Standard, social and property tax deductions
Data about tax agent
1.1.INN/KPP for organization or INN for an individual 7743665424/773401001__________________________
1.2.Name of organization / Full name of an individual
LLC ZhilStroy-M __________________________________________________________________________
1.3. OKATO code 45293554000 ____________ 1.4. Telephone (495) 212-22-43_________________
Data about an individual - earnings recipient
2.1.INN 461601587472 2.2. Full name Evgeny Aleksandrovich Efremov_____________________
2.3. Tax payer status 1_______ 2.4. Date of birth 20.10.1973_______
2.5. Citizenship (country code) 643_______
2.6. Code of identity document 21____ 2.7. Series and number of document 38 02 709662_____________
2.8. Residential address in the Russian Federation: Postal index 111538 Region code 77___
District __________________________ City ________________ Population centre ________________
Street Veshnyakovskaya _______ House _ 25/2____ Building ___ Apartment 78______
2.9. Address in the country of residence: Country code: ________________ Address _____________________
3. Income leviable at the rate of 13%
| Month | Income code | Income amount | Deduction code | Deduction amount | Month | Income code | Income amount | Deduction code | Deduction amount | |
| 28 000.00 |
Standard, social and property tax deductions
4.1. Amounts of tax deductions granted to a taxpayer
| Deduction code | Deduction amount | Deduction code | Deduction amount | Deduction code | Deduction amount | Deduction code | Deduction amount | |||
| 1400.00 | 1400.00 |
4 2. No. of Notice confirming the right to property tax deduction _________________________________________
4.3. Issue date of Notice __________ 4.4. Code of tax authority that issued Notice ______________________
5. Total amounts of income and tax based on rersults of the tax period at the rate of 13%
| 5.1. Total amount of income | 28 000.00 |
| 5.2. Tax base | 25200.00 |
| 5.3. Calculated amount of tax | |
| 5.4. Deducted amount of tax | |
| 5.5. Transferred amount of tax * | |
| 5.6. Amount of tax, over withheld by a tax agent | |
| 5.7. Amount of tax, not withheld by a tax agent |
Tax agent Chief accountant _________________ E.A. Bakhreva ______________
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(position) (signature) (full name)
Round seal: ZhilStroy-M
Limited Liability Company
Moscow
OGRN 1077..61980911
* This paragraph shall be filled in relation to the amount of tax calculated on income, earned from 2011
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