Xxxxxxx x. 4 k xxxxxxxx x. 467/2003 Sb.
Xxxx xxxxxxxxx xxx xxxxxxxx xxxxxxxxxx xxxxxxx
XXXXX
x xxxxxxxxx, xxxxxxx x xxxxxxxxx xxxxxxxxxx xxxxxxxxx xx xxxxxxxx xxxxxxx
1. Xxxxx xxxxxxxxx tabákových xxxxxxx
a) xxx xxxxxxxx
____________________________________________________________________________________________
Xxxxx xxxxxx Xxxx pro xxxxxxxxx Xxxxxxxx
(xx) xxxxxxxxxxxx xx balení
____________________________________________________________________________________________
____________________________________________________________________________________________
Xxxxx xxxxxxx: CELKEM:
____________________________________________________________________________________________
Xxxxx xxxxxxxx Xxxxx x xxxxxx xxxxxx xxxxx xxxxxxxxxx xxxxxxx xxxxx:
x) xxx xxxxxxxx x cigarillos
____________________________________________________________________________________________
Xxxxx balení Množství
(xx)
____________________________________________________________________________________________
____________________________________________________________________________________________
Xxxxx položek: XXXXXX:
____________________________________________________________________________________________
Datum xxxxxxxx Xxxxx x xxxxxx xxxxxx osoby pověřeného xxxxxxx xxxxx:
x) xxx tabák xx xxxxxxx
____________________________________________________________________________________________
Xxxxx balení Množství
(xx)
____________________________________________________________________________________________
____________________________________________________________________________________________
Xxxxx xxxxxxx: XXXXXX:
____________________________________________________________________________________________
Xxxxx xxxxxxxx Xxxxx x xxxxxx xxxxxx xxxxx pověřeného xxxxxxx úřadu:
2. Výkaz xxxxx xxxxxxxxxx nálepek ve xxxxxx xx daňovém xxxxx Xxxxx xxxxxxxxx
____________________________________________________________________________________________
Xxxxx xxxxxx Xxxxx Cena pro Xxxxx tabákových xxxxxxx x kusech
xx xxxxxx xxxxxx xxxxxxxxx __________________________________________
(xx, xx) xxxxxxxxxxxx xxxxxxxx do skutečně poškozených
xx balení do xxxxxx xxxxxxx
xxxxxxx
____________________________________________________________________________________________
____________________________________________________________________________________________
Xxxxx xxxxxxx: XXXXXX:
____________________________________________________________________________________________
3. Xxxxx xxxxx xxxxxxxxxx nálepek xxxx xxxxxx xxxxx Xxxxx xxxxxxxxx
____________________________________________________________________________________________
Xxxxx xxxxxxxx Xxxxx Cena xxx Počet xxxxxxxxxx xxxxxxx v kusech
xxxxxx xxxxxxxxx ________________________________________________
(xx, xx) xxxxxxxxxxxx xxxxxxxxx xxxx xxxxxxxx užitých xxxxxxxxxxx
xx xxxxxx xxxxxx xxxxx mimo xxxxxx xxxxx
cigaret České xxxxxxxxx Xxxxx xxxxxxxxx
____________________________________________________________________________________________
____________________________________________________________________________________________
Xxxxx xxxxxxx: XXXXXX:
____________________________________________________________________________________________
4. Xxxxx xxxxxxxxx xxxxxxxxxxx xxxxxxxxxx xxxxxxx
____________________________________________________________________________________________
Xxxxx Xxxxx Xxxx pro Počet xxxxxxxxxx xxxxxxx x xxxxxx
xxxxxxx xxxxxx xxxxxxxxx __________________________________________
(ks, xx) xxxxxxxxxxxx xxxxxxxxx xxxxxx xxxxxx xxxxxxxx
xx balení
xxxxxxx
____________________________________________________________________________________________
____________________________________________________________________________________________
Xxxxx xxxxxxx: CELKEM:
____________________________________________________________________________________________
Xxxxx: Xxxxxxx x xxxxxx
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