12

12
MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 124/17.II.2016
ACTE ALE ORGANELOR DE SPECIALITATE

ALE ADMINISTRAIEI PUBLICE CENTRALE
MINISTERUL DEZVOLTRII REGIONALE I ADMINISTRAIEI PUBLICE
ORDIN
privind aprobarea unor formulare tipizate pentru activitatea de colectare a impozitelor
i taxelor locale, precum i a altor venituri ale bugetelor locale de ctre organele fiscale locale,
i pentru modificarea i completarea Ordinului viceprim-ministrului, ministrul dezvoltrii regionale
i administraiei publice, nr. 2.068/2015 privind aprobarea unor formulare tipizate
pentru activitatea de stabilire a impozitelor i taxelor locale de ctre organele fiscale locale
n temeiul prevederilor art. 342 alin. (2) din Legea nr. 207/2015 privind Codul de procedur fiscal, cu modificrile i
completrile ulterioare, al avizului Ministerului Finanelor Publice comunicat prin Adresa nr. 400.066/712.102 din 4 februarie 2016
i al prevederilor art. 12 alin. (7) din Hotrrea Guvernului nr. 1/2013 privind organizarea i funcionarea Ministerului Dezvoltrii
Regionale i Administraiei Publice, cu modificrile i completrile ulterioare,
viceprim-ministrul, ministrul dezvoltrii regionale i administraiei publice, emite urmtorul ordin:
Art. 1. (1) Se aprob urmtoarele formulare tipizate pentru desfurarea activitii de stabilire a impozitelor i taxelor
locale de ctre organele fiscale locale, precum i a altor venituri ale bugetelor locale, prevzute n anexele nr. 137, care fac parte
integrant din prezentul ordin, dup cum urmeaz:
Nr.
anexei
Denumirea
Model
1
2
3
4
5
6
7
8
Declaraie pentru scoaterea din eviden a mijloacelor de transport

Decont impozit pe spectacole
Nota de plat
Borderou desfurtor al ncasrilor
Proces-verbal de verificare casier
Registru de rol nominal unic
Registru de rol alte venituri
Extras de rol
Model 2016 ITL 016

Model 2016 ITL 017
Model 2016 ITL 018
Model 2016 ITL 019
Model 2016 ITL 020
Model 2016 ITL 021
Model 2016 ITL 022
Model 2016 ITL 023
Matricol pentru evidena centralizat a impozitului pe cldiri, a taxei pe cldiri, a impozitului pe

Model 2016 ITL 024
teren, a taxei pe teren i a impozitului pe mijloacele de transport
10
11
12
13
14
Borderou de debite scderi

Confirmare de primire a debitelor
Anun individual pentru comunicarea prin publicitate
Anun colectiv pentru comunicarea prin publicitate
Proces-verbal privind ndeplinirea procedurii de comunicare prin publicitate
15
Legitimaie pentru funcionarul public din organul fiscal local cu atribuii n: stabilirea,
constatarea, controlul fiscal, inspecia fiscal, urmrirea, executarea silit, ncasarea impozitelor Model 2016 ITL 030
i taxelor locale i a altor venituri la bugetul local
16
17
18
19
20
21
22
23
24
25
26
27
28
29
Ordin de serviciu
Aviz de inspecie fiscal
Invitaie
Proces-verbal de reinere/restituire de nscrisuri
Decizie de impunere privind creanele datorate bugetului local, n urma inspeciei fiscale
Decizie privind nemodificarea bazei de impunere
Somaie
Titlu executoriu
Proces-verbal privind comunicarea somaiei
Proces-verbal privind calculul sumelor prevzute prin titlul executoriu
Decizie de instituire a msurilor asigurtorii
Decizie de ridicare a msurilor asigurtorii
Adres de nfiinare a popririi asigurtorii
Adres de nfiinare a popririi
Model 2016 ITL 025

Model 2016 ITL 026
Model 2016 ITL 027
Model 2016 ITL 028
Model 2016 ITL 029
Model 2016 ITL 031

Model 2016 ITL 032
Model 2016 ITL 033
Model 2016 ITL 034
Model 2016 ITL 035
Model 2016 ITL 036
Model 2016 ITL 037
Model 2016 ITL 038
Model 2016 ITL 039
Model 2016 ITL 040
Model 2016 ITL 041
Model 2016 ITL 042
Model 2016 ITL 043
Model 2016 ITL 044
13

Nr.
anexei
Denumirea
Model
30
ntiinare privind nfiinarea popririi
Model 2016 ITL 045
31
Proces-verbal de constatare a contraveniei
Model 2016 ITL 046
32
Proces-verbal de identificare bunuri mobile
Model 2016 ITL 047
33
Proces-verbal de identificare bunuri imobile
Model 2016 ITL 048
34
Proces-verbal de sechestru asupra bunurilor mobile
Model 2016 ITL 049
35
Proces-verbal de sechestru asupra bunurilor imobile
Model 2016 ITL 050
36
Proces-verbal de adjudecare pentru bunuri mobile
Model 2016 ITL 051
37
Proces-verbal de adjudecare pentru bunuri imobile sau pentru ansamblu de bunuri
Model 2016 ITL 052
(2) Tipizatele utilizate de ctre organele fiscale locale se

codific, dup cum urmeaz:
a) Model 2016, reprezentnd anul ncepnd cu care
acestea se utilizeaz;
b) grupa de litere ITL, reprezentnd acronimul de la
impozite i taxe locale;
c) cifrele 016052, care reprezint elementele de
identificare ale fiecrui formular tipizat.
(3) Codificarea altor tipizate utilizate de ctre organele fiscale
locale n activitatea de stabilire, constatare, impunere, control
fiscal, ncasare, urmrire i executare silit se realizeaz potrivit
prevederilor alin. (2).
Art. 2. (1) Formularele prevzute la art. 1, n anexele
nr. 137 reprezint modele-cadru i pot fi completate cu
informaii specifice fiecrui organ fiscal local, cu respectarea
prevederilor Legii nr 207/2015 privind Codul de procedur
fiscal, cu modificrile i completrile ulterioare i ale Legii
nr. 227/2015 privind Codul fiscal, cu modificrile i completrile
ulterioare.
(2) Organele fiscale locale, n condiii de autonomie local i
de eficien economic, pot opta pentru achiziionarea
formularelor tipizate ori pot imprima aceste formulare utiliznd
sistemele informatice proprii.
(3) Organele fiscale locale care au pagin de internet proprie
vor asigura publicarea formularelor tipizate pe pagina
respectiv, astfel nct acestea s poat fi consultate i
imprimate de ctre contribuabili utiliznd sisteme informatice
proprii.
(4) Organele fiscale locale pun gratuit la dispoziia
contribuabililor formularele necesare ndeplinirii obligaiilor ce le
revin n baza titlului IX din Legea nr. 227/2015, cu modificrile i
completrile ulterioare, sau a Legii nr. 207/2015, cu modificrile
i completrile ulterioare.
Art. 3. Organele fiscale locale gestioneaz informaiile din
formularele prevzute la art. 1, depuse de contribuabili pentru
ndeplinirea atribuiilor stabilite de lege.
Art. 4. Cheltuielile ocazionate de achiziionarea sau

imprimarea utiliznd sistemele informatice proprii, dup caz, a
formularelor prevzute la art. 1 se asigur din bugetele locale
ale comunelor, ale oraelor, ale municipiilor, ale sectoarelor
municipiului Bucureti, respectiv ale judeelor, dup caz.
Art. 5. Tipizatele aflate n stocul organelor fiscale, dup
intrarea n vigoare a prezentului ordin, se utilizeaz, adaptate
corespunztor, pn la epuizare.
Art. 6. Ordinul viceprim-ministrului, ministrul dezvoltrii
regionale i administraiei publice nr. 2.068/2015 privind
aprobarea unor formulare tipizate pentru activitatea de stabilire
a impozitelor i taxelor locale de ctre organele fiscale locale,
publicat n Monitorul Oficial al Romniei, Partea I, nr. 975 din
29 decembrie 2015, se modific dup cum urmeaz:
1. n anexa nr. 1 la formularul Model 2016 ITL Regim
special 001 Chitan pentru ncasarea creanelor
bugetare locale, notele de subsol 2 i 3 se modific i vor
avea urmtorul cuprins:
2) n cazul emiterii n format electronic din sistemele
informatice ale organului fiscal local se utilizeaz serii i numere
de chitane conform prevederilor Ordinului viceprim-ministrului,
ministrul dezvoltrii regionale i administraiei publice
nr. 2.123/2015 privind aprobarea instruciunilor pentru emiterea
unitar a formularului tipizat Model 2016 ITL Regim special
001.
3) n cazul tipririi chitanelor de ctre Compania Naional
Imprimeria Naional, organele fiscale locale comunic acesteia
seria i plaja de numere de chitane alocate, innd cont de plaja
de numere de chitane alocat pentru emiterea de chitane n
format electronic din sistemele informatice ale organului fiscal
local. Compania Naional Imprimeria Naional ine o eviden
pe fiecare unitate/subdiviziune administrativ-teritorial a
chitanelor tiprite.
2. n anexa nr. 3 la formularul Model 2016 ITL 003
Declaraie fiscal pentru stabilirea impozitului/taxei pe
teren n cazul persoanelor fizice, la finalul tipizatului, dup
dat i semntur, se introduce un cartu cu urmtorul
cuprins:
Dac din motive independente de voina contribuabilului/pltitorului acesta este n imposibilitatea de a scrie, atunci un
reprezentant al organului fiscal i va redacta declaraia fiscal i i va citi integral coninutul acesteia. Declaraia fiscal constituie
proces-verbal n sensul art. 103 alin. (2) din Legea nr. 207/2015, cu modificrile i completrile ulterioare.
Data i semntura
Posed actul
de identitate:
Tipul
Date de identificare ale reprezentantului organului fiscal:

Seria
Numrul
Eliberat de:
14
3. n anexa nr. 5, la formularul Model 2016 ITL - 005 Declaraie fiscal pentru stabilirea impozitului/taxei pe
mijloacele de transport aflate n proprietatea persoanelor fizice (PF) persoanelor juridice (PJ), la finalul tipizatului,
dup dat i semntur, se introduce un cartu, cu urmtorul cuprins:
Data i semntura
Posed actul
de identitate:
Tipul
Seria
Numrul
Eliberat de:
4. n anexa nr. 7, la formularul Model 2016 ITL - 007 Declaraie fiscal pentru stabilirea impozitului/taxei pe
mijloacele de transport pe ap aflate n proprietatea persoanelor fizice (PF) persoanelor juridice (PJ), la finalul
tipizatului, dup dat i semntur se introduce un cartu, cu urmtorul cuprins:
Data i semntura
Posed actul
de identitate:
Tipul
Seria
Numrul
Eliberat de:
5. n anexa nr. 10, la formularul Model 2016 ITL - 010 Cerere pentru eliberarea unui certificat de atestare fiscal
pentru persoane fizice privind impozite, taxe locale i alte venituri datorate bugetului local, notele de subsol 1 i 3 se
modific i vor avea urmtorul cuprins:
1) Executorii fiscali ai altor organe fiscale, executori judectoreti/bancari, notari sau delegai ai acestora.
........
3) Dac se cunoate. n cazul solicitrii de ctre notar sau delegat, conform mandatului dat de ctre contribuabil, se trec i datele de identificare ale
contribuabilului.
6. n anexa nr. 11, la formularul Model 2016 ITL - 011 Certificat de atestare fiscal pentru persoane fizice privind
impozitele i taxele locale i alte venituri datorate bugetului local, nota de subsol 1 se modific i va avea urmtorul
cuprins:
1) Spre exemplu, notarul public sau delegatul acestuia, conform mandatului dat de ctre contribuabil.
7. n anexa nr. 12, la formularul Model 2016 ITL - 012 Cerere pentru eliberarea unui certificat de atestare fiscal
pentru persoane juridice privind impozite, taxe locale i alte venituri datorate bugetului local, dup not se introduce o
nou not cu urmtorul cuprins:
Certificatul de atestare fiscal se elibereaz solicitantului la sediul organului fiscal. Eliberarea certificatului se poate realiza
i n format electronic.
8. n anexa nr. 13, la formularul Model 2016 ITL - 013 Certificat de atestare fiscal pentru persoane juridice privind
impozite, taxele locale i alte venituri datorate bugetului local, nota de subsol 1 se modific i va avea urmtorul cuprins:
1) Executorii fiscali ai altor organe fiscale, executori judectoreti/bancari, lichidatori, notari sau delegai ai acestora, conform mandatului dat de ctre
contribuabil.
Art. 7. n cazul n care actele administrative fiscale se comunic prin afiare, n conformitate cu prevederile art. 163 din
Legea nr. 134/2010 privind Codul de procedur civil, republicat, cu modificrile i completrile ulterioare, reprezentanii organelor
fiscale locale iau msuri de protecie a datelor cu caracter personal prin acoperirea cu marker a codului unic de identificare fiscal
care poate fi codul numeric personal, sau, dup caz numrul de identificare fiscal.
Art. 8. Prezentul ordin se public n Monitorul Oficial al Romniei, Partea I.
Viceprim-ministru, ministrul dezvoltrii regionale i administraiei publice,

Vasile Dncu
Bucureti, 9 februarie 2016.

Nr. 144.
15
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ROMN IA
MODEL 2016 ITL - 026
Judeul
Cod SIRUTA
Codul de nregistrare fiscal
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Adresa de pot
Codul potal
e lec tron ic
@
Nr.
din
/
)
)
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PRIMIRE A DEBITELOR
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/20
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MENIUNI PRIVIND NREGISTRAREA DEBITULUI

BORDEROUL DE DEBITE NR.
DIN
/
/20
REGISTRUL DE ROL NOMINAL UNIC

Codul din clasificaia bugetar
ELEMENTE DE IDENTIFICARE A EXPEDITORULUI
Str.
bl.
, sc.
Localitatea
Codul potal
, nr.
, et.
, ap.
Judeul/sectorul
La adresa dumneavoastr naintat sub nr. .. din .. / ../20 ,

v confirmm primirea debitului n sum de .. lei (.),
(n cifre)
(n litere)
reprezentnd debit principal ... accesorii

privind debitorul ......., cu
domiciliul fiscal la adresa: str. nr. , bl. ., sc. ., et. , ap.
din localitatea ..., codul potal
.. .
CONDUCTORUL COMPARTIMENTULUI DE SPECIALITATE
FUNCIA
L.S.
SEMNTURA
PRENUMELE I NUMELE SEMNATARILOR
1
NTOCMIT
) Se menioneaz: COMUNA ./ORAUL ../ MUNICIPIUL ../SECTORUL .

) Se menioneaz: codul de nregistrare fiscal a unitii administrativ-teritoriale sau a sectorului municipiului Bucureti.
) Se menioneaz: n cazul persoanelor fizice (P.F.) numele, iniiala tatlui i prenumele; n cazul persoanelor juridice (P.J.) denumirea.
NOT: Expeditor este unitatea administrativ-teritorial/sectorul municipiului Bucureti, prin organul fiscal local, iar destinatar este entitatea care a trimis debitul spre urmrire.
Tiprit n carnete cu cte 200 de file, formate din 100 de seturi a cte dou file.
2
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51
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52

ANEXA Nr. 31**)

ROMN IA
Anexa nr. 31
Judeul
Stema
1
unitii

)
Model 2016 ITL - 046
administrativ Codul SIRUTA
teritoriale
2
Codul de nregistrare fiscal

)
Str.
,
nr.
Adresa de pot

Codul potal
e lec tron ic

PROCESUL-VERBAL DE CONSTATARE A

@
CONTRAVENIEI NR. .
din
/
/20
Nr.
ELEMENTE DE IDENTIFICARE A UNITII ADMINISTRATIV TERITORIALE DIN CARE FACE PARTE AGENTUL CONTATATOR

1
ncheiat astzi, .. .. 20 .., ora ., la ...
)

Agentul constatator .. avnd funcia de n
cadrul ., identificat prin legitimaia nr. ./20., avnd n vedere prevederile Legii
nr. 227/2015 privind Codul fiscal, cu modificrile i completrile ulterioare i pe cele ale Legii nr. 207/2015 privind Codul de
procedur fiscal, cu modificrile i completrile ulterioare, coroborate cu cele ale Ordonanei Guvernului nr. 2/2001 privind
regimul juridic al contraveniilor, aprobat cu modificri i completri prin Legea nr. 180/2002, cu modificrile i completrile
ulterioare, am constatat c:
PERSOANA FIZIC ..., avnd CNP .,
domiciliat() n , str. . nr. , bl. .., sc. , et. .,
ap. .., sectorul .., judeul .., legitimat cu *), seria , nr. ., emis() de
,
la
data
..,
avnd
ocupaia
de
.., la locul de munc .., cu sediul n
, str. . nr. , bl. .., sc. , et. , ap. ..,
sectorul .., judeul ...
PERSOANA JURIDIC ...., avnd CODUL DE
IDENTIFICARE FISCAL , cu sediul n , str.
nr. , bl. .., sc. , et. ., ap. .., sectorul .., judeul .., reprezentat prin
...,
avnd
CNP
.,domiciliat()
n
, str. . nr. , bl. .., sc. , et. ., ap. ..,
sectorul .., judeul .., legitimat cu *), seria , nr. ., emis() de
,
la
data
..,
avnd
ocupaia
de
..; persoana juridic are conturile bancare: 1. ..
deschis la .... i 2. .. deschis
la ...,
a svrit n ziua de , luna .., anul 20 , urmtoarea/urmtoarele
contravenie/contravenii:
1. .
fapt prevzut la art. .... alin.(.) lit. .) din .;
2. .
fapt prevzut la art. .... alin.(.) lit. .) din .;
3. .
fapt prevzut la art. .... alin.(.) lit. .) din . .
Semntura martorului
Semntura agentului constatator
"
1)
2)
"
Semntura contravenientului
"
Se nscrie unitatea administrativ-teritorial/sectorul municipiului Bucureti la nivelul creia/cruia se face constatarea.

Se nscrie codul de nregistrare fiscal emis de ctre A.N.A.F.
CONTINUARE PE VERSO
............... aici se detaeaz ...............
PROCESUL-VERBAL DE NDEPLINIRE A PROCEDURII *)

Astzi, , .. .. 20 .., agentul procedural , din cadrul
., avnd de nmnat Procesul-verbal de constatare a contraveniei nr. din .. .
20. cu ntiinarea de plat nr. . din .. 20, m-am deplasat la domiciliul fiscal al
. din , str. . nr. ,
bl. .., sc. , et. ., ap. .., sectorul .., judeul .., codul potal , gsind pe
contravenient sau pe . rud cu acesta/persoan care locuiete la aceeai adres/
administrator/portar/mputernicitul contravenientului, care, primind actul, a semnat n faa noastr.
Semntura primitorului,
"
Primitorul are CNP .. i se legitimeaz cu . *), seria , nr. ., emis() de
, la data .. .
CONTINUARE DE PE VERSO
i se sancioneaz potrivit:
**) Anexa nr. 31 este reprodus n facsimil.

1. art. .... alin.(.) lit. .) din . cu amend de la lei la .. lei i
stabilesc amenda contravenional n cuantum de lei;
stabilesc amenda contravenional n cuantum de lei;
stabilesc amenda contravenional n cuantum de lei.
ALTE MENIUNI, inclusiv obieciunile fcute de contravenient cu privire la coninutul prezentului proces-verbal:
...
...
...
...
Suma total a amenzii de .. lei se va achita n termen de 15 zile de la data prezentului proces-verbal la
Trezoreria .. n contul nr. .. sau la casieriile
. din str. .....nr. ...,
prin mandat potal, prin virament bancar din conturile contribuabilului deschise la bnci sau utiliznd contul
tranzitoriu3 sau alte modaliti.
Prezentul proces-verbal constituie ntiinare de plat. n termen de 15 zile de la comunicare acesta devine
titlu executoriu. n caz de neachitare a amenzii la termenul stabilit se va trece la executarea silit, conform prevederilor
legale n vigoare la data prezentului proces-verbal.
n baza art. .... alin.(.) lit. .) din . dispun i confiscarea/ridicarea n
vederea confiscrii a bunurilor/sumei de .. lei, prevzute n anexa care face parte integrant din prezentul procesverbal, aparinnd .., avnd CNP , domiciliat n domiciliat()
n , str. . nr. , bl. .., sc. , et. ., ap. ..,
, la data .., care vor fi depuse la
pn la valorificare.
Contravenientul (nu) este de fa/refuz/nu poate lua la cunotin de prezentul proces-verbal, fapt atestat de martorul
..,
identificat
prin
CNP
,
domiciliat()
n
, str. . nr. , bl. .., sc. , et. ., ap. ..,
, la data .. fiind de fa, i s-a nmnat un exemplar din
prezentul proces-verbal, pe care-l primete/refuz s l primeasc n faa noastr.
Cu drept de plngere n termen de 15 zile de la data nmnrii/primirii/comunicrii la
.
Semntura martorului
Semntura agentului constatator
"
"
Semntura contravenientului
"
*) Se nscrie actul de identitate, respectiv: C.I. cartea de identitate; A.I. adeverina de identitate; B.I. buletinul de
identitate; P paaportul. Prin CNP se nelege codul numeric personal.
NOT: Prin CODUL DE IDENTIFICARE FISCAL se nelege: codul numeric personal, numrul de identificare fiscal, codul
de nregistrare fiscal sau codul unic de nregistrare.
............... aici se detaeaz ...............

Refuznd primirea/negsind nici o persoan s-a afiat prezentul proces-verbal pe ua principal la domiciliul fiscal al
contravenientului.
Drept pentru care s-a ncheiat prezentul proces-verbal.
Semntura agentului procedural,
"
NOT: 1. Aceast parte se detaeaz de prezentul proces-verbal i se anexeaz exemplarului transmis compartimentelor de specialitate spre executare
silit.
2. n cazul n care procesul-verbal se comunic prin afiare, n conformitate cu prevederile art. 163 din Legea nr. 134/2010 privind Codul de
procedur civil, republicat, cu modificrile ulterioare, reprezentanii organelor fiscale locale iau msuri de protecie a datelor cu caracter personal prin
acoperirea cu marker a codului unic de identificare fiscal care poate fi codul numeric personal, sau, dup caz numrul de identificare fiscal i se va lipi
numai la coluri.
3. Ordinul ministrului finanelor publice nr. 1.801/2011 pentru aprobarea Normelor metodologice privind informaiile obligatorii care se nscriu n
ordinele de plat pentru Trezoreria Statului prin care contribuabilii persoane fizice efectueaz pli ctre bugetele componente ale bugetului general
consolidat prin contul tranzitoriu deschis pe numele Ministerului Finanelor Publice i informaiile cuprinse n mesajul electronic de pli care se transmite n
sistem informatic de ctre instituiile de credit iniiatoare, cu modificrile i completrile ulterioare.
53
54

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12

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 124/17.II.2016

ACTE ALE ORGANELOR DE SPECIALITATE

Declaraie pentru scoaterea din eviden a mijloacelor de transport

Model 2016 ITL 016

Matricol pentru evidena centralizat a impozitului pe cldiri, a taxei pe cldiri, a impozitului pe

Borderou de debite scderi

Model 2016 ITL 025

Model 2016 ITL 031

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 124/17.II.2016

ntiinare privind nfiinarea popririi

Model 2016 ITL 045

Proces-verbal de constatare a contraveniei

Model 2016 ITL 046

Proces-verbal de identificare bunuri mobile

Model 2016 ITL 047

Proces-verbal de identificare bunuri imobile

Model 2016 ITL 048

Proces-verbal de sechestru asupra bunurilor mobile

Model 2016 ITL 049

Proces-verbal de sechestru asupra bunurilor imobile

Model 2016 ITL 050

Proces-verbal de adjudecare pentru bunuri mobile

Model 2016 ITL 051

Proces-verbal de adjudecare pentru bunuri imobile sau pentru ansamblu de bunuri

Model 2016 ITL 052

(2) Tipizatele utilizate de ctre organele fiscale locale se

Art. 4. Cheltuielile ocazionate de achiziionarea sau

Date de identificare ale reprezentantului organului fiscal:

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 124/17.II.2016

Date de identificare ale reprezentantului organului fiscal:

Date de identificare ale reprezentantului organului fiscal:

Viceprim-ministru, ministrul dezvoltrii regionale i administraiei publice,

Bucureti, 9 februarie 2016.

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 124/17.II.2016

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