(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 2015 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 xxx | First name xxx | Patronymic name* |
| Еaxpayer status 1 | Date of Birth xxxx | Citizenship (country code) 792 |
| Code of the Identity Document: 10 | Series and Number of the Document xxxx | |
| Residential Address in Russian Federation: | Post Code 103274 | Region Code 77 |
| District | City | Settlement |
| Street Krasnopresnenskaya Naberezhnaya | Building xxx 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 |
🌐 Translation Services: Form 2-NDFL Document from Russian to English
🌐 Translation Services: Form 2-NDFL Document from ORIGINAL IN RUSSIAN to English
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 | xxxxxx | Withheld tax amount | 16 364 |
| Tax basis | xxxxxx | 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
xxxxxx 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