOSS ON OPERATIONS
FINANCIAL PROFIT OR LOSS
PROFIT OR LOSS ON ORDINANRY ACTIVITIES
PROFIT OR LOSS ON NON ORDINARY ACTIVITIES
NET PROFIT OR LOSS
DETERMINATION OF SELF-FINANCING CAPACITY

GROSS PROFIT OR LOSS

+ Book value of current assets disposed (account 654)
- Proceeds from disposal of current assets (account 754)

= OPERATIONAL SELF -FINANCING CAPACITY

+ Financial revenue
+ Foreign exchange gain
+ Transfer of financial expenses
+ N.O.A Income
+ Transfer of N.O.A expenses
- Financial expenses
- Foreign exchange losses
- Participation
- Income taxes
= GLOBAL SELF-FINANCING CAPACITY (C.A.F.G.)
- Distribution of dividends during the year
= SELF-FINANCING
PROFITABILITY ANALYSIS

Economic profitability = Operating results (a) /Shareholders’ equity + financial

debts. Financial profitability= Net profit/Shareholders’ equity
ANALYSIS OF FINANCIAL STRUCTURE

Equity and assimilated resources

+ Financial debts and other assimilated resources(b)
= Stable resources
- Assets capitalised (b)
= WORKING CAPITAL (1)

Current assets (b)

- Current liabilities (b)
= OPERATING FINANCIAL NEED(2)
N.O.A. Current assets (b)
- N.O.A. Current liabilities(b)
= N.O.A FINANCIAL NEED(3)
GLOBAL FINANCIAL NEED (4) = (2) + (3)
NET TREASURY (5) = (1) - (4)
CONTROL : NET TREASURY = (TREASURY- ASSET) - (TTREASURY– LIABILITY)
ANALYSIS OF TREASURY VARIATIONS

Cash flow from operating activities

-Cash flow from investing activities
+Cash flow from financing activities

= NET TREASURY VARIATION FOR THE PERIOD

ANALYSIS OF CHANGE IN NET FINANCIAL DEBT

Gross financial debt (Financial debt* + Treasury – Liabilities)

-Treasury - asset
= NET FINANCIAL DEBT

(a) Theoretical operating profits after tax .

(b) Translation adjustments must be eliminated in order to bring the relevant receivables and debts back to their initial value.
Financial debts* = Borrowings and other financial liabilities + acquisition lease liabilities.
Entity Designation :………………………………… Fin. year ended
31/12/…
Identification number :…………………………. Duration ( in months).….
MANDATORY NOTE FOR ENTITIES WITH A WORKFORCE OF MORE THAN 250 EM-
PLOYEES
List of social, environmental and societal information to be provided
SOCIAL INFORMATION
Occupation :
• The total number and distribution of employees by sex, age and geographical area ;
• Hiring and lay-off;
• Remuneration and their evolution.
Social relations :
• The organisation of social dialogue ;
• The statement of collective agreements
Health and security :
• Occupational health and safety conditions ;
• The statement of agreements signed with trade unions or employees representatives in the area of
health and safety at work
Training :
• The policies implemented in terms of training ;
• The total number of hours of training.
Equal treatment :
• Measure taken to promote equality between men and women;
• Measures taken to promote the employment and intergration of people with disabilities ;
ENVIRONMENTAL INFORMATION
General policy on the environment :
• The organisation of the company to take into account environmental issues and, where applicable,
environmental assessment or certification procedures ;
• Training and information campaigns on the protection of the environment by employees devoted to
the prevention of environmental risks and pollution.
Pollution and waste management :
• Measures to prevent, reduce or repair releases to the air, water and soil that seriously affect the envi-
ronment ;
• Measures to prevent, recycle and dispose of waste ;
• The taking into account of of noise and other forms of pollution specific to an activity.
Sustainanble use of resources :
• Water consumption and water supply according to local constraints ;
• Consumption of raw materials and measure taken to improve efficiency in their use ;
• Energy consumption; measure taken to improve energy efficiency and the use of renewable energies.

Climate change :
• Greenhouse gas emissions.
Protection of biodiversity :
• measure taken to preserve or develop biodiversity.
INFORMATION RELATING TO SOCIAL COMMITMENTS IN FAVOR OF SUSTAINABLE DEVELOP-
MENT
The territorial, economic and social impact of the company activity :
• employment and regional development ;
• on riparian or local population.
Relations with persons or organisationa interested in the activity of the society (integration associations ,
educational institutions, etc) :
• the conditions for dialogue with such persons or organisations ;
• Partnership or patronage actions.
Sub-contracting and suppliers:
• in the inclusion of social and environmental issues in the purchasing policy.
 1 - Legal form code   3 - Head-quarter country code

Public Limited Company (PLC) 0 0 OHADA Countries

Public Limited Company (PLC) 0 1 Other African countries 2 1

Private Limited Company (LTD) 0 2 France 2 3

Limited Partnership 0 3 Other countries of the European 3 9

General partnership 0 4 U.S.A. 4 0

Joint Venture Companies 0 5 Canada 4 1

Economic Interest Group (EIG) 0 6 Other U.S Countries 4 9

Association 0 7 Asian countries 5 0

Joint Stock company 0 8 Other countries 9 9

Other legal form (to be specified) 0 9

2 - Tax Regime

Real 1
Real (Medium-size co) 2
Simplified 3
Flat rate 4

Replace the first by 0 if the entity receives a prior approval

Benin = 01 ; Burkina Faso = 02 ; Cote d'ivoire = 03 ; Guinee Bissau = 04 ; Mali = 05 ; Niger
= 06 ; Senegal = 07 ; Togo = 08; Cameroon = 09; Congo = 10; Gabon = 11;
Central African Republic = 12; Chad = 13; Comoros = 14; Guinea = 15; Equatorial
Guinea = 16; Congo DRC = 17.