Xxxxxxxx od 14.7.2005 xx 3.4.2007 (do xxxxxx x. 72/2007 Xx.)
Xxxxxxx x. 4 x vyhlášce x. 467/2003 Xx.
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1. Xxxxx xxxxxxxxx xxxxxxxxxx xxxxxxx
x) xxx xxxxxxxx
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Xxxxx xxxxxx Xxxx xxx xxxxxxxxx Xxxxxxxx
(xx) xxxxxxxxxxxx za balení
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Počet xxxxxxx: XXXXXX:
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Xxxxx xxxxxxxx Xxxxx x xxxxxx zaměstnance xxxxxxxx celního xxxxx:
x) xxx xxxxxxxx a xxxxxxxxxx
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Xxxxx xxxxxx Xxxxxxxx
(xx)
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Xxxxx xxxxxxx: XXXXXX:
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Xxxxx xxxxxxxx Xxxxx x xxxxxx zaměstnance xxxxxxxx xxxxxxx xxxxx:
x) xxx xxxxx
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Xxxxx xxxxxx Xxxxxxxx
(xx)
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Xxxxx položek: XXXXXX:
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Xxxxx xxxxxxxx Xxxxx x xxxxxx zaměstnance xxxxxxxx xxxxxxx xxxxx:
2. Xxxxx xxxxx xxxxxxxxxx nálepek xx xxxxxx na xxxxxxx území Xxxxx xxxxxxxxx
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Xxxxx xxxxxx Xxxxx Xxxx xxx Xxxxx tabákových xxxxxxx x xxxxxx
xx xxxxxx xxxxxx xxxxxxxxx __________________________________________
(xx, xx) xxxxxxxxxxxx xxxxxxxx xx xxxxxxxx xxxxxxxxxxx
xx xxxxxx xx xxxxxx xxxxxxx
xxxxxxx
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Xxxxx položek: XXXXXX:
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3. Výkaz xxxxx xxxxxxxxxx xxxxxxx mimo xxxxxx xxxxx Xxxxx xxxxxxxxx
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Xxxxx xxxxxxxx Xxxxx Xxxx pro Xxxxx xxxxxxxxxx nálepek x xxxxxx
xxxxxx xxxxxxxxx ________________________________________________
(xx, xx) xxxxxxxxxxxx xxxxxxxxx xxxx xxxxxxxx užitých xxxxxxxxxxx
xx xxxxxx xxxxxx xxxxx mimo xxxxxx xxxxx
xxxxxxx Xxxxx xxxxxxxxx Xxxxx xxxxxxxxx
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Xxxxx položek: XXXXXX:
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4. Xxxxx xxxxxxxxx xxxxxxxxxxx xxxxxxxxxx nálepek
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Datum Xxxxx Xxxx pro Počet xxxxxxxxxx xxxxxxx v xxxxxx
xxxxxxx xxxxxx xxxxxxxxx __________________________________________
(xx, xx) xxxxxxxxxxxx xxxxxxxxx xxxxxx xxxxxx xxxxxxxx
xx xxxxxx
xxxxxxx
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Xxxxx xxxxxxx: XXXXXX:
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Xxxxx: Xxxxxxx x podpis
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