________________________________

______________________________
______________________________

C TRE,

Nr.nregistrare la organul fiscal

_______________________________

ADMINISTRA IA FINAN ELOR PUBLICE A

MUNICIPIULUI ARAD

S.C.

______________________________________________________,

avnd

Cod

de

identificare fiscal ______________ i sediul social n ________________________________________,

reprezentat prin ______________________________________________________________ n calitate
de _______________________________, legitimat cu C.I./B.I. seria _________ nr. ____________
eliberat

de ____________________ i delega ia nr.

__________________ n vederea clarific rii

situa iei fiscale solicit eliberarea fi ei sintetice totale pe pl titor pentru urm toarele categorii de impozite i
taxe:
1.

_____________________________________________________

2.

_____________________________________________________

3.

_____________________________________________________

4.

_____________________________________________________

5.

_____________________________________________________

6.

_____________________________________________________

7.

_____________________________________________________

8.

_____________________________________________________

9.

_____________________________________________________

10. _____________________________________________________
11. _____________________________________________________
12. _____________________________________________________
13. _____________________________________________________
14. _____________________________________________________
15. INTEGRAL

Eliberarea acestora se va face pe :

1.

suport informatic (format pdf)

2.

suport hrtie

3.

prin mail la adresa___________________________________

Semn tura i tampila,
___________________________

1.
2.
3.

Se ntocme te n 2 (dou ) exemplare, din care unul r mne pe circuit la registratur , iar cu cel lalt se
face dovada depunerii, pentru ob inerea pe loc a documentului solicitat.
Se anexeaz n original
Se elibereaz doar pe suport informatic sau pe mail