ENGLISH TRANSLATION of INCOME STATEMENT OF AN INDIVIDUAL

Please provide the text of the “INCOME STATEMENT OF AN INDIVIDUAL” in Russian, and we will promptly translate it into English. If you already have the document ready, you can upload it, and we’ll take care of the translation. Upload the text for a quick and accurate translation into English at [email protected].

Перевод Справки о Доходах Физического Лица на Английский

INCOME STATEMENT OF AN INDIVIDUAL

(Document barcode number: 39908018)

Appendix No. 1

to the Order of the FNS of Russia

FNS (Federal Tax Service)

dated 30.10.2015

No. MMV-7_11/485@

Form 2-NDFL

Code according to KND 1151078

KND (Income Type Codes)

for 2016 year	N 1	issued 03.08.2023
Type 1	Number of corrections 00	IFNS (Code) 7714
		IFNS (Inspection of the Federal Tax Service)

1. Information about the tax agent

Code according to OKTMO 45333000	Phone +7 (495) 941-61-64	INN 7709602209	KPP 771401001
OKTMO (Russian Classification of Municipal Territories)		INN (Taxpayer Identification Number)	KPP (Tax Registration Reason Code)
Tax Agent	Limited Liability Company “ANT YAPY”

2. Information about the individual – recipient of the income

TIN in the Russian Federation	TIN in the country of citizenship
Surname Lacin	First name Fikret	Patronymic name*
Еaxpayer status 1	Date of Birth 01.01.1988	Citizenship (country code) 792
Code of the Identity Document: 10	Series and Number of the Document U09324647
Residential Address in Russian Federation:	Post Code 103274	Region Code 77
District	City	Settlement
Street Krasnopresnenskaya Naberezhnaya	Building 16A House number	Apartment
Сountry of residence code	Address

3. Incomes taxed at the rate of 13%

Month	Income Code	Income Amount	Deduction Code	Deduction Amount	Month	Income Code	Income Amount	Deduction Code	Deduction Amount
7	2000	14,055.56			10	2000	16,500.00
7	2530	4,140.00			10	2530	4,860.00
8	2000	16,500.00			11	2000	17,300.00
8	2530	4,680.00			11	2530	4,500.00
9	2000	16,500.00			12	2000	17,300.00
9	2530	4,680.00			12	2530	4,860.00

4. Standard, social, investment and property tax deductions

Deduction Code	Deduction Amount	Deduction Code	Deduction Amount	Deduction Code	Deduction Amount	Deduction Code	Deduction Amount

Notification, confirming the right to social tax deduction: No. ____ Date _____ IFNS code ____

Notification, confirming the right to property tax deduction: No. ____ Date _____ IFNS code ____

5. Total income and tax amounts

Total income amount	125 875.56	Withheld tax amount	16 364
Tax basis	125 875.56	Transferred tax amount	0
Assessed tax amount	16 364	Tax amount, overdeducted by tax agent	0
Amount of fixed advance payments	0	Tax amount, not deducted by tax agent	0

Notification confirming the right
to deduction of tax on fixed advance payments:No. ____ Date _____ IFNS Code ____

Tax agent (1 – tax agent, 2 – authorized representative): 1

Shelykhova Tatyana Vladimirovna

Signed

(signature)

Name of the document confirming representative’s powers_____

*Patronymic name to be stated, if any

Stamp^{(Stamp: Partially illegible. Unable to fully translate due to poor quality / damage / illegibility)} , OGRN ^{(Primary State Registration Number)} 10 146585918 * MOSCOW * Limited Liability Company * ANT YAPY

Перевод Справки о Доходах Физического Лица на Английский

---

---