Primaria Cluj-Napoca

Primarie - Numar si data inregistrare: ___________________________ Oficiul registrului comertului de pe langa tribunal numar si data inregistrare: ___________________________ CERERE |_| Autorizare si inregistrare |_| Completare/modificare autorizatie si inregistrare

DOMNULE PRIMAR, 1. Subsemnatul ______________________________________ (nume, prenume), in calitate de ______________________________________ (persoana fizica/reprezentant asociatie familiala), identificat cu BI/CI, seria _____, nr. _______________ CIF (cod de identificare fiscala) _________________________, data si locul nasterii: |_|_|_|_|_|_|_|_| localitate ______________________, judet/tara _______________________________________ 2. Cu domiciliu in: localitatea ______________________________, str. ________________ nr. ______, bloc ____, scara ____, etaj ____, ap. _____, judet/sector ______________, cod postal ______________, tara ________________, telefon ___________________, fax ___________________, cetatenie __________________, stare civila: ___________________; 3. Resedinta in Romania (daca este cazul): _______________________________ | 4. prin (nume, prenume)_____________________________________________________, CIF (cod de identificare fiscala) ______________________________ in calitate de ____________________________, conform ____________________________, in temeiul Legii nr. 300/2004 privind autorizarea persoanelor fizice si a asociatiilor familiale care desfasoara activitati economice in mod independent si a Legii nr. 26/1990 privind registrul comertului, republicata, cu modificarile ulterioare, va solicit: 4.1. |_| eliberarea autorizatiei pentru desfasurarea de activitati economice, inregistrarea in registrul comertului si la organul fiscal; 4.2. |_| completarea/modificarea autorizatiei si inregistrarea in registrul comertului; dupa cum urmeaza: 1. Forma de organizare: |_| persoana fizica |_| asociatie familiala 2. Denumire firma: ____________________________________________________________, avand numar de ordine in registrul comertului*1) ________________________, cod unic de inregistrare*1) __________________________; 3. Sediul firmei: localitatea _________________________, str. _____________________ nr. _____, bloc _____, scara ______, etaj ______, ap. ______, judet/sector __________, cod postal ____________, telefon _________________, fax _____________________, e-mail _____________________________, web site ___________________________________________;

4. Obiectul de activitate 4.1. Activitatea principala: clasa CAEN |_|_|_|_| ____________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ 4.2. Activitati secundare: |_| constituire |_| completare Clasa CAEN |_|_|_|_| _________________________________________________________________ ______________________________________________________________________________________ Clasa CAEN |_|_|_|_| _________________________________________________________________ ______________________________________________________________________________________ Clasa CAEN |_|_|_|_| _________________________________________________________________ ______________________________________________________________________________________ Clasa CAEN |_|_|_|_| _________________________________________________________________ ______________________________________________________________________________________ Clasa CAEN |_|_|_|_| _________________________________________________________________ ______________________________________________________________________________________ Clasa CAEN |_|_|_|_| _________________________________________________________________ ______________________________________________________________________________________ 4.3. Activitati itinerante (clasa CAEN) ______________________________________________ ______________________________________________________________________________________ Locul de desfasurare a activitatilor (inclusiv activitati itinerante in alte localitati): 1. |_| Sediul firmei 2. |_| Domiciliul consumatorului/clientului 3. |_| Alte sedii: _________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ (localitate, judet/sector, strada, numar, bloc, scara, etaj, apartament) |_| Solicit inregistrarea fiscala conform datelor inscrise in anexa nr. 6.2 | Modificari ale datelor inscrise in autorizatie: ______________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Declar ca nu detin o alta autorizatie in calitate de persoana fizica si nu fac parte dintr-o alta asociatie familiala autorizata. Domnului Primar al ...........................