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Approved by Order of Federal Tax Agency
of Russia of 14.10.2007
No. САЭ-3-04/705@

Form 2-Person income tax

 

EMPLOYEE EARNINGS CERTIFICATE FOR 2010 No. 15 of *** to Inspectorate of the Federal Tax Service No. ***

  1. Data on tax agent

1.1  INN/KPP for company or INN for individual ***

1.2  Company's name/Individual’s full name
"***" LTD

1.3  OKATO ***                   1.4       Phone: ***; ***

  1. Information about individual - income recipient

2.1  INN ***              2.2       Full name ***

2.3. Status (1-resident, 2 - nonresident) 1

2.4. Date of birth ***            2.5       Nationality (country code) ***

2.6. Code of the identity document 21                     2.7.      Series, document number ***

2.8. Permanent address in Russian Federation: postal index *** region code 52
district _______________ city KSTOVO community
street 2-nd MKP house 10 building __________ apartment 45

2.9. Address in the country of residence: Country code ________
Address:                                 __________________________________

                                               __________________________________

                                               __________________________________

  1. Incomes liable to tax at the rate of 13%

 

Month Income code Income amount Deduction code Deduction amount
 
Month Income code Income Amount Deduction code Deduction amount
01 2000 44,058.13     05 2000 43,758.13    
02 2000 44,058.13     06 2000 43,758.13    
03 2000 27,846.08     07 2000 3,978.01    
04 2000 31,824.09     07 2012 41,740.16    

 

  1. Standard and property tax deductions (by types)

4.1  Amounts of tax deductions, the right to which is granted to taxpayer

 

Deduction code Deduction amount   Deduction code Deduction amount   Deduction code Deduction amount   Deduction code Deduction amount

 4.2  No. of notification confirming the right to property tax deduction

 4.3. Date of issuance of notification

 4.4. Code of tax authority which issued notification

 4.5. Total amount of provided standard tax deductions

 4.6. Total amount of provided property tax deductions

 

 

 

  1. Total amounts of income and tax on the basis of the results for a tax period

 5.1.  Total amount of income                                                                                                                 281,020.86

 5.2. Taxable amount of income                                                                                                                       281,020.86

 5.3. Amount of calculated tax                                                                                                                          36,533

 5.4. Amount of tax withheld                                                                                                                             36,533

 5.5. Amount of tax to be reimbursed accordingto recalculation from incomes

for the previous years

 5.6. Set-off amount when paying the tax according to recalculation from incomes

for the previous years

 5.7. Amount of tax withheld according to recalculation from incomes

for the previous years

 5.8. Tax payable by the tax payer

 5.9. The surplus amount of tax withheld by the tax authority

 5.10. Amount of tax submitted to the tax authority for collection

 

 

Tax agent:

Chief accountant                                                       /Signature/      ***

                                                                                                                (title)      (Full name)

Seal: "***" Limited Liability Company