Xxxxxxx x. 4 x xxxxxxxx x. 467/2003 Xx.
Xxxx xxxxxxxxx xxx xxxxxxxx xxxxxxxxxx xxxxxxx
XXXXX
x xxxxxxxxx, xxxxxxx a xxxxxxxxx xxxxxxxxxx xxxxxxxxx xx xxxxxxxx xxxxxxx
1. Xxxxx přijatých tabákových xxxxxxx
x) xxx xxxxxxxx
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Obsah xxxxxx Xxxx xxx xxxxxxxxx Xxxxxxxx
(xx) xxxxxxxxxxxx za xxxxxx
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Xxxxx položek: XXXXXX:
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Xxxxx xxxxxxxx Xxxxx x xxxxxx xxxxxx xxxxx xxxxxxxxxx xxxxxxx úřadu:
x) xxx xxxxxxxx x xxxxxxxxxx
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Xxxxx xxxxxx Xxxxxxxx
(xx)
____________________________________________________________________________________________
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Xxxxx xxxxxxx: XXXXXX:
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Xxxxx xxxxxxxx Xxxxx a xxxxxx xxxxxx xxxxx xxxxxxxxxx xxxxxxx xxxxx:
x) xxx xxxxx xx xxxxxxx
____________________________________________________________________________________________
Xxxxx xxxxxx Xxxxxxxx
(xx)
____________________________________________________________________________________________
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Xxxxx xxxxxxx: XXXXXX:
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Xxxxx xxxxxxxx Xxxxx a podpis xxxxxx osoby pověřeného xxxxxxx xxxxx:
2. Výkaz xxxxx xxxxxxxxxx xxxxxxx xx xxxxxx na xxxxxxx xxxxx Xxxxx xxxxxxxxx
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Xxxxx vydání Xxxxx Cena pro Počet xxxxxxxxxx xxxxxxx x xxxxxx
xx xxxxxx xxxxxx xxxxxxxxx __________________________________________
(xx, xx) xxxxxxxxxxxx xxxxxxxx xx xxxxxxxx xxxxxxxxxxx
xx balení do xxxxxx xxxxxxx
xxxxxxx
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Xxxxx xxxxxxx: XXXXXX:
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3. Xxxxx xxxxx xxxxxxxxxx nálepek xxxx xxxxxx xxxxx České xxxxxxxxx
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Datum xxxxxxxx Xxxxx Xxxx xxx Xxxxx xxxxxxxxxx xxxxxxx x xxxxxx
xxxxxx xxxxxxxxx ________________________________________________
(xx, xx) xxxxxxxxxxxx xxxxxxxxx xxxx xxxxxxxx xxxxxxx xxxxxxxxxxx
za balení daňové xxxxx xxxx xxxxxx xxxxx
xxxxxxx Xxxxx xxxxxxxxx Xxxxx xxxxxxxxx
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Xxxxx položek: XXXXXX:
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4. Xxxxx xxxxxxxxx xxxxxxxxxxx xxxxxxxxxx xxxxxxx
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Xxxxx Xxxxx Cena xxx Xxxxx xxxxxxxxxx xxxxxxx x xxxxxx
xxxxxxx xxxxxx xxxxxxxxx __________________________________________
(ks, xx) xxxxxxxxxxxx xxxxxxxxx xxxxxx xxxxxx xxxxxxxx
xx xxxxxx
cigaret
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Xxxxx xxxxxxx: XXXXXX:
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Xxxxx: Xxxxxxx x podpis
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