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| Unitatea creditoare
Nr. de nregistrare ...... din ........ |
| ...............................
Ctre ................................. |
| Cod fiscal ....................
....................................... |
| Nr. ord. reg. com./an .........
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| Localitatea ...................
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| Judeul .......................
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| Cont ..........................
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| Banca .........................
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EXTRAS DE CONT
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| Conform dispoziiilor n vigoare, v ntiinm c, n evidenele noastre
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| contabile, la data de ............., unitatea dvs. figureaz cu urmtoarele |
| debite ..................................................................... |
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Documentul
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Explicaii
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Suma
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| (felul, numrul i data) |
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14-6-3
A5
t2

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(verso)
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n termen de 5 zile de la primire urmeaz s ne restituii acest extras
confirmat pentru suma acceptat, iar n caz de refuz total sau parial s
anexai nota explicativ cuprinznd obieciile dvs. Prezentul extras de cont
ine loc de conciliere conform procedurii arbitrale.
DIRECTOR,
L.S. ..............

Conductorul compartimentului
financiar-contabil,
.............................
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Unitatea debitoare
Nr. de nregistrare ........ din .........
..................
Ctre ....................................
..................
..........................................
..................
..........................................
Confirmm prezentul extras de cont pentru suma de ................... lei,
pentru achitarea creia (se va completa dup caz):
a) am depus la banc ordinul de plat nr. .......... din .................
b) am depus la Oficiul Potal nr. .... mandatul potal nr. ..... din .....
Obieciile noastre privind sumele din prezentul extras de cont sunt
cuprinse n nota explicativ anexat.
DIRECTOR,
L.S. ..............

Conductorul compartimentului
financiar-contabil,

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