| ID | 1660 |
|---|---|
| Data | 2014-06-13 |
| Symbol | 2014/06/13/1660 |
| Instytucja | Urząd Marszałkowski Województwa Małopolskiego |
| Nazwa | Wniosek o wydanie zaświadczenia o niezaleganiu z opłatami za korzystanie ze środowiska |
| Czy Aktualny | 1 |
| Ustawa z dnia 17 lutego 2005 r. o informatyzacji działalności podmiotów realizujących zadania publiczne |
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<p> </p>
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<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> <span>
<label>
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<xsl:if test="true()">
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<xsl:value-of select="wnio:TrescDokumentu/wnio:MiejscowoscDokumentu"/>
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<br/>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<em>(Miejscowość i data)</em>
</span>
</div>
<div align="right">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<em>
<br/>
</em>
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<div align="right">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<em>
<br/>
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<div align="right">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<em>
<br/>
</em>
</span>
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<div align="left">
<table border="0" style="width: 100%;">
<tbody>
<tr>
<td colspan="2" style="width: 50%;">
<div style="text-align: left;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
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<xsl:if test="true()">
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<xsl:value-of select="wnio:DaneDokumentu/str:Nadawcy/meta:Podmiot/inst:Instytucja/inst:NazwaInstytucji"/>
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</xsl:if>
</span>
</span>
</div>
</td>
<td style="width: 5%;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr align="center">
<td colspan="2" style="text-align: left;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<em>(Imię i Nazwisko / nazwa Wnioskodawcy)</em>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr align="center">
<td style="text-align: left;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Skrót nazwy:</span>
</td>
<td style="text-align: left;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:SkrotNazwy"/>
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</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
</tbody>
</table>
<xsl:for-each select="wnio:DaneDokumentu/str:Nadawcy/meta:Podmiot/inst:Instytucja">
<xsl:if test="true()">
<xsl:for-each select="inst:IdInstytucji">
<xsl:if test="true()">
<table border="0" style="width: 100%;">
<tbody>
<tr align="center">
<td style="text-align: left; width: 30%;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Numer NIP:</span>
</td>
<td style="text-align: left;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="inst:NIP"/>
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<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr align="center">
<td style="text-align: left;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Numer REGON:</span>
</td>
<td style="text-align: left;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="inst:REGON"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
<xsl:for-each select="adr:Adres">
<xsl:if test="true()">
<p>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</p>
<table border="0" style="width: 100%;">
<tbody>
<tr>
<td colspan="2">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Adres zamieszkania lub siedziby Wnioskodawcy:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td style="width: 30%;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Miejscowość:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Miejscowosc"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Nazwa ulicy:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Ulica"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Numer budynku:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Budynek"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Numer lokalu:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Lokal"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Poczta:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Poczta"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Kraj:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:value-of select="adr:Kraj "/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Kod pocztowy:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:KodPocztowy"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
</tbody>
</table>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</xsl:if>
</xsl:for-each>
<xsl:for-each select="inst:Jednostka/adr:Adres">
<xsl:if test="true()">
<table border="0" style="width: 100%;">
<tbody>
<tr>
<td colspan="2">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Adres korespondencyjny:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td style="width: 30%;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Miejscowość:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Miejscowosc"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Nazwa ulicy:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Ulica"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Numer budynku:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Budynek"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Numer lokalu:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Lokal"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Poczta:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Poczta"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Kraj:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:value-of select="adr:Kraj "/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Kod pocztowy:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:KodPocztowy"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
</tbody>
</table>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</xsl:if>
</xsl:for-each>
<xsl:for-each select="adr:Kontakt">
<xsl:if test="true()">
<table border="0" style="width: 100%;">
<tbody>
<tr>
<td colspan="2">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Kontakt:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td style="width: 30%;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">E-mail:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Email"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Telefon stacjonarny:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Telefon"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Telefon komórkowy</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:InnyKontakt"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Faks:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Faks"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
</tbody>
</table>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</xsl:if>
</xsl:for-each>
<table border="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 30%;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Informacja o kontakcie telefonicznym:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Uwagi"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
<xsl:for-each select="inst:Pracownik">
<xsl:if test="true()">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span> <table border="0" style="width: 100%;">
<tbody>
<tr>
<td colspan="2">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Dane osoby wysyłającej formularz:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td style="width: 40%;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Imię:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="oso:Imie"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Drugie imię:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Kontakt/adr:InnyKontakt"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Nazwisko:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="oso:Nazwisko"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Numer PESEL:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="oso:IdOsoby/oso:PESEL"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Rodzaj dokumentu tożsamości:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="oso:IdOsoby/oso:InnyIdentyfikator/oso:TypIdentyfikatora"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Seria i numer dokumentu tożsamości:</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="oso:IdOsoby/oso:InnyIdentyfikator/oso:WartoscIdentyfikatora"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
</tbody>
</table>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</xsl:if>
</xsl:for-each>
</xsl:if>
</xsl:for-each>
<p>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</p>
<table border="0" style="width: 100%;">
<tbody>
<tr>
<td style="width: 400px;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td style="width: 40%;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> <strong>Urząd Marszałkowski<br/>
</strong>
</span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> <strong>Województwa<span style="color: #ffffff;">_<span style="color: #000000;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:Wojewodztwo "/>
</span>
</xsl:if>
</span>
</span>
</span>
<br/>
</strong>
</span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> <span style="text-decoration: underline;">w <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:Miejscowosc"/>
</span>
</xsl:if>
</span>
<br/>
</span>
</span>
</td>
</tr>
<tr>
<td colspan="2">
<p>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</p>
<div align="left">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</div>
<div align="center">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</div>
<div align="center">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<strong>W N I O S E K<br/>
</strong>
</span>
</div>
</td>
</tr>
<tr align="center">
<td colspan="2">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td colspan="2">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> <strong>
<br/>
</strong>Na podstawie <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:PodstawaPrawnaWniosku"/>
</span>
</xsl:if>
</span> wnoszę o wydanie zaświadczenia o niezaleganiu z opłatami za korzystanie ze środowiska, zgodnie z <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:PodstawaPrawnaUstawa"/>
</span>
</xsl:if>
</span>.</span>
<br/>
<p>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</p>
</td>
</tr>
<tr>
<td align="center" colspan="2">
<p>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:CelWydania"/>
</span>
</xsl:if>
</span>
</span>
</p>
</td>
</tr>
<tr>
<td align="center" colspan="2">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<em>(Cel wydania zaświadczenia)</em>
</span>
</td>
</tr>
<tr>
<td align="center" colspan="2" style="text-align: left;">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">Sposób odbioru odpowiedzi: <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:choose>
<xsl:when test="normalize-space(wnio:TrescDokumentu/wnio:Wartosc/wnio:SposobOdbioru) = 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>
<span>
<xsl:choose>
<xsl:when test="normalize-space(wnio:TrescDokumentu/wnio:Wartosc/wnio:SposobOdbioru) = normalize-space(' 2 ')">
<span>[<b>X</b>]</span>
</xsl:when>
<xsl:otherwise>
<span>[ ]</span>
</xsl:otherwise>
</xsl:choose>
<label>
<span>wysyłka na adres korespondencyjny </span>
</label>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</div>
<div align="left">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</div>
<div align="left">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</div>
<div align="left">
<table border="0" style="width: 100%;">
<tbody>
<tr>
<td colspan="2">
<p>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</p>
<p>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<strong>Oświadczam, że:</strong>
</span>
</p>
</td>
</tr>
<tr>
<td style="width: 5%;" valign="top">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</td>
</tr>
<tr>
<td valign="top">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:choose>
<xsl:when test="contains(concat(concat(' ', normalize-space(wnio:TrescDokumentu/wnio:Wartosc/wnio:ZgodaNaPrzetwarzanie)),' '), ' 1 ' )">
<span>[<b>X</b>]</span>
</xsl:when>
<xsl:otherwise>
<span>[ ]</span>
</xsl:otherwise>
</xsl:choose>
<label>
<span> </span>
</label>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:PrzetwarzajacyDane"/>
</span>
</xsl:if>
</span>
<br/>
</span>
</td>
</tr>
<tr>
<td valign="top">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:choose>
<xsl:when test="contains(concat(concat(' ', normalize-space(wnio:TrescDokumentu/wnio:Wartosc/wnio:KomunikacjaElektroniczna)),' '), ' 1 ' )">
<span>[<b>X</b>]</span>
</xsl:when>
<xsl:otherwise>
<span>[ ]</span>
</xsl:otherwise>
</xsl:choose>
<label>
<span> </span>
</label>
</span>
</xsl:if>
</span>
</span>
</td>
<td>
<span style="font-size: small; font-family: arial,helvetica,sans-serif;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:ID0"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</div>
<div align="center">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</div>
<div align="center">
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</div>
<div align="left">
<span style="font-size: small; font-family: arial,helvetica,sans-serif;">
<strong>Załączniki:</strong>
</span>
</div>
<div align="left">
<xsl:for-each select="wnio:TrescDokumentu/str:Zalaczniki/str:Zalacznik">
<xsl:if test="true()">
<br/>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:value-of select="str:DaneZalacznika/../@nazwaPliku"/>
</span>
</span>
</xsl:if>
</xsl:for-each>
<span style="font-family: arial,helvetica,sans-serif; font-size: small;"> </span>
</div>
<p>
<span style="font-family: arial,helvetica,sans-serif;"> <span>
<label>
<span/>
</label>
<xsl:if test="false()">
<span type="text">
<xsl:value-of select="wnio:TrescDokumentu/@format"/>
</span>
</xsl:if>
</span>
<span>
<label>
<span/>
</label>
<xsl:if test="false()">
<span type="text">
<xsl:value-of select="wnio:TrescDokumentu/@kodowanie"/>
</span>
</xsl:if>
</span>
</span>
</p>
</body>
</html>
</xsl:for-each>
<xsl:call-template name="Podpis_v23.99"/>
</xsl:template>
<xsl:template name="Podpis_v23.99">
<div align="right" style="text-align: right;font-size: 10px;font-family: Verdana;line-height: 20px;">
<table style="float: right;">
<tr>
<td style="width: 340px;">
<h5 class="acc" align="center">Podpisy elektroniczne</h5>
<p align="center" style="text-align: center;font-size: 10px;font-family: Verdana;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>
<xsl:choose>
<xsl:when test="count(//wnio:Dokument/ds:Signature/ds:Object/descendant::*[local-name() = 'SigningTime']) > 1">
<br/>
<xsl:text>Daty złożenia podpisu: </xsl:text>
<xsl:for-each select="//wnio:Dokument/ds:Signature/ds:Object/descendant::*[local-name() = 'SigningTime']">
<xsl:value-of select="."/>
</xsl:for-each>
</xsl:when>
<xsl:when test="count(//wnio:Dokument/ds:Signature/ds:Object/descendant::*[local-name() = 'SigningTime']) = 1">
<br/>
<xsl:text>Data złożenia podpisu: </xsl:text>
<xsl:for-each select="//wnio:Dokument/ds:Signature/ds:Object/descendant::*[local-name() = 'SigningTime']">
<xsl:value-of select="."/>
</xsl:for-each>
</xsl:when>
<xsl:when test="0 >= count(//wnio:Dokument/ds:Signature/ds:Object/descendant::*[local-name() = 'SigningTime'])">
</xsl:when>
</xsl:choose>
</xsl:when>
<xsl:otherwise>
<xsl:text>Dokument nie zawiera podpisu</xsl:text>
</xsl:otherwise>
</xsl:choose>
<br/>
<span name="info_v99.23" style="font-size: 7pt;font-weight: bold;">
</span>
</p>
</td>
</tr>
</table>
</div>
<div name="clear_v23.23" style="clear: both;"/>
</xsl:template>
</xsl:stylesheet>