‫اﻟﺠﻤﻬﻮرﻳﺔ اﻟﺘﻮﻧﺴﻴﺔ‬

‫وزارة اﻟﻤﺎﻟﻴﺔ‬

‫ﺷﮭﺎدة ﻓﻲ اﻟﺨﺼﻢ ﻣﻦ اﻟﻤﻮرد ﻋﻠﻰ اﻟﺼﻔﻘﺎت‬

‫اﻟﻤﺒﺮﻣﺔ‬
‫ﻣﻊ اﻟﺪوﻟﺔ واﻟﺠﻤﺎﻋﺎت اﻟﻤﺤﻠﯿّﺔ واﻟﻤﺆﺳﺴﺎت‬
‫واﻟﻤﻨﺸﺂت‬
‫اﻟﻌﻤﻮﻣﯿﺔ ﺑﻌﻨﻮان اﻷداء ﻋﻠﻰ اﻟﻘﯿﻤﺔ اﻟﻤﻀﺎﻓﺔ‬
‫واﻟﻀﺮﯾﺒﺔ‬
‫ﻋﻠﻰ اﻟﺪﺧﻞ واﻟﻀﺮﯾﺒﺔ ﻋﻠﻰ اﻟﺸﺮﻛﺎت‬
‫ﺃ ـ ﺍﻟﻬﻴﻜل ﺍﻟﻤﺩﻴﻥ ‪:‬‬
‫ﺍﻻﺴﻡ ﻭﺍﻟﻠﻘﺏ ﺃﻭ ﺍﻻﺴﻡ ﺍﻻﺠﺘﻤﺎﻋﻲ ‪.................................................................... :‬‬
‫ﺍﻟﻨﺸﺎﻁ ‪............................................................................................... :‬‬
‫ﺍﻟﻌﻨﻭﺍﻥ ‪............................................................................................... :‬‬
‫ﺭﻗﻡ ﺍﻟﻤﺅﺴﺴﺔ ﺍﻟﺜﺎﻨﻭﻴﺔ‬ ‫ﺭﻤﺯ ﺍﻟﺼﻨﻑ‬ ‫ﺭﻤﺯ ﺍﻷﺩﺍﺀ ﻋﻠﻰ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬ ‫ﺍﻟﻤﻌﺭﻑ ﺍﻟﺠﺒﺎﺌﻲ‬

‫ﺏ ـ ﺍﻟﻤﺴﺘﻔﻴﺩ ‪:‬‬
‫ﺍﻻﺴﻡ ﻭﺍﻟﻠﻘﺏ ﺃﻭ ﺍﻻﺴﻡ ﺍﻻﺠﺘﻤﺎﻋﻲ‪..................................................................... :‬‬

‫‪07-5.019-02‬‬
‫ﺍﻟﻨﺸﺎﻁ ‪............................................................................................... :‬‬
‫ﺍﻟﻌﻨﻭﺍﻥ ‪............................................................................................... :‬‬
‫ﺭﻗﻡ ﺍﻟﻤﺅﺴﺴﺔ ﺍﻟﺜﺎﻨﻭﻴﺔ‬ ‫ﺭﻤﺯ ﺍﻟﺼﻨﻑ‬ ‫ﺭﻤﺯ ﺍﻷﺩﺍﺀ ﻋﻠﻰ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬ ‫ﺍﻟﻤﻌﺭﻑ ﺍﻟﺠﺒﺎﺌﻲ‬

‫ﺝ ـ ﻤﻌﻠﻭﻤﺎﺕ ﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﺼﻔﻘﺔ ‪:‬‬

‫ﻤﻭﻀﻭﻉ ﺍﻟﺼﻔﻘﺔ ‪..................................................................................... :‬‬
‫ﻤﺒﻠﻎ ﺍﻟﺼﻔﻘﺔ ‪.......................................................................................... :‬‬
‫ﺘﺎﺭﻴﺦ ﺇﺒﺭﺍﻡ ﺍﻟﺼﻔﻘﺔ ‪................................................................................... :‬‬
‫ﺩ ـ ﺍﻟﻤﺒﺎﻟﻎ ﺍﻟﻤﺩﻓﻭﻋﺔ ﺒﺎﻟﺩﻴﻨﺎﺭ‪:‬‬
‫ﺍﻟﺨﺼﻡ ﻤﻥ ﺍﻟﻤﻭﺭﺩ ‪:‬‬ ‫ﺍﻷﺩﺍﺀ ﻋﻠﻰ ﺍﻟﻘﻴﻤﺔ‬ ‫ﺍﻟﻤﺒﻠﻎ ﺍﻟﺠﻤﻠﻲ ﻤﻊ‬ ‫ﺍﻷﺩﺍﺀ ﻋﻠﻰ ﺍﻟﻘﻴﻤﺔ‬ ‫ﻨﺴﺒﺔ ﺍﻷﺩﺍﺀ ﻋﻠﻰ‬ ‫ﺍﻟﻤﺒﻠﻎ ﺨﺎل ﻤﻥ‬
‫ﺍﻟﻀﺭﻴﺒﺔ ﻋﻠﻰ ﺍﻟﺩﺨل ﺃﻭ ﻋﻠﻰ ﺍﻟﺸﺭﻜﺎﺕ‬ ‫ﺍﻟﻤﻀﺎﻓﺔ ﺍﻟﻤﺨﺼﻭﻡ‬ ‫ﺍﺤﺘﺴﺎﺏ ﺍﻷﺩﺍﺀ ﻋﻠﻰ‬ ‫ﺍﻟﻤﻀﺎﻓﺔ‬ ‫ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬ ‫ﺍﻷﺩﺍﺀ ﻋﻠﻰ‬
‫ﻤﻥ ﺍﻟﻤﻭﺭﺩ ‪% 50‬‬ ‫ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬ ‫ﺍﻟﻤﺴﺘﻭﺠﺏ‬ ‫ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬
‫ﻤﺒﺎﻟﻎ ﺍﻟﺨﺼﻡ‬ ‫ﻨﺴﺒﺔ ﺍﻟﺨﺼﻡ‬
‫)‪(4) × (3‬‬ ‫)‪* (4‬‬ ‫)‪2 / (2) × (1‬‬ ‫)‪(3‬‬ ‫)‪(2) × (1‬‬ ‫)‪(2‬‬ ‫)‪(1‬‬

‫‪---------------------------------------‬‬

‫ﺇﻨﻲ ﺍﻟﻤﻤﻀﻲ ﺃﺴﻔﻠﻪ ‪ ،‬ﺃﺸﻬﺩ ﺒﺼﺤﺔ ﺍﻟﺒﻴﺎﻨﺎﺕ ﺍﻟﻭﺍﺭﺩﺓ ﺒﻬﺫﻩ ﺍﻟﺸﻬﺎﺩﺓ‪.‬‬ ‫)*( ﻨﺴﺒﺔ ﺍﻟﺨﺼﻡ ﺘﺴﺎﻭﻱ ‪:‬‬
‫ـ ‪ % 5‬ﺒﺎﻟﻨﺴـﺒﺔ ﻟﻸﺘﻌﺎﺏ ﺍﻟﻤﺩﻓﻭﻋﺔ ﻟﻸﺸﺨﺎﺹ ﺍﻟﻤﻌﻨﻭﻴﻴﻥ ﻭﺍﻷﺸﺨﺎﺹ ﺍﻟﻁﺒﻴﻌﻴﻴﻥ ﺍﻟﺨﺎﻀﻌﻴﻥ‬
‫ﺒـ…………… ﻓﻲ ……‪…………..‬‬ ‫ﻟﻠﻀﺭﻴﺒﺔ ﻋﻠﻰ ﺍﻟﺩﺨل ﺤﺴﺏ ﺍﻟﻨﻅﺎﻡ ﺍﻟﺤﻘﻴﻘﻲ ‪.‬‬
‫ـ ‪ % 15‬ﺒﺎﻟﻨﺴـﺒﺔ ﻟﻸﺘﻌـﺎﺏ ﺍﻟﻤﺩﻓﻭﻋﺔ ﻟﻸﺸﺨﺎﺹ ﻏﻴﺭ ﺍﻟﺨﺎﻀﻌﻴﻥ ﻟﻠﻀﺭﻴﺒﺔ ﻋﻠﻰ ﺍﻟﺩﺨل‬
‫ﺍﻹﻤﻀﺎﺀ ﻭﺍﻟﺨﺘﻡ‬ ‫ﺤﺴﺏ ﺍﻟﻨﻅﺎﻡ ﺍﻟﺤﻘﻴﻘﻲ ‪.‬‬
‫ـ ‪ % 15‬ﺒﺎﻟﻨﺴـﺒﺔ ﻟﻸﺘﻌﺎﺏ ﺍﻟﻤﺩﻓﻭﻋﺔ ﻟﻐﻴﺭ ﺍﻟﻤﻘﻴﻤﻴﻥ ﻭﻓﻲ ﺼﻭﺭﺓ ﻭﺠﻭﺩ ﺍﺘﻔﺎﻗﻴﺔ ﺘﻁﺒﻕ ﺍﻟﻨﺴﺒﺔ‬
‫ﺍﻟﻭﺍﺭﺩﺓ ﺒﻬﺎ ﺇﺫﺍ ﻜﺎﻨﺕ ﺃﻗل ‪.‬‬
‫ـ ‪ % 1,5‬ﻓﻲ ﺠﻤﻴﻊ ﺍﻟﺤﺎﻻﺕ ﺍﻵﺨﺭﻯ ‪.‬‬