In inspection of the Ministry of Taxes and Tax Collection of the Republic of Belarus (further – inspection of the Ministry of Taxes and Tax Collection)

Sign

Mark X

on ___________________________________

Modification and (or) amendments in part I of the tax declaration (calculation)

(the name of the area, city, area in the city)

management (department) of work with payers on _________________________________
                                                 (name of the area)

Modification and (or) amendments in part II of the tax declaration (calculation)

Code of inspection of the Ministry of Taxes and Tax Collection (management (department) of work with payers)

Modification and (or) amendments in the tax declaration (calculation):

UNP1

_____________________________________

according to subitem 1.11 of Item 1 of the Presidential decree of the Republic of Belarus of  October 23, 2012 No. 488 "About some measures for the prevention of illegal minimization of the amounts of the tax liabilities" (The national legal Internet portal of the Republic of Belarus, 25.10.2012, 1/13843)

(the name (surname, own name, middle name (if that is available) the payer)

_____________________________________

(location (residence)
payer)

_____________________________________

(surname, own name, middle name (if that is available) the responsible person, phone)

according to Item 5 of article 70 of the Tax Code of the Republic of Belarus according to the notification

number

date

in connection with detection of incompleteness of data or mistakes

The choice since the next tax, accounting period of payment method of the value added tax by part I of the tax declaration (calculation)

ezhekvar-
talno

ezheme-
syachno

Sign of submission of the tax declaration (calculation)

Mark X

According to part one of Item 21 of article 63 of the Tax Code of the Republic of Belarus

According to part two of Item 21 of article 63 of the Tax Code of the Republic of Belarus

According to part four of Item 21 of article 63 of the Tax Code of the Republic of Belarus

According to part five of Item 21 of article 63 of the Tax Code of the Republic of Belarus

date of representation in registering

body of the petition for dissolution

(number)

(number of month)

(four figures of year)

(activities termination), date

liquidations of separate division

date of the termination of foreign

the organization of activities in the territory

(number)

(number of month)

(four figures of year)

The Republic of Belarus through permanent

representation

Type of the tax declaration (calculation):

monthly

quarterly

for  

month

years

(number of month) ²

(four figures of year)

Indicators

Amount

VAT rate

VAT amount

1

2

3

4

Section I. TAX BASE

1. On the transactions assessed at the rate

20/120

11. On the transactions assessed at the rate

25/125

2. On the transactions assessed at the rate

18/118

3. On the transactions assessed at the rate (line 3.1 + line 3.2 + line 3.3), including:

10/110

3.1. in case of realization of the crop production products made in the territory of the Republic of Belarus (except for floriculture, cultivation of ornamental plants), wild-growing berries, nuts and other fruits, mushrooms, other wild-growing products, beekeeping, livestock production (except for furs productions) and fish breeding

10/110

3.2. in case of realization of food products and goods for children according to the list approved by the President of the Republic of Belarus

10/110

3.3. in case of realization of other goods

10/110

4. On the transactions assessed at the rate

 % 16,67

5. On the transactions assessed at the rate

 % 9,09

6. On the transactions assessed at the rate

0 %

x

7. On transactions on sales of goods (works, services), free from VAT (exempted from the VAT), the deduction of VAT amounts on which is made in full (line 7.1 + line 7.2 + line 7.3), including according to:

x

x

7.1. the regulatory legal acts of the President of the Republic of Belarus determining such procedure for deduction of VAT amounts

x

x

7.2. subitem 23.4 of Item 23 of article 107 of the Tax Code of the Republic of Belarus

x

x

7.3. subitems 23.6 and 23.7 of Item 23 of article 107 of the Tax Code of the Republic of Belarus

x

x

8. On the transactions exempted from the VAT

x

x

9. On transactions which place of realization the territory of the Republic of Belarus is not recognized

x

x

91. On the transactions on voluntary conveyance of goods (works, services), property rights (further – objects) which are not recognized by realization or the taxation object of the VAT according to the legislation

x

x

10. On transactions on sales of goods on retail prices

x

11. The tax amounts which are excessively shown to buyers

x

x

12. The amounts of reduction of the tax deductions exceeding the amount of deductions of accounting tax period

x

x

13. The tax base and VAT amounts which are subject to payment in case of acquisition of objects at the foreign organizations

x

14. TOTAL according to the Section I

(line 1 + line 11 + line 2 + line 3 + line 4 + line 5 + line 6 + line 7 + line 8 + line 9 + line 91 + line 10 + line 11 + line 12 + line 13)

x

14a. VAT amount on objects which turnovers on realization are exempted from payment of the VAT

x

x

14b. VAT amount on objects on which turnovers on realization the tax credit is granted

x

x

14 century. VAT amount on other objects

x

x

Section II. TAX DEDUCTIONS

15. The tax deductions – all (line 15a + line 15b + line 15v)

x

x

15a. The tax deductions on objects which turnovers on realization are exempted from payment of the VAT

x

x

15b. The tax deductions on objects on which turnovers on realization the tax credit is granted

x

x

15 century. The tax deductions on other objects

x

x

Section III. TAX AMOUNT

VAT amount the accruing result – all
(line 16a + line 16b + line 16v) and (line 14 – line 15)  

x

x

16a. VAT amount the accruing result, being at the command (subject to reduction) (line 14a – line 15a)

x

x

16b. The VAT amount the accruing result which is subject to payment (return) on objects on which turnovers on realization the tax credit is granted (line 14b – line 15b)

x

x

16 century. The VAT amount the accruing result which is subject to payment (return) (line 14v – line 15v)

x

x

17. VAT amount for the accounting period – all
(line 17a + line 17b + line 17v)

x

x

17a. VAT amount for the accounting period, being at the command (subject to reduction) (line 16a – line 16a of the previous tax declaration (calculation))

x

x

17b. The VAT amount for the accounting period which is subject to payment (return) on objects on which turnovers on realization the tax credit is granted (line 16b – line 16b of the previous tax declaration (calculation))

x

x

17 century. VAT amount for the accounting period to payment (return) on other objects (line 16v – line 16v of the previous tax declaration (calculation))

x

x

18. VAT amount to payment (return) for the accounting period – all
(line 17b + line 17v)

x

x

18.1. including to return for the accounting period of difference between the amount of the tax deductions and total amount of the VAT estimated on realization of objects

x

x

19. From line 18 to surcharge (reduction) according to the inspection statement

x

x

19.1. including to return according to the inspection statement of difference between the amount of the tax deductions and total amount of the VAT estimated on realization of objects

x

x

On payment due date  

(number)

(number of month)

(four figures of year)

Indicators

Amount

1. The VAT amounts of the current tax period shown in case of acquisition or paid when importing objects – all ( p. 1.1 + p. 1.2 + p. 1. 3)

1a. including VAT amounts on the created, acquired (imported) fixed assets, intangible assets

1.1. the VAT amounts shown in case of acquisition of objects in the territory of the Republic of Belarus

1.2. the VAT amounts estimated and paid in case of commodity importation from the territory of state members of the Eurasian Economic Union

1.3. the VAT amounts paid in case of release of goods according to the declared customs procedure

2. The VAT amounts which are not accepted to deduction in last tax period (line 2.1 + line 2.2)

2.1. including VAT amounts on the created, acquired (imported) fixed assets, intangible assets, from them:

2.1.1. accepted to deduction in the current tax period in full by equal shares (on 1/12 or on 1/4) of VAT amount on the created, acquired (imported) fixed assets, intangible assets

2.2. including the VAT amounts paid in case of commodity importation, which are deductible in that accounting period of the current tax period in which 60 calendar days from the date of their release according to the declared customs procedure will expire

3. The VAT amounts accepted to deduction in full falling on turnovers on the sales of goods (works, services) assessed at the rate zero (0) percent

4. The VAT amounts accepted to deduction in full falling on turnovers on the sales of goods assessed at the rates of 10 percent and (or) 9,09 of percent

5. The VAT amounts accepted to deduction in full falling on turnovers on sales of goods (works, services), free from VAT (exempted from the VAT), according to subitems 23. 4, 23.6, 23.7 of Item 23 of article 107 of the Tax Code of the Republic of Belarus

6. The VAT amounts which are not accepted to deduction and included in costs on production and realization of objects

6.1. including in connection with application of release from the VAT

6-1. The tax deductions transferred to the receiver and (or) the tax amounts on value added transferred by reorganization of the organization according to Item 21 of article 107 of the Tax Code of the Republic of Belarus

7. Free from VAT turnover on sales of goods from storage locations, from trade fairs in the territory of state members of the Eurasian Economic Union, the deduction of VAT amounts on which is made in full,

8. Zero assessed at the rate (0) percent turnover on sales of goods on the territory of state members of the Eurasian Economic Union (line 8.1 + line 8.2 + line 8.3 + line 8.4), including:

8.1. exported on the territory of the Russian Federation

8.2. exported on the territory of the Republic of Kazakhstan

8.3. exported on the territory of the Republic of Armenia

8.4. exported on the territory of the Kyrgyz Republic

9. The turnover exempted from the VAT and (or) assessed at the rates 20, of 10 percent on sales of goods on the territory of state members of the Eurasian Economic Union (line 9.1 + line 9.2 + line 9.3 + line 9.4), including:

9.1. exported on the territory of the Russian Federation

9.2. exported on the territory of the Republic of Kazakhstan

9.3. exported on the territory of the Republic of Armenia

9.4. exported on the territory of the Kyrgyz Republic

10. Zero assessed at the rate (0) percent turnover on realization by persons having the status of Authorized Economic Operator, goods when which importing to the territory of the Republic of Belarus the VAT was not levied by customs authorities

11. The VAT amounts which are not accepted to deduction by the end of the reporting period

11.1. deductible in the next accounting periods in full equal shares (on 1/12 or on 1/4) of VAT amount on the created, acquired (imported) fixed assets, intangible assets (line 2.1 – line 2.1.1)

11.2. the VAT amounts paid in case of commodity importation, which are deductible in the next accounting periods in which 60 calendar days from the date of their release according to the declared customs procedure will expire

11.3. VAT amounts on other objects (line 11 – line 11.1 – line 11.2)

12. The VAT amounts accepted to deduction in full according to:
(line 12.1+ line 12.2 + line 12.3)

12.1. The decree of the President of the Republic of Belarus of  August 6, 2009 No. 10 "About creation of additional terms for investing activities in the Republic of Belarus" (The national register of legal acts of the Republic of Belarus,  2009, No. 188, 1/10912) in connection with implementation of the investment agreement:
(line 12.1.1 + line 12.1.2 + …)

12.1.1. ______________________________________________________________________

(date and number of the investment agreement signed with the Republic of Belarus)

12.1.2. ______________________________________________________________________

(date and number of the investment agreement signed with the Republic of Belarus)

…

12.2. the investment agreements signed with the Republic of Belarus, providing the Republic of Belarus, other than the Decree of the President, of  August 6, 2009 No. 10 of condition and (or) procedure for acceptance of VAT amounts to deduction in full:
(line 12.2.1 + line 12.2.2 + …)

12.2.1. ______________________________________________________________________

(date and number of the investment agreement signed with the Republic of Belarus)

12.2.2. ______________________________________________________________________

(date and number of the investment agreement signed with the Republic of Belarus)

…

12.3. other acts of the President of the Republic of Belarus which grant the right to acceptance (the procedure for acceptance is established) VAT amounts to deduction in full:
(line 12.3.1 + line 12.3.2 + …)

12.3.1. ______________________________________________________________________________

(the paragraph, part, the subitem, Item, Article (in case of their availability), acceptance date, number and type of the act of the President of the Republic of Belarus)

12.3.2. ______________________________________________________________________________

(the paragraph, part, the subitem, Item, Article (in case of their availability), acceptance date, number and type of the act of the President of the Republic of Belarus)

…

13. The VAT amount which did not come to the budget in connection with application of release from the VAT
(line 8 of the Section I of part I of the tax declaration (calculation) for the VAT – line 6.1) x 20/100) – line 6.1)

14. The turnovers which are not recognized by the taxation object of the VAT:

x

14.1. according to subitem 2.5.1 of Item 2 of article 93 of the Tax Code of the Republic of Belarus

14.2. according to the paragraph the second parts one of subitem 2.5.3 of Item 2 of article 93 of the Tax Code of the Republic of Belarus

14.3. according to the paragraph third parts one of subitem 2.5.3 of Item 2 of article 93 of the Tax Code of the Republic of Belarus

14.4. according to subitem 2.7 of Item 2 of article 93 of the Tax Code of the Republic of Belarus

14.5. according to subitem 2.30 of Item 2 of article 93 of the Tax Code of the Republic of Belarus

14.6. according to subitem 2.31 of Item 2 of article 93 of the Tax Code of the Republic of Belarus

14.7. according to subitem 2.32 of Item 2 of article 93 of the Tax Code of the Republic of Belarus

The accounting period ^2, for which the incompleteness of data or errors which led to understating (overestimate) of tax amount for this period are found

Is subject to payment (return) for the corresponding accounting period for which are found incompleteness of data or error (+, –)

The accounting period ^2, for which the incompleteness of data or errors which led to understating (overestimate) of tax amount for this period are found

Is subject to payment (return) for the corresponding accounting period for which are found incompleteness of data or error (+, –)

VAT amount

difference amount between the amount of the tax deductions and total amount of the VAT estimated on realization of objects

VAT amount

difference amount between the amount of the tax deductions and total amount of the VAT estimated on realization of objects

1

2

3

4

5

6

January

July

February

Augustus

Mart

September

April

October

Mai

November

June

December

TOTAL in year, including:

it is estimated according to subitem 1.11 of Item 1 of the Presidential decree of the Republic of Belarus of  October 23, 2012 No. 488

it is estimated according to Item 5 of article 70 of the Tax Code of the Republic of Belarus

for  

month

years

(number of month)

(four figures of year)

Code of the state

Indicator

Tax base

VAT rate

VAT amount

1

2

3

4

1. On the transactions assessed at the rate

20/100

1.1. including increase in tax base

20/100

2. On the transactions assessed at the rate

10/100

2.1. including increase in tax base

10/100

3. On the transactions exempted from the VAT

x

x

3.1. including increase in tax base

x

4. TOTAL

x

x

4.1. including to surcharge (reduction) (line 4.1.1 + line 4.1.2):

x

x

4.1.1. according to the inspection statement

x

x

4.1.2. according to Item 5 of article 70 of the Tax Code of the Republic of Belarus

x

x

On payment due date  

(number)

(number of month)

(four figures of year)

Total to payment:

Total to payment by part I

rub.

Total to payment by part II

rub.

data on the size and structure of the used privileges according to appendix 1 to this form

the register of numbers of electronic customs declarations on the goods issued according to customs procedure of export (issued according to the declared customs procedure), according to appendix 2 to this form

the register of the international transport or commodity-transport documents and requests (tasks or other documents) according to appendix 3 to this form

the document register, confirming commodity exportation out of limits of the Republic of Belarus and their realization from storage locations, from trade fairs in the territory of state members of the Eurasian Economic Union, according to appendix 4 to this form

the document register, confirming commodity exportation out of limits of the Republic of Belarus and their realization from storage locations in the territory of foreign states and (or) from the trade fairs held in the territory of foreign state according to appendix 5 to this form

the document register, the duty-free shops confirming self-produced sales of goods to owners, according to appendix 6 to this form

the document register, the services in servicing of the aircrafts which are carrying out the international flights and (or) the international airborne transportations confirming rendering according to appendix 7 to this form

the register of documentary confirmations of commodity exportation out of limits of customs area of the Eurasian Economic Union according to appendix 8 to this form

the document register, confirming self-produced sales of goods and their export out of limits of the Republic of Belarus under the contract of international leasing with repurchase right, according to appendix 9 to this form

the document register, confirming performance of works, rendering services in repair, maintenance of the vehicles registered in foreign states, according to appendix 10 to this form

the list of statements for commodity importation and payment of indirect taxes according to appendix 11 to this form

the document register, the services in provision confirming rendering in use of cars, containers, carts, cars of refrigerator sections, shift of cars on wheel vapors of other track, services in work of locomotives and locomotive crews (service of locomotive draft), according to appendix 12 to this form

Head of the organization
(individual entrepreneur)
or person authorized by it

_______________

_____________________

(signature)

(initials, surname)

Official of inspection of the Ministry of Taxes and Tax Collection (management (department) of work with payers)

_______________

_____________________

(signature)

(initials, surname)

(number)

(number of month)

(four figures of year)

Section I. Data on the size and structure of the used privileges

№
payment order

Content of privilege with indication of the paragraph, the subitem, Item, Article, acceptance date, number and type of the legal act by which it is established

Code ^gosudarstva1

Code ^lgoty2

The size granted tax allowance tax ^bazy3

The tax amount which did not come to the budget in connection with use ^lgoty4

1

2

3

4

5

6

Section II. Data on the bases of application of the privilege established by the Presidential decree of the Republic of Belarus of September 22, 2017 No. 345
"About development of trade, public catering and consumer services" (The national legal Internet portal of the Republic of Belarus, 26.09.2017, 1/17274)

Name of type of activity

Data on the shopping facility (place), object of public catering, consumer services

Implementation of activities in calendar year according to the Presidential decree of the Republic of Belarus of September 22, 2017 No. 345 (the sign "X" is put down)

code like object (place)

name of object (place)

location (address)

number of month

code of inspection of the Ministry of Taxes and Tax Collection (management (department) of work with payers) in the location of object (place) ²

naimeno-
vany territories of the rural zone or small residential location

area

area

naimeno-
vaniye rural (poselko-
vy) Council

the type is inhabited -
Item leg

naime-
novaniye it is inhabited -
Item leg

type of element of street road net and the element equated to it gradostroi-
telny planning structure

the name of element of street road net and the element equated to it gradostroi-
telny planning structure

number

1

2

3

4

5

6

7

8

9

10

11

12

houses

box -
pusa

pome-
shcheniya

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

The average number of workers for calendar month, persons.

January

February

March

April

May

June

July

August

September

October

November

December

1

2

3

4

5

6

7

8

9

10

11

12

Head of the organization
(individual entrepreneur)
or person authorized by it

_____________________

_____________________________

(signature)

(initials, surname)

for  

month

years

(number of month) ²

(four figures of year)

Details of electronic customs declarations on goods

Date of permission to departure of goods

Amount of turnover (rub)

date of issue of goods

registration number

registration number of release of goods

code of customs procedure

1

2

3

4

5

6

TOTAL

Head of the organization
(individual entrepreneur)
or person authorized by it

_____________

___________________

(signature)

(initials, surname)

for  

month

years

(number of month) 1

(four figures of year)

Date and agreement number, the exported transport services providing rendering

Date and requisition number (tasks or other documents) 2

Date and number international transport or commodity-transport dokumentov3

Route

Moment of the actual realization

Amount of turnover (rub)

1

2

3

4

5

6

TOTAL

Head of the organization
(individual entrepreneur)
or person authorized by it

_______________

_____________________

(signature)

(initials, surname)

for  

month

years

(number of month) 1

(four figures of year)

Rekvizity2 statements for commodity importation and payment of indirect taxes

The transport (consignment) documents confirming movement of goods from the territory of the Republic of Belarus on the territory of other state member of the Eurasian Economic Union

Details of the agreements providing storage of goods in the territory of state member of the Eurasian Economic Union and (or) participation of goods in the trade fairs held in the territory of state member of the Eurasian Economic Union

Date, agreement number with the buyer – the foreign organization and (or) physical person

Date of leave (shipment) of goods of the payer to the buyer – the foreign organization and (or) physical person from storage locations in the territory of state member of the Eurasian Economic Union and (or) from the trade fair held in the territory of state member of the Eurasian Economic Union

The turnover amount on sales of goods from storage locations, from trade fairs in the territory of state members of the Eurasian Economic Union (rub)

Date and document number, confirming receipt of revenue into accounts platelshchikov3

date

registration number

date, agreement number with the keeper, the organizer of trade fairs

code of state member of the Eurasian Economic Union in the territory of which storage and (or) participation of goods in trade fairs was performed

name of documents

date, number

1

2

3

4

5

6

7

8

9

10

TOTAL

x

Head of the organization
(individual entrepreneur)
or person authorized by it

_____________________

_____________________________

(signature)

(initials, surname)

for  

month

years

(number of month) 1

(four figures of year)

Details of customs declarations on the goods issued according to customs procedure of export

Date of putting down by customs authority of the Republic of Belarus the marks "The Goods Are Exported" in the special register exported tovarov2

Details of the agreement providing storage of goods in the territory of foreign state and (or) participation of goods in the trade fairs held in the territory of foreign state

Date, agreement number with the buyer – the foreign organization or the foreign physical person

The documents confirming leave (shipment) of goods to the buyer – to the foreign organization and (or) the foreign physical person

The turnover amount on sales of goods from storage locations in the territory of foreign state and (or) from the trade fairs held in the territory of foreign state (rub)

Date and document number, confirming receipt of revenue into accounts platelshchikov3

registration number of release of goods

date of issue of goods

date, agreement number with the keeper, the organizer of trade fairs

the name of foreign state in the territory of which storage of goods and (or) participation of goods in trade fairs was performed

name, date, document number

date of leave (shipment) of goods

1

2

3

4

5

6

7

8

9

10

TOTAL

x

Head of the organization
(individual entrepreneur)
or person authorized by it

_____________________

_____________________________

(signature)

(initials, surname)

for  

month

years

(number of month) 1

(four figures of year)

Name of the owner of duty-free shop

Date, agreement number of purchase and sale, the duty-free shop concluded with the owner

Number and date of commodity-transport delivery note

Details of the certificate of self-produced products

Details of customs declarations on the self-produced goods placed under customs procedure of duty-free trade

The turnover amount on self-produced sales of goods, liable to the value added tax at the rate 0 (zero) percent (rub)

number, date of issue

action period

registration number of release of goods

date of issue of goods

1

2

3

4

5

6

7

8

TOTAL

Head of the organization
(individual entrepreneur)
or person authorized by it

_____________________

_____________________________

(signature)

(initials, surname)

for  

month

years

(number of month) 1

(four figures of year)

Name of services

Date, agreement number (agreements) based on which rendering services is performed

The name, number and document date, the services confirming rendering

The turnover amount on rendering of services, liable to the value added tax at the rate 0 (zero) percent (rub)

1

2

3

4

TOTAL

Head of the organization
(individual entrepreneur)
or person authorized by it

_______________

_____________________

(signature)

(initials, surname)

for  

month

years

(number of month) 1

(four figures of year)

Date, agreement number on rendering services in value added tax return to foreign persons 2, concluded with the organization having the right to value added tax return to foreign persons

The act details on compensation of tax amounts on value added signed by the payer and the organization having the right to value added tax return to foreign persons

The turnover amount on sales of goods, 0 (zero) percent (rub) realized to foreign persons through shop, liable to the value added tax at the rate

the date of receipt

signature date payer

the VAT amount shown to compensation

1

2

3

4

5

TOTAL

Head of the organization
(individual entrepreneur)
or person authorized by it

_______________

_____________________

(signature)

(initials, surname)

for  

month

years

(number of month) 1

(four figures of year)

Date, agreement number of purchase and sale, concluded with the lessor

Details of the document on goods belonging to self-produced products

Numbers and dates of the shipping documents confirming the fact of shipment by the seller of goods to the lessor

Numbers and dates of shipping documents with mark lizingopoluchatelya2

Details of the customs declaration on the goods issued according to customs procedure exporta3

Amount of turnover (rub)

number, date of issue

action period

registration number of release of goods

date of putting down of the mark "the goods are exported" 4

date of permission to departure tovara5

1

2

3

4

5

6

7

8

9

TOTAL

Head of the organization
(individual entrepreneur)
or person authorized by it

_____________________

_____________________________

(signature)

(initials, surname)

for  

month

years

(number of month) 1

(four figures of year)

Date and agreement number (contract) for performance of works, rendering services in repair, maintenance of the vehicle registered in foreign state concluded by the payer

Details of the certificate or other registration document of foreign state on the vehicle

Date, document number, the performance of works confirming the fact, rendering services by the payer in repair, maintenance of the vehicle belonging to the categories M 3, N 2, N 3, of O3 or O4 registered in foreign state

Amount of turnover (rub)

with the foreign organization or physical person, except for citizen of the Republic of Belarus

with insurance organizatsiyey2

series, number, date of issue, the body which performed issue of the certificate or other registration document

state registration number of the vehicle

1

2

3

4

5

6

TOTAL

Head of the organization
or person authorized by it

_______________

_____________________

(signature)

(initials, surname)

for  

month

years

(number of month) 1

(four figures of year)

Registration number and date of the statement for commodity importation and payment of indirect taxes

Identification code (number) of the taxpayer (importer)

Receipt date in the Ministry of Taxes and Tax Collection of information on the statement for commodity importation and payment of indirect taxes in the form provided by the separate international interdepartmental treaty

Amount of turnover (rub)

1

2

3

4

TOTAL

Head of the organization
(individual entrepreneur)
or person authorized by it

_______________

_____________________

(signature)

(initials, surname)

for

month

years

(number of month) ¹

(four figures of year)

Name of service

Date and agreement number, the services in provision providing rendering in use of cars, containers, carts, cars of refrigerator sections, shift of cars on wheel vapors of other track, services in work of locomotives and locomotive crews (service of locomotive draft)

Date and document number, confirming rendering services in provision in use of cars, containers, carts, cars of refrigerator sections, shift of cars on wheel vapors of other track, services in work of locomotives and locomotive crews (service of locomotive draft)

Moment of the actual realization

Amount of turnover (rub)

1

2

3

4

5

TOTAL

Head of the organization
or person authorized by it

_______________

_______________________

(signature)

(initials, surname)

In inspection of the Ministry of Taxes and Tax Collection of the Republic of Belarus (further – inspection of the Ministry of Taxes and Tax Collection)

Sign

Mark X

on ___________________________________

Modification and (or) amendments in part I of the tax declaration (calculation)

(the name of the area, city, area in the city)

management (department) of work with payers on _________________________________
                                                   (name of the area)

Modification and (or) amendments in the tax declaration (calculation):

Code of inspection of the Ministry of Taxes and Tax Collection (management (department) of work with payers)

according to subitem 1.11 of Item 1 of the Presidential decree of the Republic of Belarus of  October 23, 2012 No. 488 "About some measures for the prevention of illegal minimization of the amounts of the tax liabilities" (The national legal Internet portal of the Republic of Belarus, 25.10.2012, 1/13843)

UNP1

_____________________________________

(the name (surname, own name, middle name (if that is available) the payer)

_____________________________________

(location (residence)
payer)

_____________________________________

(surname, own name, middle name (if that is available) the responsible person, phone)

according to Item 5 of article 70 of the Tax Code of the Republic of Belarus according to the notification

number

date

in connection with detection of incompleteness of data or mistakes

Representation sign
tax declaration (calculation)

Mark X

According to part one of Item 21 of article 63 of the Tax Code of the Republic of Belarus

According to part two of Item 21 of article 63 of the Tax Code of the Republic of Belarus

According to part four of Item 21 of article 63 of the Tax Code of the Republic of Belarus

According to part five of Item 21 of article 63 of the Tax Code of the Republic of Belarus

date of representation in registering

body of the petition for dissolution

(number)

(number of month)

(four figures of year)

(activities termination), date

liquidations of separate division

date of the termination of foreign

the organization of activities in the territory

(number)

(number of month)

(four figures of year)

The Republic of Belarus through permanent

representation

for  

month

years

(number of month)

(four figures of year)

№
payment order

Indicators

Unit of measure

I will eat around (quantity) of goods in natural vyrazhenii2

Share of ethyl alcohol 2, (%)

Rate of excises for unit of the taxation (rub)

Amount of excises, (rub)

1

2

3

4

5

6

7

Part I. Calculation of the excises levied by tax authorities in case of commodity importation on the territory of the Republic of Belarus

Code of group of excise goods according to the reference book of groups of excise goods

Total

x

x

x

x

1.1

Including to surcharge (reduction):

x

x

x

x

1.1.1

according to the inspection statement

x

x

x

x

1.1.2

according to Item 5 of article 70 of the Tax Code of the Republic of Belarus

x

x

x

x

On payment due date  

(number)

(number of month)

(four figures of year)

Part II. Calculation of excises for the realized excise goods

Code of group of excise goods according to the reference book of groups of excise goods

Section I. Realization of the excise goods assessed by excises

Realization of excise goods in the territory of the Republic of Belarus

1

The added amount of excises – all (line 1.1 + line 1.2):

x

x

x

x

1.1

in case of realization (use) of the imported (acquired) excise goods, when importing (acquisition) of which payment of excises was not made, – all (line 1.1.1 + line 1.1.2):

x

x

x

x

1.1.1

in case of realization of the imported (acquired) excise goods – everything, including by types of excise goods:

x

x

x

x

1.1.2

when using excise goods for own needs, transfer (realization) to the workers, exchange, voluntary conveyance – everything, including by types of excise goods:

x

x

x

x

1.2

in case of realization (use) of the made excise goods – all (line 1.2.1 +
+ line 1.2.2 + line 1.2.3):

x

x

x

x

1.2.1

in case of realization of the excise goods made from own raw materials – everything, including by types of excise goods:

x

x

x

x

1.2.2

in case of realization of the excise goods made from raw materials supplied by the customer – everything, including by types of excise goods:

x

x

x

x