...,;i:ftt~~~~1]~--~f~ ==== --- I f----=. -~-==-~·' -+]...extravilane, dad! se afla in circuitul...

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CONSIUUL CONCURENTEI DECLARATIE DE AVERE pZ5~atie dp3~$;~~ :'l-'r N[...:.' Data : : . ~~'i!ft?t::,~~/b;.:~.~~~:::.i~.l~~~~~:':.::~:::.;:NP: .. ~. avand fun~t;,lk r.aw.: U/ ~?"/. . . ,I ~~:;~~~~~';i p~~~~derii:' ~~t:··29i di~ Cod~I··-penal privind ~Isul /in'dedarati'i"'d'~~i~'; '1) I ! proprie raspundere ca impreuna cu familia 1l detin urmato,arele: "')Prin familie se intelege sotulfsotia ~i copiii aflati in intretinerea acestora. I. Bunuri imobile 1. Terenuri NOTA: Se vor declara inclusiv cele aflate in alte tiki. __ Adre~-;';~i~~~~-;-]~!i~~~~i~- , .. i I ..".,;"i:ftt~~~~1]~~f~~t~~W -- ~:-tJ j , I I' ! ·------------T----- --'T-' --,--.------.--.----.- 1 =====---- I ! ! f----=.-~-==-~·'--+] -----.--------------r-.-----+-- -----+------+------------.------I ···.------··-------------·i---- +- ' +.- -.... - .. ---------!----------------~ "'------:-~-~~~~~~t: (1) agricol; (2) forestieri (3) intravilan; (4; luciu de apa; ~5) alte categorii de te I'IJri extravilane, dad! se afla in circuitul civil. I l ')La "Titular" se mentioneaza, in cazul bunurilor proprii, numele proprietarului (titularul, sotul!sotia, copilul), la' Iin cazul bunurilor in coproprietate, cota-parte ~i numele coproprietarilor. I I I I 2. Cladiri I I I NOTA: I I Se vor declara inclusiv cele aflate in alte t~ki. I I ;-:---:'T<~~,·'~:;·~',r::.<,': -_ ,.~ :.~::..~; '):: . .v. .,. .:.~.:i::,:».,~ ."~ :---;,' -c-1- t-' !-'!~J:~'~~~~ , ___r--- ,t~~~~UI~j=tt .-------- .. -------}-----j---------+----t--- ----t-------T---------- .. ·------ .-.---. ..-- ..-----.-----------.---.--+ 'I ' . --_.-. I 1"'-----.----- .. ----.,-.----- . i t I I! I I --1--- I -T-------T------------------ '-r- --------------- .. -------.--! I --- : I ------.----- ---1- ___ ,__________________ _ , J , ------ .J Categoriile indicate sunt: (1) apartament; (2) casa de locuiti 0) casa de vacanta; (4) spatii comerci IE-/~: productie. ------------ 2)La "Titular" se mentioneaza, in cazul bunurilor proprii, numele proprietarului (titularul, sotul!sotia, copilul), iari cazul bunurilor in coproprietate, cota-parte ~i numele coproprietarilor.

Transcript of ...,;i:ftt~~~~1]~--~f~ ==== --- I f----=. -~-==-~·' -+]...extravilane, dad! se afla in circuitul...

Page 1: ...,;i:ftt~~~~1]~--~f~ ==== --- I f----=. -~-==-~·' -+]...extravilane, dad! se afla in circuitul civil. I l ')La "Titular" se mentioneaza, in cazul bunurilor proprii, numele proprietarului

CONSIUUL CONCURENTEI

DECLARATIE DE AVERE

pZ5~atiedp3~$;~~:'l-'rN[...:.' Data : : .

~~'i!ft?t::,~~/b;.:~.~~~:::.i~.l~~~~~:':.::~:::.;:NP:..~.avand fun~t;,lkr.aw.: U/~?"/. . . ,I~~:;~~~~~';ip~~~~derii:' ~~t:··29idi~ Cod~I··-penalprivind ~Isul /in'dedarati'i"'d'~~i~'; '1) I !

proprie raspundere ca impreuna cu familia1ldetin urmato,arele:"')Prin familie se intelege sotulfsotia ~i copiii aflati in intretinerea acestora.

I. Bunuri imobile1. TerenuriNOTA:Se vor declara inclusiv cele aflate in alte tiki.

__Adre~-;';~i~~~~-;-]~!i~~~~i~-,..i

I

..".,;"i:ftt~~~~1]~~f~~t~~Wl~-- ~:-tJj ,

I I' !·------------T---1·-- --'T-' --,--.------.--.----.- 1

=====---- I ! ! f----=.-~-==-~·'--+]-----.--------------r-.-----+-- -----+------+------------.------~ ·I···.------··-------------·i---- +- ' +.- -....-..---------!----------------~"'------:-~-~~~~~~t: (1) agricol; (2) forestieri (3) intravilan; (4; luciu de apa; ~5) alte categorii de te I'IJriextravilane, dad! se afla in circuitul civil. I l

')La "Titular" se mentioneaza, in cazul bunurilor proprii, numele proprietarului (titularul, sotul!sotia, copilul), la' Iincazul bunurilor in coproprietate, cota-parte ~i numele coproprietarilor. I

I I I

2. Cladiri I I INOTA: I ISe vor declara inclusiv cele aflate in alte t~ki. I I

;-:---:'T<~~,·'~:;·~',r::.<,':-_,.~:.~::..~; ')::..v..,..:.~.:i::,:».,~ ."~ :---;,' -c-1- t-'!-'!~J:~'~~~~, ___r--- ,t~~~~UI~j=tt

.--------..-------}-----j---------+----t--- ----t-------T---------- ..·------.-.---...--..-----.-----------.---.--+ 'I ' . --_.-. I 1"'-----.----- ..----.,-.----- .

i t I I! II --1--- I -T-------T------------------ '-r-

---------------..-------.--! I --- : I ------.----- ---1-___ ,__________________ _ , J , ------ .J

• Categoriile indicate sunt: (1) apartament; (2) casa de locuiti 0) casa de vacanta; (4) spatii comerci IE-/~:productie.------------2)La "Titular" se mentioneaza, in cazul bunurilor proprii, numele proprietarului (titularul, sotul!sotia, copilul), iar icazul bunurilor in coproprietate, cota-parte ~i numele coproprietarilor.

Page 2: ...,;i:ftt~~~~1]~--~f~ ==== --- I f----=. -~-==-~·' -+]...extravilane, dad! se afla in circuitul civil. I l ')La "Titular" se mentioneaza, in cazul bunurilor proprii, numele proprietarului

r

I~--~~ei,S:4mcirt· ;;~-,.:-.,;Y:- r <~~t~~lth~*~m.flii.gp.!~ifi~i~j;!$;E'F:;~i~¥\"'·;:--,''''al~~~eil~stim<!ti --- ~~I~:] t;

:-~~:~~=-=~-=-=-~_--4c:~~----=l --~==:=~:H--------.----.-'"~'--. L ---..--- 1 .,

III. Bunuri mobile, a ciiror valoare depa~e~te 3.000 de euro fiecare, ~i b ~I~ iimobile instrainate in ultimele 12 luni I i --

--'{~ijrl~~l'iIt~~l!;Sr-'; -~a~oar ; C'] II' I

....1.;.~~~,.>;~~~~~,~~~.*;,..~~;~-.~....t" t. .' -.; -.. ', ;", ~ ! i~ 'II ! ----j 1

---r------------r-------- - 1- 1 I 'i 1-------------r-------------;------- - --l __.<1 j 1

-- ---~~~ Active financiare -1'---1. Conturi ~i depozite bancare, fonduri de investitii, forme echivalen

economisire ~i investire, indusiv cardurile de credit, daca valoarea insumata a t t1t1racestora depa~e~te 5.000 de euro

NOTA:Se vor declara inclusiv cele aflate in banci sau institutii financiare din std3inatate. _ _._ I

, __-_....._._.·-'_;~_~~~i_;_l_"::_,;~!_;L_;tQ_t:_:tt_;;~!~_~,ti.~~_;~_J..-_~·-.y_-·_- _ of,,; \-J~~~!~~~:~~iJl~.~~ela zi ;1' :!!ll I'- - - ----- -"-"-- - I I I ·=-'-'-l---'-'---~-c-'--'--c----c---.-- - --- "':1 ; 'I

~------------------------·------T- ---- I -------,------------------ - :1 --

-__~_:~=~~~::===?[-/-~t==--L-J---=~=-~jji·,--- Ii - - I i ---------- - --J "'- . I : _ i _' + ._

• Categoriile indicate sunt: (1) cont curent sau echivalente (inclusill card); (2) depozit bancar sau echivale t!~ffonduri de investitii sau echivalente, inclusiv fonduri private de pensil sau alte sisteme cu acumulare (se vor decl rollaferente anului fiscal anterior). I

2. Plasamente, investitii directe ~i imprumuturii acordate, dadi valoarea deinsumata a tuturor acestora depa~e~te 5.000 de euro

NOTA:Se vor declara inclusiv investitiile ~i participarile in strainatate.

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·~---2~Bunu,Jubforma de ~2f!ioase, bijuterii,obiectede~r::~:d;~~~:c~Lj:de arta ~i numismatica, obiecte care fac parte din lilatrimoniul cultural national !;runiversal, ~ caror valoare insumata depa~e$te 5.000 de euro 1

NOTA:Se vor mentiona toate bunurile aflate in proprietate, indiferent daca ele se afla sau

teritoriul Romaniei la momentul declararii.

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----------_,,_. __ 0 ------ I .-------- --!______~_-_~~~_-u -------- -------~---.-------------~ +=--=:~=---·-----t==_~:~~:_.~__~ _

• categoriile indicate sunt: (1) hartii de valoare detinute (titluri de !itat, certificate, obligat;iuni); (2) act;iuni suasociale in societati comerciale; (3) imprumuturi acordate in nume personal.

Page 3: ...,;i:ftt~~~~1]~--~f~ ==== --- I f----=. -~-==-~·' -+]...extravilane, dad! se afla in circuitul civil. I l ')La "Titular" se mentioneaza, in cazul bunurilor proprii, numele proprietarului

3. Alte active producatoare de venituri netE!, care insumate depa~escechivalentul a 5.000 de euro pe an:

:..>::::::::::::::::::::::::::::::::::::::::::::::::::::::::::~~::::::::::~:~:::::::::::::::::::::'::::'::.::.::.::...:.::.:.:...::::.:.::.:.::.:.....:.:--.[..NOTA: -Se vor declara inclusiv cele aflate in strainatate. ', IV.DatoriiDebite, ipoteci, garantii emise in beneficiul unui t,er1,bunuri achizitionate in si tl~

leasing ~i alte asemenea bunuri, daca valoarea insumiClitaa tuturor acestora depa~ :p5.000 de euro

NOTA:Se vor declara inclusiv pasivele financiare acumulate in strainatate.

~__==-:=-~~~=-··~:·::i~;ctidii4r(:;;:~;~;;:;:E;~~{t;\!)1~~~~~,fihi~tJImi£'9~~[~~~~]~7m'sSB2T--v~';;a~e~.·i. t' l'i I,I . j I'I ,II ---;------.-1-. ';I'

.----.-.---- :---.--.----t T,--, ..-.~~-----t--·-..------..-1- +. ':I.. _ .... -•.....•.• ---.-----. .1......• ._. 1.__ . - .... --... --l ,.L:

VI. Cadouri, servicii sau avantaje primite grcutuit sau subventionate fat- ~.valoarea de piata, din partea unor persoane, organizatii, societati comerciale, E ~iautonome, companii/societati nationale sau institutii publice romane~ti sau str illf'inclusiv burse, credite, garantii, decontari de cl1leltuieli, al,t,e..I.e. de.ca.t cele~i '. .angajatorului, a caror valoare individuala depa$e$te 50(JI de euro· :,

~Ctilr,:-:--:m:,.'··:O;T=-:-:-:::'--:::· ---- If! "Cine a rejl!i~a~"~~nlt,,Il. ...~i¥'i";-/::.-~.~:/{I_~\f.~"ltLiI;anLl2i1inc 5~~i ,;

i.1.' Titular .J, :"'.'~"".'J.~"'.,~" 'J',.,~. '~_.:.2__ ._ -- r~-==~~~~---.-_.-----------------..----- -l~==~~~==~=l-t:~::_~:.~=~y.:otie----.--.------r-----.---. I ---.------L-----------.-~--..!-i'

I Iii ,:..... -. - - - - ..- .. - .. -- ..----------+- .. - - -... ---r---------·-------r-----------·+ ~.!,

1.3. Copii ! i I :._...:_:_.~...:~.~::=~_~~----.·..-···-·----..t-·---- .__ ~_~ ~~~~=~=·__-_-_-·--=-r- .=~=__~-:=__-~:-..~j

• Se excepteaza de /a declarare cadourile ~i tratatiile uzua/e primite din partea rude/or de gradul I ~i al II-lea. , IVII. Venituri ale declarantului $i ale membrilor salide familie, realizate in ultim I a I

fiscal incheiat (potrivit art. 41 din Legea nr. 571/2003 privind Codul fiscal, cu modific I~i completarile ulterioare) I

NOTA: I

Se vo, decla,a Inclus;v venl'unle pcovenlte din s'''lln.,a:e ..,:.,,.;.,r"'- .,. _:". ~.:'; " . "'.;'.c- ..'~.;;.,t-::-=--~-=·-t.-Ie: ,,'J:~;!g~~:f~~t~~(~~lif~~Jy~IJ't~'..,~ua'_~ ~ ..i1

1~t~Ef~~?~~~~~0~-==~·----r(J1;07HrkJt;.t ....~:~~~-. --- -- T--~_=_-T~l "f0'! f! (T-!L..~.':'.(!'!~?t. .. ~_Pay tV IU-8 ~ 9o.;t-~.--. ····l· '; I.1.._~=~.~=~~e______ I ---.-------"'--------- i- :1\ !

-1.3~;pii-.---- I . I .----- ... t- :11 ::1iJ 7#W~'!/!!f!'-1!!±~ ..l__u~_!;Jtc!.~....:..J~~ll!---~-~~--..--.----.-.=J'--.-Jd ?~~-. - .., JI '~illl 'I~2.venit~r~.~~~:.~~~!~ati ~:!.~pe~de~~_ . ---- ....--------------- ..-------.-.f- ;J : I

I ' ,

II : ,! I,

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II I I ------ Ii::1 i,------.---- - ~t:!I! i' I

·2:-i.--s~ti~~~~·_.. uu ---·- •• --·-·---r-;::-----·----T----::::) -------------\---.-----. .---1 ';1 I

3_. -_~~_:-_;,_~~;;'=e=d~a-~~e-a-·--fO;~:~-t-e-i--b-;;;,U-,r-ilof----·---· i ---.-----------~~~------=j--~-.-----~~~~~Ji·· i.!

3.1. Titular -,,---------------------- ]L, ,.

j~~--s~V;ot;~-:_==~i~=-------.~,---=:=--- - -T,:---~=--~---~~;,!,__________ . 1__ _ ~ .. ~

4. Venituridin investitii T ' I'I I,4:i-:-m~iar ------! ---.--..-..-----.--.-·-,L.t'·f I, i'l!I • I :

r------- i ---.--.----- -;1 I !

.:~.:~=~:~_o~:=~_-.._-_.~==_-_-_~-__-_-__-_-...-__-_-_-_,-l-.. ------.--~---- l~------~.::---~;i' ,5. Venituri din pensii -----------......-'----- --------.---1,------.----.---- .-1-: : ;'5:l'-Tit~~----------------l--------'----=t===== I ------ it·:----..-------------·I-~~-~I--/--------·--t--..-·----------.i-; ,._

S_._2__~_otJ_so~ie II I: ; -- ":1 I :_ _ I _.__ ._________ I 11 '_._.__.__.__~__. ._. ._.-=r__ --l-------·------· --Ji . I !, I

~~_ven!~~r~~~~_a_c_tivit~_t_i_a_g_rJ_·c_o_leT- =================~~ ~_-~-_~-__~~-_ -.1,': 'I·6.1. Titular !I, ---0---------

! I I. --'--"'--t I !

I r'ii; I----------r-------------: I I ; ,! I , I

"'"i.L. : I

±·:I:,.,.7.i~-nt~-i~~-------------------I'--- J ! -l"~::II I I 1'1_==~-·-·--------------I I --i------- ,--i-- I Ii7.2_ So.'so.ie I ' --- --t

Y > I I I :i .::~ i -----. ·-t i

____________________~I---------- .•.....--.-- I I ;7.3. Copii I, ---~.----------.- .. ---- -f- 'I': '

'I ..._-_~_..-~_=~_===-----..-------r -------',--------- -r I:;;~:::~~-·n-a-lt-e-s-u-rs--e------___"I I' --.===--------, -T--·-~~=-=-~-li'I

I II '-' - -------'--- , I -,-------'-- -, ~-!! I !--·------··--·------·-----"-~,I·- --r-----.----------.--j--.----.------ -_.

8.2. SotJso~ie ! i

_._._---,.__.--...._-..__._---------------.~--.----------r__---.------------!------.--------! ! l-.- -----------------------------1- ----------------; ----.--------------r------------- ---_._-

8.3. Copii ; \ •__________ I . ------ I ,..~~=~===_~=~ ""T I -' T--==.~_== --i-::Prezenta declaratie constituie act public ~i raspund potrivit legii penale pe 1'T ':.

inexactitatea sau caracterul incomplet al datelor men~iol'1ate. '1

II

IIIII

Data completarii

o.~:.P.~:_;1>.!~ .