251382QE

Name: Leucuta Bogdan Vasile

Order nr.: 251382

Questionnaire

Product for Slovakia

Name:Leucuta Bogdan Vasile Date of birth:04.11.1981

Tax year:2019 Working period:

Are you married? YES NO

Date of marriage:

Worldwide income of your spouse: currency:

Do you have children? YES NO

Date of birth of your children:

Child (nr.) 1: Child (nr.) 2:

Child (nr.) 3: Child (nr.) 4:

Child (nr.) 5: Child (nr.) 6:

Did you have income outside of Slovakia? YES NO

Your income outside of Slovakia currency:

Additional information:

I declare that the information is correct. I also understand that every detail mentioned in
the questionnaire can have an impact on the result of the precalculation.

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 251382QE
Name: Date of birth:

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