ANEXA Nr.

2*)
Model 2016 ITL -054
 % Primaria Municipiului
 Craiova
$
Primaria Municipiului Craiova  Directia Impozite si Taxe
Directia Impozite si Taxe
&2175$&7'( 9kQ]ăWRUXO QX DUH GHELWH OD
&,) 4425424 6,587$ 69900 GDWDGHvQWkLDOXQLLXUPăWRDUH
$GUHVD: Calea Bucuresti nr.51C Ì1675Ă,1$5('2%Æ1',5( vQUHJLVWUăULL DFWXOXL GH
7HO 0251/414237 ID[. 0251/417254
$818,0,-/2&'(75$163257 vQVWUăLQDUHGREkQGLUH 
HPDLO: direxec_dit@primariacraiova.ro
5(07,,   VHFRPSOHWHD]ă‫܈‬LSHFRSLL 
 3UHQXPHOH«««««««
1U««««««««
5ROQU««««««««  1XPHOH«««««««««

 )XQF‫܊‬LD««««««««
2ULJLQDO&RSLH
 /6

 3(562$1$&$5(Ì1675Ă,1($=Ă6XEVHPQDWXO D  Subscrisa ...........................................................................................,
cu domiciliul/sediul în ROMÂNIA/ ......................, judeаul ..............................., codul poЮtal ..................., municipiul/oraЮul/comuna
............................................., satul/sectorul .................................., str. ................................................................................. nr. ......,
bl. ......, sc. ......., et. ......, ap ......, identificat prin B.I./C.I./C.I.P./PaЮaport seria ...... nr. ................,
C.N.P./C.I.F ...................................................., tel./fax ................................, e-mail …………………….…………………, ‫܈‬L
GRPLFLOLXO ILVFDO vQ 520Æ1,$  MXGH‫܊‬XO  FRGXO SR‫܈‬WDO 
PXQLFLSLXORUD‫܈‬XOFRPXQD VDWXOVHFWRUXO  VWU 
 QU  EO  VF  HW  DS  UHSUH]HQWDWă SULQ 
 LGHQWLILFDW SULQ %,&,&,33D‫܈‬DSRUW VHULD « QU  &,)
 WHOID[ HPDLO «« vQ FDOLWDWH GH
 
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
  3(562$1$ &$5( '2%Æ1'(‫܇‬7( 6XEVHPQDWXO D  Subscrisa ............................................................................................,
cu domiciliul/sediul în ROMÂNIA/ ......................, judeаul ..............................., codul poЮtal ..................., municipiul/oraЮul/comuna
............................................., satul/sectorul .................................., str. ................................................................................. nr. ......,
bl. ......, sc. ......., et. ......, ap ......, identificat prin B.I./C.I./C.I.P./PaЮaport seria ...... nr. ................,
C.N.P./C.I.F ...................................................., tel./fax ................................, e-mail …………………….…………………, ‫܈‬L
GRPLFLOLXO ILVFDO vQ 520Æ1,$  MXGH‫܊‬XO  FRGXO SR‫܈‬WDO 
PXQLFLSLXORUD‫܈‬XOFRPXQD VDWXOVHFWRUXO  VWU 
 QU  EO  VF  HW  DS  UHSUH]HQWDWă SULQ 
 LGHQWLILFDW SULQ %,&,&,33D‫܈‬DSRUW VHULD « QU  &,)
 WHOID[ HPDLO «« vQ FDOLWDWH GH
XCVSDF

BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
 2%,(&78/&2175$&78/8,
0LMORFXOGHWUDQVSRUWPDUFD««««««««««WLSXO«««««QXPăUGHLGHQWLILFDUH««
VHULH PRWRU ««« FDSDFLWDWHD FLOLQGULFă «« FPñ JUHXWDWH PD[LPă DGPLVă SHQWUX UHPRUFLVHPLUHPRUFL  «««
WRQHQXPăUGHvQPDWULFXODUHvQUHJLVWUDUH««««GDWDODFDUHH[SLUăLQVSHF‫܊‬LDWHKQLFăSHULRGLFă«««««««««
QXPăUXOFăU‫܊‬LLGHLGHQWLWDWHDYHKLFXOXOXL«««««DQXOGHIDEULFD‫܊‬LHQRUPDHXURGREkQGLWODGDWDGH
FRQIRUPDFW«««««««««««««««««««««
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
 35(‫܉‬8/vQFLIUH«««««««OHLvQOLWHUH««««««««««««««««««
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
 3HUVRDQDFDUHvQVWUăLQHD]ăPHQ‫܊‬LRQDWăODSXQFWXO  GHFODUăFăPLMORFXOGHWUDQVSRUWHVWHSURSULHWDWHDVDOLEHUGHRULFHVDUFLQL
'H DVHPHQHD GHFODUă Fă D SUHGDW SHUVRDQHL FDUH GREkQGH‫܈‬WH PHQ‫܊‬LRQDWH OD SXQFWXO   YHKLFXOXO FKHLOH FHUWLILFDWXO GH
vQPDWULFXODUH‫܈‬LFDUWHDGHLGHQWLWDWHDYHKLFXOXOXLSULPLQGGHODDFHDVWDSUH‫܊‬XOSUHYă]XWODSXQFWXO  
3HUVRDQDFDUHGREkQGH‫܈‬WHPHQ‫܊‬LRQDWăODSXQFWXO  GHFODUăFDDSULPLWGHODYkQ]ăWRUXOPHQ‫܊‬LRQDWODSXQFWXO  DOPLMORFXOXL
GH WUDQVSRUW FKHLOH FHUWLILFDWXO GH vQPDWULFXODUH ‫܈‬L FDUWHD GH LGHQWLWDWH D YHKLFXOXOXL DFKLWkQG SHUVRDQHL FDUH vQVWUăLQHD]ă SUH‫܊‬XO
PHQ‫܊‬LRQDWODSXQFWXO  
$QH[HODFRQWUDFW 'D x1X
$WkWSHUVRDQDFDUHvQVWUăLQHD]ăFkW‫܈‬LGREkQGLWRUXOGHFODUăFXQRVFkQGSUHYHGHULOH/HJLLQUSULYLQG&RGXOSHQDOFXPRGLILFăULOH 

‫܈‬LFRPSOHWăULOHXOWHULRDUHSULYLQGIDOVXO‫܈‬LX]XOGHIDOVFăWRDWHLQIRUPD‫܊‬LLOHvQVFULVHvQSUH]HQWXOGRFXPHQWFRUHVSXQGUHDOLWă‫܊‬LL
ÌQFHSkQG FX GDWD VHPQăULL GREkQGLWRUXO DUH FDOLWDWHD GH SURSULHWDU GH GUHSW ‫܈‬L GH IDSW DVXSUD PLMORFXOXL GH WUDQVSRUW FH IDFH
RELHFWXO SUH]HQWXOXL FRQWUDFW GH vQVWUăLQDUHGREkQGLUH SUHOXkQG WRDWH REOLJD‫܊‬LLOH SUHYă]XWH GH OHJH LQFOXVLY FHOH OHJDWH GH

WUDQVFULHUHDYHKLFXOXOXLSHQXPHOHVăXvQPD[LPXPGH]LOHGHODGDWDvQFKHLHULLSUH]HQWXOXLDFW

 
'DWD‫܈‬LORFXOvQFKHLHULLFRQWUDFWXOXL««««««««««««««««««««««««««««


6HPQăWXUDSHUVRDQHLFDUHvQVWUăLQHD]ă««««««6HPQăWXUDSHUVRDQHLFDUHGREkQGH‫܈‬WH««««««




 



5(07,,5HJLVWUXOGHHYLGHQ‫܊‬ăDPLMORDFHORUGHWUDQVSRUWVXSXVHvQPDWULFXOăULLvQUHJLVWUăULLGHODRUJDQXOILVFDOORFDODO

SHUVRDQHLFDUHvQVWUăLQHD]ă

&RSLH±„Conform cu originalul”
 3ULQFRPSOHWDUHDGHFăWUHRUJDQXOILVFDOORFDODFDUWXúXOXL%VHDWHVWăvQGHSOLQLUHDSUHYHGHULORUDUWDOLQ
  GLQ/HJHD 6HVHPQHD]ăGRDUSHFRSLL 
QUSULYLQG&RGXOGHSURFHGXUăILVFDOăFXPRGLILFăULOH‫܈‬LFRPSOHWăULOHXOWHULRDUHQHPDLILLQGQHFHVDUăHOLEHUDUHD

XQXLFHUWLILFDWGHDWHVWDUHILVFDOă&DUWXúHOH$‫܈‬L%VHFRPSOHWHD]ăGHRUJDQXOILVFDOORFDOXQGHHVWHvQUHJLVWUDWPLMORFXOGH 6HPQăWXUă

WUDQVSRUWDOSHUVRDQHLFDUHvQVWUăLQHD]ă
 6HFRPSOHWHD]ăvQFD]XOSHUVRDQHORUIL]LFH 9kQ]ăWRU&XPSăUăWRU
 6HFRPSOHWHD]ăFRGXOGHLGHQWLILFDUHILVFDOă FRGXOQXPHULFSHUVRQDOQXPăUXOGHLGHQWLILFDUHILVFDOăGXSăFD]  «««««««««««««
 6HFRPSOHWHD]ăvQFD]XOSHUVRDQHORUMXULGLFH
 0RúWHQLWRULLWUHEXLHVăIDFăGRYDGDSURSULHWăĠLLFXFHUWLILFDWXOGHPRúWHQLWRUVDXvQOLSVDDFHVWXLDFXVHQWLQĠD
MXGHFăWRUHDVFăGXSăFD]
 & 
 Primaria 3UHQXPHOH«««««««
CUI / Siruta 1XPHOH«««««««««
Adresa: )XQF‫܊‬LD««««««««
Tel. / Fax. /6
e-mail:
5(07,, 

1U««««««««

 5(07,,5HJLVWUXOGHHYLGHQ‫܊‬ăDPLMORDFHORUGHWUDQVSRUWVXSXVHvQPDWULFXOăULLvQUHJLVWUăULLGHODRUJDQXOILVFDOORFDODOSHUVRDQHLFDUHGREkQGH‫܈‬WH6HFRPSOHWHD]ăSHH[HPSODUXORULJLQDOFDUHUăPkQHODGREkQGLWRUSH
H[HPSODUXOFRSLHFDUHvQVR‫܊‬H‫܈‬WHGHFODUD‫܊‬LDGHLPSXQHUH‫܈‬LSHH[HPSODUXOFRSLHFDUHVHGHSXQHODRUJDQXOFRPSHWHQWSULYLQGvQPDWULFXODUHDvQUHJLVWUDUHDUDGLHUHDPLMORDFHORUGHWUDQVSRUW
&DUWX‫܈‬XO&VHFRPSOHWHD]ăGHRUJDQXOILVFDOORFDOGHODGRPLFLOLXOSHUVRDQHLFDUHDGREkQGLWPLMORFXOGHWUDQVSRUW
,QIRUPD‫܊‬LLOHUHIHULWRDUHODWUDQVPLWHUHDGUHSWXOXLGHSURSULHWDWHVHFRPXQLFă‫܈‬LVHPHQ‫܊‬LRQHD]ăvQ5HJLVWUXOQD‫܊‬LRQDOGHHYLGHQ‫܊‬ăDSHUPLVHORUGHFRQGXFHUH‫܈‬LDYHKLFXOHORUvQPDWULFXODWHDFHDVWăPHQ‫܊‬LXQHQXSURGXFHHIHFWXOMXULGLFDOWUDQVFULHULLWUDQVPLWHULL
GUHSWXOXLGHSURSULHWDWH