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Appendix III - Statement of changes in equity for the year ended __ 202X

A. Statement of recognized income and expense for the year ended ___202X

ACCOUNT No.Note to the financial statements no.202X202X-1
A. RESULT FROM INCOME STATEMENT
Income and expenses imputed directly to equity
I. For valuation of financial instruments
(800), (89), 900, 991, 9921. Financial assets at fair value through changes in equity
2. Other income/ expenses
(810), 910II. For cash-flow hedges
94III. Subsidies, donations and legacies received
(85), 95IV. For actuarial gains or losses and other adjustments
(8300)*, 8301*,(833), 834, 835, 838V. Tax effect
B. TOTAL REVENUES AND EXPENSES IMPUTED DIRECTLY TO EQUITY (1+11+111)
Transfers to the income statement
VI. For valuation of financial instruments
(802), 902, 993, 9941. Financial assets at fair value through changes in equity.
2. Other income/expenses.
(812), 912VII. For cash-flow hedges
(84)VIII. Subsidies, gifts and bequests
8301, (836), (837)IX. Tax efect
C. TOTAL TRANSFERS TO THE INCOME STATEMENT (VI+VII+VIII+IX)
TOTAL INCOME AND EXPENSES RECOGNIZED (A + B + C)

B. Statement of total changes in equity for the year ended ___202X

A. BALANCE 202X-2
I. Adjustments for changes of accounting policy 202X-2 and previous years
II. Adjustments for errors 202X-2 and previous years
B. ADJUSTED BALANCE, START OF YEAR 202X-1
I. Total income and expense recognised
II. Operations with shareholders or owners
1. Capital increases
2. ( - ) Capital reductions
3. Conversion of financial liabilities to equity (conversion of debentures, waiver of debts)
4. ( - ) Dividend distribution
5. Operations with treasury shares or instruments (net)
6. Increase (reduction) in equity resulting from business a combination
7. Other operations with shareholders or owners
III. Other changes in equity
C. BALANCE, END OF YEAR 202X — 1
I. Adjustments for changes in criteria 202X-1
II. Adjustments for errors 202X-1
D. ADJUSTED BALANCE, START OF YEAR 202X
I. Total income and expense recognized
II. Operations with shareholders or owners
1. Capital increases
2. ( - ) Capital reductions
3. Conversion of financial liabilities into equity (conversion of debentures, waiver of debts)
4. ( - ) Dividend destribution
5. Operations with treasury shares or instruments (net)
6. Increase (reduction) in equity resulting from a business combination
7. Other operations with shareholders or owners
III. Other changes in equity
E. BALANCE, END OF YEAR 202X
(*) May be positive or negative
* Chart of accounts approved by Royal Decree 1514/2007 of November 16, 2007 approving the Spanish National Chart of Accounts, version in force as from January 31, 2021.