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DECLARA.T!E .DE AVf,H.f.
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HI. IHJNURI \IOfHLE, ,\ CAROB VA.LOA.RE DKPA.SES"f'.E:IMOOJ Ji: INSTHAIN/'d..'g IN tLTt\IELE 12 LUNJ
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V. ACTIVE FINAN ClARE
l.COntmi si depozite bancare, fonduri de investitii, forme echivalente de economisire si investire,daca valoarea insumata a tuturor acestora depaseste 5.000 EuroNota.. se vor declara inclusiv cele ajlate in banci sau institutiijinanciare din strainatate
*Categoriile indicate soot: (1) Cont curent sau echivalente ( inclusiv card); (2) Depozit bancar sauechivalente; (3) Fonduri de investitii sau echivalente, inclusiv fonduri private de pensii sau alte sisteme cuacumulare
2. Plasamente, investitii directe si imprumuturi acordate, daca valoarea de piata insumata a tuturoracestora depaseste 5.000 Euro-.-----
*Categoriile indicate sunt : (l) Hartii de valoare detinute ( titlun' de stat, certificate, obligatiuni) ; (2) Actiuni sauparti sociale in societati comerciale (3) Imprumuturi acordate in nume personal3. Alte active producatoare de venituri nete, care insumate depasesc echivalentul a 5.000 Euro pe an :Nota: se vor declara inclusiv cele aflate in strainatate.
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V. DATORII
Debite ( inclusiv taxe neachitate), ipoteci, garantii emise in beneficiul unui tel"t, bunuri achizitionate insistem leasing si alte asemenea bunuri, daca valoarea insumata a tututror acestora depaseste 5.000Euro.
,Nota: se vor dec!ara inclusiv pasivele financiare acumulate in strainatateHHHH HHUHHHHHHHH,H"UUUUU'U'HHHHHHHHHHHHHHHHH'HH,HH.,,~ ~VI. Cadoul"i, selvicii sau avantaje primite gratuit sau subventionate fata de valoarea de piata, dinpartea unor pel"soane, organizatii, societati comerciale, regii autonome, companii / societati nationalesau institutii publice romanesti sau straine, inclusiv burse, credite, garantii, decontari de cheltuieli saualte asemenea, a cal"or valoare individuala de aseste 300 Euro*CINEA REALIZAT SURSAVENITULUI: SEVICIULPRESTAT/
NUME, OBIECTULVENIT ANUAL INCASAT
*Se excepteaza de la declarare cadourile si tratatiile uzuale primite din partea rudelor de gradul I si ILVII. Venituri ale declarantului si ale membrilor sai de familie, realizate in ultimul an fiscal incheiat(ptrivit art.41 din Legea nr. 571/2003 - Codul fiscal, cu modificarile si completarile ultel"ioare)ota : se vor declara inclusiv veniturile provenite din strainatate
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VENITUL ADRESA GENERATOR DE VENIT1,1. Titular
1.2, Sot! sotie
1.3. Copii...
1.1. Titular
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1.2. Sot! sotie
1.3. Copii
Tprinfamilie se intelege sotul/ sotia si copii aflatl in intretmerea acestora.2La titular, se mentioneaza, in cazul bunurilor proprii, numele proprietarului ( titularul, sotul/sotia,
copilul), iar in cazul bunurilor proprii in coproprietate, cota-parte si numele coproprietarilor.Prezenta declaratie constituie act public si raspund, potrivit legii penale, pentru inexactitatea sau caracter
incomplet al atelor mentionate.Data completarii :
,8. <)3. rw08sernnatu~ 3
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