| ID | 12097 |
|---|---|
| Data | 2023-01-20 |
| Symbol | 2023/01/20/12097 |
| Instytucja | Urząd Miejski w Wielbarku |
| Nazwa | Wniosek o wydanie zaświadczenia o wielkości gospodarstwa rolnego w hektarach fizycznych i przeliczeniowych |
| Czy Aktualny | 1 |
| Ustawa z dnia 17 lutego 2005 r. o informatyzacji działalności podmiotów realizujących zadania publiczne (t.j. Dz. U. z 2023 r. poz. 57). |
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<tbody>
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<td style="background-color: #e2e2e2; border-style: solid; border-width: 1px; border-color: #000000; text-align: center;">
<p>
<strong>
<span style="font-family: verdana, geneva; font-size: small;">Wniosek o wydanie zaświadczenia o wielkości gospodarstwa rolnego w hektarach fizycznych i przeliczeniowych</span>
</strong>
</p>
</td>
</tr>
</tbody>
</table>
<p> </p>
<table border="0" cellpadding="0" cellspacing="1" style="width: 100%;">
<tbody>
<tr>
<td style="text-align: right;">
<span style="font-family: verdana, geneva; font-size: small;">Miejscowość <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:miejscowosc"/></span></xsl:if></span>, dnia
<span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:dataWniosku"/></span></xsl:if></span> </span>
</td>
</tr>
</tbody>
</table>
<table border="0" cellpadding="0" cellspacing="1" style="width: 100%;">
<tbody>
<tr>
<td>
<hr/>
</td>
</tr>
</tbody>
</table>
<table border="0" cellpadding="0" cellspacing="1" style="width: 100%;">
<tbody>
<tr>
<td align="right" style="text-align: right;" valign="middle">
<p>
<strong> </strong>
</p>
<p style="text-align: center;">
<span style="font-family: verdana, geneva; font-size: small;">
<strong> </strong>
</span>
<strong>
<span style="font-size: small; font-family: verdana, geneva;">Burmistrz Wielbarka<br/></span>
</strong>
</p>
<p style="text-align: center;">
<strong>
<span style="font-size: small; font-family: verdana, geneva;">
<span class="LrzXr">Ul. Grunwaldzka 2, 12-160
Wielbark</span>
</span>
</strong>
</p>
<p>
<strong>
<span style="font-family: verdana, geneva; font-size: medium;"> <br/></span>
</strong>
</p>
</td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td>
<strong>
<span style="font-family: verdana, geneva; font-size: small;">Wnioskodawca</span>
</strong>
</td>
</tr>
<tr>
<td>
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
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<xsl:variable name="RadioID20"> Osoba fizyczna </xsl:variable>
<xsl:choose>
<xsl:when test="normalize-space(wnio:TrescDokumentu/wnio:wnioskodawca/@typPodmiotu) = normalize-space($RadioID20)">
<span>[<b>X</b>]</span>
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<xsl:otherwise>
<span>[ ]</span>
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<label>
<span>Osoba fizyczna </span>
</label>
</span>
<span>
<xsl:variable name="RadioID21"> Instytucja </xsl:variable>
<xsl:choose>
<xsl:when test="normalize-space(wnio:TrescDokumentu/wnio:wnioskodawca/@typPodmiotu) = normalize-space($RadioID21)">
<span>[<b>X</b>]</span>
</xsl:when>
<xsl:otherwise>
<span>[ ]</span>
</xsl:otherwise>
</xsl:choose>
<label>
<span>Instytucja </span>
</label>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
<xsl:for-each select="wnio:TrescDokumentu/wnio:wnioskodawca/oso:Osoba">
<xsl:if test="//wnio:TrescDokumentu/wnio:wnioskodawca/@typPodmiotu = 'Osoba fizyczna'">
<table border="0" cellpadding="0" cellspacing="1" style="width: 100%;">
<tbody>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Imię</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="oso:Imie"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Nazwisko</span>
</td>
<td align="left" style="width: 50%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="oso:Nazwisko"/>
</span>
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</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">PESEL</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="oso:IdOsoby/oso:PESEL"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">NIP</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="oso:IdOsoby/oso:NIP"/>
</span>
</xsl:if>
</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Województwo</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Wojewodztwo"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Powiat</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Powiat"/>
</span>
</xsl:if>
</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Gmina</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Gmina"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Miejscowość</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Miejscowosc"/>
</span>
</xsl:if>
</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Ulica</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Ulica"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Nr budynku</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Budynek"/>
</span>
</xsl:if>
</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Nr lokalu</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Lokal"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle"> </td>
<td align="left" style="width: 30%;" valign="middle"> </td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Kod pocztowy</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:KodPocztowy"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Poczta</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Poczta"/>
</span>
</xsl:if>
</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle"> </td>
<td align="left" style="width: 30%;" valign="middle"> </td>
<td align="left" style="width: 10%;" valign="middle"> </td>
<td align="left" style="width: 30%;" valign="middle"> </td>
</tr>
<tr>
<td align="left" colspan="4" style="width: 10%;" valign="middle">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">Dane kontaktowe</span>
</strong>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Telefon</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Kontakt/adr:Telefon"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">E-mail</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Kontakt/adr:Email"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
<xsl:for-each select="wnio:TrescDokumentu/wnio:wnioskodawca/inst:Instytucja">
<xsl:if test="//wnio:TrescDokumentu/wnio:wnioskodawca/@typPodmiotu = 'Instytucja'">
<table border="0" cellpadding="0" cellspacing="1" style="width: 100%;">
<tbody>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Nazwa</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="inst:NazwaInstytucji"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle"> </td>
<td align="left" style="width: 50%;" valign="middle"> </td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">NIP</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="inst:IdInstytucji/inst:NIP"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">REGON</span>
</td>
<td align="left" style="width: 50%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="inst:IdInstytucji/inst:REGON"/>
</span>
</xsl:if>
</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Województwo</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Wojewodztwo"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Powiat</span>
</td>
<td align="left" style="width: 50%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Powiat"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Gmina</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Gmina"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Miejscowość</span>
</td>
<td align="left" style="width: 50%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Miejscowosc"/>
</span>
</xsl:if>
</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Ulica</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Ulica"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Nr budynku</span>
</td>
<td align="left" style="width: 50%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Budynek"/>
</span>
</xsl:if>
</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Nr lokalu</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Lokal"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle"> </td>
<td align="left" style="width: 50%;" valign="middle"> </td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Kod pocztowy</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:KodPocztowy"/>
</span>
</xsl:if>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Poczta</span>
</td>
<td align="left" style="width: 50%;" valign="middle">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Poczta"/>
</span>
</xsl:if>
</span>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle"> </td>
<td align="left" style="width: 30%;" valign="middle"> </td>
<td align="left" style="width: 10%;" valign="middle"> </td>
<td align="left" style="width: 50%;" valign="middle"> </td>
</tr>
<tr>
<td align="left" colspan="4" style="width: 10%;" valign="middle">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">Dane kontaktowe</span>
</strong>
</td>
</tr>
<tr>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Telefon</span>
</td>
<td align="left" style="width: 30%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Kontakt/adr:Telefon"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td align="left" style="width: 10%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">E-mail</span>
</td>
<td align="left" style="width: 50%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Kontakt/adr:Email"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
<table border="0" cellpadding="0" cellspacing="1" style="width: 100%;">
<tbody>
<tr>
<td> </td>
</tr>
<tr>
<td>
<hr/>
</td>
</tr>
<tr>
<td>
<p> <span style="font-family: verdana, geneva; font-size: small;">Proszę o wydanie zaświadczenia o wielkości użytków
rolnych gospodarstwa rolnego.<br/></span></p>
<p>
<span style="font-family: verdana, geneva; font-size: small;">Zaświadczenie to jest mi niezbędne celem przedłożenia w
<span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="wnio:TrescDokumentu/wnio:celWniosku"/></span></xsl:if></span><br/></span>
</p>
</td>
</tr>
</tbody>
</table>
<table border="0" cellspacing="1" style="width: 100%;">
<tbody>
<tr>
<td>
<hr/>
</td>
</tr>
<tr>
<td>
<p>
<span style="font-family: verdana, geneva; font-size: small;">Sposób dostarczenia:</span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:choose>
<xsl:when test="normalize-space(wnio:TrescDokumentu/wnio:sposobDostarczenia) = normalize-space(' 1 ')">
<span>[<b>X</b>]</span>
</xsl:when>
<xsl:otherwise>
<span>[ ]</span>
</xsl:otherwise>
</xsl:choose>
<label>
<span>odbiór osobisty </span>
</label>
</span>
<br/>
<span>
<xsl:choose>
<xsl:when test="normalize-space(wnio:TrescDokumentu/wnio:sposobDostarczenia) = normalize-space(' 2 ')">
<span>[<b>X</b>]</span>
</xsl:when>
<xsl:otherwise>
<span>[ ]</span>
</xsl:otherwise>
</xsl:choose>
<label>
<span>za pośrednictwem operatora pocztowego przesłane na adres </span>
</label>
</span>
<br/>
<span>
<xsl:choose>
<xsl:when test="normalize-space(wnio:TrescDokumentu/wnio:sposobDostarczenia) = normalize-space(' 3 ')">
<span>[<b>X</b>]</span>
</xsl:when>
<xsl:otherwise>
<span>[ ]</span>
</xsl:otherwise>
</xsl:choose>
<label>
<span>wysyłka elektroniczna przez ePUAP </span>
</label>
</span>
</xsl:if>
</span>
</span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span>adres :</span>
</label>
<xsl:if test="//wnio:TrescDokumentu/wnio:sposobDostarczenia = '2'">
<span type="text">
<xsl:value-of select="wnio:TrescDokumentu/wnio:adresDostarczenia"/>
</span>
</xsl:if>
</span>
<br/>
</span>
</p>
</td>
</tr>
<tr>
<td>
<hr/>
</td>
</tr>
</tbody>
</table>
<table border="0" cellpadding="0" cellspacing="1" style="width: 100%;">
<tbody>
<tr>
<td>
<strong>
<span style="font-family: verdana, geneva; font-size: small;">Załączniki</span>
</strong>
</td>
</tr>
</tbody>
</table>
<xsl:for-each select="wnio:TrescDokumentu/str:Zalaczniki/str:Zalacznik">
<xsl:if test="true()">
<table border="0" cellpadding="0" cellspacing="1" style="width: 100%; background-color: #ffffff;">
<tbody>
<tr>
<td align="left" style="width: 40%;" valign="middle">
<span style="font-family: verdana, geneva; font-size: small;">Opis załącznika <span><label><span/></label><xsl:if test="true()"><span type="text"><xsl:value-of select="str:OpisZalacznika"/></span></xsl:if></span></span>
</td>
<td> <span style="font-family: verdana, geneva; font-size: small;"><span><label><span/></label><xsl:value-of select="str:DaneZalacznika/../@nazwaPliku"/></span></span></td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
<table align="right">
<tr>
<td style="width: 100%;">
<p/>
<p/>
<p align="right" style="text-align: left;font-size: small;font-family: verdana, geneva;line-height: 20px;">
<xsl:choose>
<xsl:when test="string-length(//wnio:Dokument/ds:Signature/ds:SignatureValue) > 0">
<xsl:text>Dokument został podpisany, aby go zweryfikować należy użyć oprogramowania do weryfikacji podpisu </xsl:text>
<br/>
<xsl:for-each select="//wnio:Dokument/ds:Signature/ds:Object">
<xsl:if test="descendant::*[local-name() = 'SigningTime']">
<xsl:value-of select="descendant::*[local-name() = 'SigningTime']"/>
</xsl:if>
<br/>
<xsl:choose>
<xsl:when test="descendant::*[local-name() = 'PodpisZP']">
Podpis profilem zaufanym: <xsl:value-of select="descendant::*[local-name() = 'Imie']"/><xsl:text> </xsl:text><xsl:value-of select="descendant::*[local-name() = 'Nazwisko']"/><br/></xsl:when>
</xsl:choose>
</xsl:for-each>
</xsl:when>
<xsl:otherwise>
<xsl:text>Dokument nie zawiera podpisu</xsl:text>
</xsl:otherwise>
</xsl:choose>
<br/>
</p>
</td>
</tr>
</table>
</body>
</html>
</xsl:for-each>
</xsl:template>
</xsl:stylesheet>