WNIOSEK o zwrot podatku akcyzowego zawartego w cenie oleju
Transkrypt
WNIOSEK o zwrot podatku akcyzowego zawartego w cenie oleju
!"#$$"%&'()*+&
,-!.&/0
1*234!$"%& 5-& 6-!7-6!35!#$"*& 8"$"()6*& 9-:$"4)+*&
"&9-!+-;<&=("&!&5$"*&>0&()?4!$"*&@A>@&6.&B7-!.&/0C
!"#$%&
'()*+',(-'./,01(/023)'*45'()/*/+,45'(*(24674('8491(
6/-:.'*45'(*30'+)3;,3*/645'(.'(-+'.10297(+'8649
6/(+'0(
81,3(
!
"#$%&'()*'+&'!,(*-./0&1!%+ê!,(*'*!4(*5)!67&+-!849!7&12$1
:,&'0*/;<
============>>
?1$1!,(*-./0&1!&!,#),&2
;74+-74<(
"#)2$1%1!,(1%+1@!!!!!!!!!!!!!!!!!!!!!42$1%1!*!)+&1!AB!71(01!CBBD!(>!#!*%(#0&'!,#)1$34!130-*#%'6#!*1%1($'6#!%!0'+&'!#8'.4!!+1,/)#%'6#!%-3#(*-2$-%1+'6#!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!)#!,(#)430.&!(#8+'.!:?*>!E>!F(!GCH!,#*>!IJK!#(1*!*!CBAA!(>!F(!ABDH!,#*>!DCCH!F(!AJAH!,#*>!ABAD!&!F(!CKAH!,#*>!AJBJ<>
L'(7&+!23M1)1+&1!%+ê@!!!!!!!#)!)+&1!A!84$'6#!)#!#2$1$+&'6#!)+&1!84$'6#N!#)!)+&1!A!2&'(,+&1!)#!)+&1!IA!2&'(,+&1>
O&'.20'!23M1)1+&1!%+ê@!!!!!!%P.$H!94(7&2$(*!:,('*-)'+$!7&12$1<!%M1Q0&%-!*'!%*68/)4!+1!7&'.20'!,#M#R'+&1!6(4+$P%!9/)50-0S!%!,#2&1)1+&4!849!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!%2,PM,#2&1)1+&4!,(#)40'+$1!(#8+'6#>
"=(>"%?$@%($&ABCB!"B(
!"#$&D
!"##$%&'(#)*+,-.'+/#01+2/3425'#,-6.'67(#48#9'%+2:8#&2.'#.9;64653#<5-8.29
""=((CB!%("C%!EFG"&B@F?!%(
!"#$&#CB
@F
="#>6/<-.98?>6/<6#12;56
F"#>GAHHH
I"#AJKJLHHHH
M"#>*,2+#48<84*#8.8)-.'2:8HHHH
M6"#$34653#1+/2/
@"#A-2+<./2#-,-B?###
######>6/<6#.9+%C856
D"#E+*:-2#-,-B
N"#G553#489*,25'#18'<-2+4/6&OC3#'8P.6,8QR#0+84/6&(#5*,2+#489*,25'*7HHHH
N6"#$34653#1+/2/
S"#>*,2+#<#T+6&8<3,#U2&2.'+/2#KO48<3,(#<#1+/31649*#:43#1+84*C25'#+8V53
184V2:6#<1-.8<-#48#'2:8#+2&2.'+*
"""=((>"%?$@%(HB>"%$H&B!"B("(BCI%$(J($"%CH"KB("(BCI%$(LI#CD@%!EB(I#M!%N#
! "#A6_.'<8
!!"#$8&2<%4/'<8
!="#A8<-6'
!@"#`,-56
!D"#[V-C6
!F"#>+#48,*
!M"#a-2&.C8<8QR
!N"#T84#18C/'8<3
!S"#A8C/'6
"O=(#P
"BC@H%!"%(#(L#
"%IH@Q!"(DRFE&S
(I#M!F@Q
TQ%&1)0*17H!R'!.'2$'7!,#2&1)10*'7!4R-$3P%!(#8+-0S!#!,#%&'(*0S+&
%2,PM,#2&1)10*'7!4R-$3P%!(#8+-0S!#!,#%&'(*0S+&!
6(4+$P%!&!94)-+3P%!%6!2$1+4!+1!)*&'U!A!84$'6#!
!I"#>+#V896V*
S1!
S1!
1!
1H
#3('Q8#+'.!%!'%&)'+0.&
(#34H!%-3#(*-2$-%1+-0S!)#!,(#)430.&!(#8+'.H
,#M#R#+-0S!+1!#92*1(*'!67&+O=("!G#I>B@?B(#(HBAT@H!"&B@Q
= "#L-C/)6#/6;OC/5-9%<HHHHH
W6/56C/3R#<#1+/31649*#<5-8.9*#8#/<+8'#1846'9*#/6#89+2.#84#45-6#!#.-2+15-6#48#45-6#@!#.'3C/5-6#0<#1+/31649*#<5-8.9%<
##########.9;64653CX#<#V*'3,#= !=#+"#/<+8'#1846'9*#1+/3.;*:*&2#/6#89+2.#84#45-6#!#<+/2Q5-6#= !!#+"#48#45-6#@!#.'3C/5-6#= !=#+"7"#
HH#########W6/56C/3R#<#1+/31649*#<5-8.9*#8#/<+8'#1846'9*#/6#89+2.#84#45-6#!#V*'2:8#48#45-6# !#V-1C6"
HHH# A846&O#'2#184,-8'3(#9'%+2#.O#8)8<-O/652#18.-646R#>GA#56#184.'6<-2#1+/21-.%<#*.'6<3#/#45-6#!@#16Y4/-2+5-96#!SSF#+"#
##########8#/6.646CX#2<-425C&-#-#-425'3Z-96C&-#1846'5-9%<#-#1;6'5-9%<#0E/"#["#/#= D#+"#>+#=IS(#18/"#=IN!(#/#1%Y5"#/,"7"
HHHH####A846R#5*,2+#AJKJL#6V)8#5*,2+#48<84*#8.8)-.'2:8#V*)#-552:8#489*,25'*#18'<-2+4/6&OC2:8#'8P.6,8QR"
HHHHH##A846R#V-C/)B#Z69'*+#\]^#6V)8#-CX#981--#18'<-2+4/853CX#/6#/:8458QR#/#8+3:-56;2,"#
H##
UJV
!"#$$"%&'()*+&
,-!.&/0
?@>!A-&7;,'(/(!
!"#!$"!%&'"()*!$
+)'",!$"!%&'"()*-#
"#$%&'()*+%(%,-./012342%*,'(56%.(70586%,%9(5:,12
&'()*+%(%.'*280*0342%*,'(56%.(70586%30%'01;6328%<038(,"##$%=>?@A%ABCD>=E>%FB=EGH@IG%J,%.'*-.0786%.'*2K2,6%*,'(56%.(70586%30%'01;6328%<038(,-L
??>!B-,*(5/41!(8(CD'-,*-1!-.+%5!$45(-.-;,-!+-;E0'/0
?I>!B-,*-!$%&'-!H-'/0
?F>!G%&'#!'08%+!+-;E0'/0!H-'/4*%24
"###$%MIGNB%HO&PQ&GO#BNBCMR%=B%HR&QBST%MHAGS>%&GNBSE>UUUUUU
./
5)6)7$)$(!"#)8*9/
5:!;!$)$<9:<)8/
5)6)7$)$(!"#)8*9/
5:!;!$)$<9:<)8/
5)6)7$)$(!"#)8*9/
5:!;!$)$<9:<)8/
5)6)7$)$(!"#)8*9/
5:!;!$)$<9:<)8/
5)6)7$)$(!"#)8*9/
5:!;!$)$<9:<)8/
5)6)7$)$(!"#)8*9/
5:!;!$)$<9:<)8/
2/
1/
0/
4/
3/
#V$%GWH#BNCM@=#B
=>#)!:'"!6?$@AB
./$"(!(A$6)$8&$8*C;*)$8*%!:!()!$D!%8"E#E'F$9>#)!:'"AG$#E()*!H&'A$"$!I;J$2KL$M$.$N9:A*8C$*!I(AO9P
2/$"(!(A$6)$8&$"!8!:E$<I"E"(!#!()!$"#I9;C$<9:!;*C$!*'E"9#AO9$"!#!I;AO9$#$'A()A$9QAHC$(!<7:9#AO9$#E*9I"E8;E#!(AO9$:9$
$$$$<I9:C*'H)$I9Q(AHJ
?J>!K-3-!(!$4.$(5!*'(45/4.-*;#
:!;!$#E<A%()A()!$#()98*C
5:")AG$R$6)A8)&'$R$I9*/$
'"E;AQ(E$<9:<)8$#()98*9:!#'E
V$%BN=GSBCX@%>AMTN>%I?#=R!?#BOSB
?L>!M*-2(
!"#$%&'()!*!$+,#$-./01!2.#!2+0'3#!245$4.-+53*-!+46'%24!53-'4*(7!$+,%.8(43!*5$9&$45(-.-'(-!:'(%!.43#;,#!*5$9&8-&<4'/9*=>
!