Forms for download

The forms below can be downloaded in various formats.

You can fill in the file in docx format on your computer, print it out and sign it by hand.

The file in html format is intended for viewing only; alternatively, you can print it out and fill it in by hand. The files in html format are available in Czech language only.

The files in pdf format are designed for download or printing.

Name of form	Purpose of form	Form for download as a docx file	Form for download - other file types
Power of attorney	To obtain deposit compensation, you may also authorize another person to collect it on your behalf based on an officially certified power of attorney. The power of attorney form will also be available at branches of the payout bank. Filled document template can be found here (in CZ only).	Power of attorney (docx)	Power of attorney (html)
Application for increased compensation	To claim a payout of increased compensation for deposits, it is necessary to complete this form and send it to the address of the Guarantee System (Contacts). More detailed information on the payout of increased compensation can be found here: Increased compensation. The applicant will be informed in writing about whether his/her application has been approved or not.	Application for increased compensation (docx)	Application for increased compensation(html)
Complaint form	If you believe you have not been awarded the right amount of compensation, you may use the complaint procedure. You can use this complaint form which, once completed, you can send to the postal or e-mail address of the Guarantee System (Contacts). For complaint forms, an officially certified signature is not required.	Complaint form (docx)	Complaint form (html)
Compensation transfer request for natural person	If you require payment of the compensation via bank transfer by correspondence, a Compensation transfer request with an officially certified signature has to be sent to the payout bank´s address: Komerční banka, a.s., CKB department 2192, Nám. Junkových 2772/1, Praha 5 – Stodůlky, postcode 155 00 Filled document template can be found here.	Compensation transfer request for NP (docx)	Compensation transfer request for NP (pfd)
Compensation transfer request for legal person	If you require payment of the compensation via bank transfer by correspondence, a Compensation transfer request with an officially certified signature has to be sent to the payout bank´s address: Komerční banka, a.s., CKB department 2192, Nám. Junkových 2772/1, Praha 5 – Stodůlky, postcode 155 00. The request must be accompanied by the original, an officially certified copy, or an electronically signed valid extract from the Commercial Register or another public register, not older than 3 months.	Compensation transfer request for LP (docx)	Compensation transfer request for LP (pfd)