200,00CRISTINA MUSTATEA

RO08 RZBR 0000 0600 1682 3444

Demetrescu CristinaRO27 BRDE 410S V263 8812 4100

Adriana PetitAstrograma

29/04/2015 Data debitarii / Debitting date

Nr. / No.PLATITOR / PayerIBAN / Payer's IBAN

BENEFICIAR / BeneficiaryIBAN / Beneficiary's IBAN

Detalii de plata /Payment details

Data platii / Payment date

Suma / Amount RON

Pentru platile catre Bugetul de stat completati / For Budget payments fill in the information:Cod de identificare fiscala platitor / Payer's fiscal identification codeCod de identificare fiscala beneficiar / Beneficiary's fiscal identification codeCod BIC banca beneficiar / Beneficiary's bank BIC Code

Ordinul de plata se va completa cu majuscule corect si lizibil / The form shall be filled in with capitals, correctly and legibly.