Model declarations and supporting material for the nomination of a candidate for a member of the Bank's Supervisory Board and for the assessment of suitability by the Bank's AGM

I. Statements to be filled in by a candidate for a member of the Supervisory Board of PKO Bank Polski S.A for the purpose of the initial assessment of suitability (applies to a candidate who is not a member of the Bank's Supervisory Board at the time of nomination by a shareholder¹):

1. Initial suitability assessment form together with information on the processing of personal data of the candidate for member of the Supervisory Board

2. Statements concerning:

• Appendix No. 1 – Candidate’s education
• Appendix No. 2 – Professional bio of the candidate
• Appendix No. 3 – Description of the position held
• Appendix No. 4 – Competences (Attention: Attachment No. 4 is also to be filled in by the Shareholder proposing the candidate in the relevant section.)
• Appendix No. 5 – Clean criminal record of the candidate
• Appendix No. 6 – Candidate’s warranty
• Appendix No. 7 – Financial situation and conflict of interest of the candidate
• Appendix No. 8 – Independence of the candidate's judgement
• Appendix No. 9 – Combination of functions
• Appendix No. 10 – Time commitment
• Appendix No. 11 – Competences regarding requirements for the possible participation in the Supervisory Board’s Audit Committee
• Appendix No. 12 – Criterion of independence within the meaning of the Best Practice for WSE listed companies 2021

¹Suitability assessment forms for the current members of the Bank's Supervisory Board, which are required for appointment for the next term of office, are submitted to the Bank directly by the members of the Bank's Supervisory Board as part of the additional suitability assessment process carried out upon the appointment of a new term of office of the Bank's Supervisory Board.

II. Background material on the recommended minimum competency levels and other requirements for the nomination of candidates for members of the Bank's Supervisory Board

III. Diversity in a business environment