__________________________________ Str. ____________, nr. ___, bl. ___, sc. ___, ap. ___ Localitate _____________, Judet _______________ CUI - ___ ___________________ Nr. ______/__________________
CATRE, ADMINISTRATIA FINANTELOR PUBLICE _________
S.C. _________________ S.R.L., cu sediul in ____________, str. ____________, nr.
___, bl. ___, sc. ___, ap. ___, Judetul ________, CUI - ___________, telefon ___________, fax _______________, e-mail ____________________ : - reprezentata prin Dl./Dna. ______________________________, in calitate de administrator. - reprezentata prin Dl./Dna. ______________________________, in calitate de __________________, conform imputernicirii nr. ___/_____________ .
Solicitam, -
amnarea la plat a obligatiilor fiscale pentru o perioada de ________ luni;
Suma total pentru care se solicit amnarea la plat, defalcat pe tipuri de impozite, taxe, contribuii i alte sume datorate bugetului general consolidat, este : - _____________________________________ - _____________________________________ - _____________________________________ - _____________________________________ - _____________________________________ - _____________________________________ iar majorrile de ntrziere aferente acestora, sunt : - _____________________________________ - _____________________________________ - _____________________________________ - _____________________________________ - _____________________________________ - _____________________________________
Data : _______________
Semnatura si stampila, _____________________________
