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Attribution Non-Commercial (BY-NC)

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Subsemnatul XXXXXXXXXX, domiciliat in XXXXXXXXXX, posesor

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posesor al autoturismului marca XXXXXXXXXX, tip XXXXXXXXXX, cu numarul
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DECLAR PE PROPRIA RASPUNDERE

ca nu mai detin dovada platii taxei de prima inmatriculare in

Romania a autoturismului susmentionat, intrucat originalul se afla la Politie,
depus la inmatriculare si nu am pastrat nici o copie.

Data Semnatura

Catre Administratiei Finantelor Publice Sector 2

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