3554

ID3554
Data2016-10-11
Symbol2016/10/11/3554
InstytucjaUrząd Gminy Kęty
NazwaWniosek o deaktywację konta na platformie eUrząd
Czy Aktualny1

Ustawy (1)

  • URI://Dziennik_Ustaw/2014/1114/16b/1
  • Art. 16b ust. 1 ustawy z dnia 17 lutego 2005 r. o informatyzacji działalności podmiotów realizujących zadania publiczne (t. j. z 2014r. poz. 1114)

    Pliki

    Styl

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        <div class="form-sign">
        WN-2
    </div><div>
        Wniosek o deaktywację konta na platformie eUrząd
    </div>
    </div><div class="section" style="border-bottom:none;">
        <div class="title">
        A. MIEJSCE SKŁADANIA WNIOSKU
    </div><xsl:for-each select="wnio:DaneDokumentu/str:Adresaci/meta:Podmiot/inst:Instytucja">
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        <strong>
        <br/><span>
        <xsl:choose>
            <xsl:when test="string(inst:NazwaInstytucji) != ''">
                <xsl:value-of select="inst:NazwaInstytucji"/>
            </xsl:when>
            <xsl:otherwise> </xsl:otherwise>
        </xsl:choose>
    </span><br/><span>
        <xsl:choose>
            <xsl:when test="string(adr:Adres/adr:KodPocztowy) != ''">
                <xsl:value-of select="adr:Adres/adr:KodPocztowy"/>
            </xsl:when>
            <xsl:otherwise> </xsl:otherwise>
        </xsl:choose>
    </span><span> </span><span>
        <xsl:choose>
            <xsl:when test="string(adr:Adres/adr:Miejscowosc) != ''">
                <xsl:value-of select="adr:Adres/adr:Miejscowosc"/>
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    </span>,<span> </span><span> </span><span>
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        </xsl:choose>
    </span><span> </span><span>
        <xsl:choose>
            <xsl:when test="string(adr:Adres/adr:Budynek) != ''">
                <xsl:value-of select="adr:Adres/adr:Budynek"/>
            </xsl:when>
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    </span><br/><xsl:if test="string(adr:Kontakt/adr:Telefon) != ''">
    			Tel:<span> </span><span>
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            <xsl:when test="string(adr:Kontakt/adr:Telefon) != ''">
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    </strong>
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    		</tr>
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        <div class="title">
        B. DANE OSOBY FIZYCZNEJ
    </div>
    </div><div class="section" style="border-bottom:none;">
        <div class="subtitle1">
        B.1 DANE IDENTYFIKACYJNE
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        <xsl:for-each select="wnio:DaneDokumentu/str:Nadawcy/meta:Podmiot/oso:Osoba">	<table class="table-with-borders" style="width:100%;" cellpadding="0" cellspacing="0">
    		
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    </div>Nazwisko</span></div>
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    			</div>
    
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    </div>Login ePuap</span></div>
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    					<xsl:when test="string(../../../../wnio:TrescDokumentu/wnio:Deklaracje/wnio:Deklaracja/wnio:Wnioskodawca/wnio:LoginEPuap) != ''">
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    							<xsl:value-of select="../../../../wnio:TrescDokumentu/wnio:Deklaracje/wnio:Deklaracja/wnio:Wnioskodawca/wnio:LoginEPuap"/>
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    			<div class="field-value">
    				<xsl:choose>
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    							<xsl:value-of select="adr:Kontakt/adr:Email"/>
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    			</div>
    
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    		</tr><tr style="vertical-align: top;">		
    			<td class="text-middle input-medium text-center"><div class="field" style="width:100%;">
    			<div class="text-left field-label"><span class="text-left"><div class="lp-value">					<xsl:call-template name="lp_tamplate_5">
    						<xsl:with-param name="lp_start" select="$lp_start_0"/>
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    </div>PESEL</span></div>
    			<div class="field-value">
    				<xsl:choose>
    					<xsl:when test="string(oso:IdOsoby/oso:PESEL) != ''">
    						<span class="field-text">
    							<xsl:value-of select="oso:IdOsoby/oso:PESEL"/>
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    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
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    			</div>
    
    </div></td>					
    		</tr><tr style="vertical-align: top;">		
    			<td class="text-middle input-medium text-center"><div class="field" style="width:100%;">
    			<div class="text-left field-label"><span class="text-left"><div class="lp-value">					<xsl:call-template name="lp_tamplate_6">
    						<xsl:with-param name="lp_start" select="$lp_start_0"/>
    					</xsl:call-template>
    </div>NIP</span></div>
    			<div class="field-value">
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    					<xsl:when test="string(oso:IdOsoby/oso:NIP) != ''">
    						<span class="field-text">
    							<xsl:value-of select="oso:IdOsoby/oso:NIP"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
    				</xsl:choose>
    
    			</div>
    
    </div></td>					
    		</tr>
    	</table>
    </xsl:for-each>
    </div>
    </div>
    </div><div class="section" style="border-bottom:none;">
        <div class="subtitle1">
        B.2 ADRES ZAMIESZKANIA
    </div><div class="editable section-indent">
        <xsl:variable name="lp_start_7" select="7"/>
    
    <xsl:for-each select="wnio:DaneDokumentu/str:Nadawcy/meta:Podmiot/oso:Osoba/adr:Adres">
    <div class="table-with-borders">
        <table style="border:none;width:100%;" cellpadding="0" cellspacing="0">
    		<tr style="vertical-align: top;">		
    			<td class="full-width" style="width:66%;"><div class="field" style="width:100%;">
    			<div class="field-label"><div class="lp-value">					<xsl:call-template name="lp_tamplate_8">
    						<xsl:with-param name="lp_start" select="$lp_start_7"/>
    					</xsl:call-template>
    </div>Kraj</div>
    			<div class="field-value">
    				<span class="field-text">
    							<xsl:choose>
    <xsl:when test="adr:Kraj='PL'">POLSKA</xsl:when>
    								<xsl:otherwise>☐</xsl:otherwise>
    							</xsl:choose>
    
    				</span>
    
    			</div>
    
    </div></td><td style="width:34%;"><div class="field" style="width:100%;">
    			<div class="field-label"><div class="lp-value">					<xsl:call-template name="lp_tamplate_9">
    						<xsl:with-param name="lp_start" select="$lp_start_7"/>
    					</xsl:call-template>
    </div>Województwo</div>
    			<div class="full-width field-value">
    <div class="full-width">				<xsl:choose>
    					<xsl:when test="string(adr:Wojewodztwo) != ''">
    						<span class="field-text">
    							<xsl:value-of select="adr:Wojewodztwo"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
    				</xsl:choose>
    </div>
    			</div>
    
    </div></td>					
    		</tr>
    </table><table style="border:none;width:100%;" cellpadding="0" cellspacing="0">
    		<tr style="vertical-align: top;">		
    			<td style="width:33%;"><div class="field" style="width:100%;">
    			<div class="field-label"><div class="lp-value">					<xsl:call-template name="lp_tamplate_10">
    						<xsl:with-param name="lp_start" select="$lp_start_7"/>
    					</xsl:call-template>
    </div>Powiat</div>
    			<div class="full-width field-value">
    <div class="full-width">				<xsl:choose>
    					<xsl:when test="string(adr:Powiat) != ''">
    						<span class="field-text">
    							<xsl:value-of select="adr:Powiat"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
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    </div>
    			</div>
    
    </div></td><td style="width:33%;"><div class="field" style="width:100%;">
    			<div class="field-label"><div class="lp-value">					<xsl:call-template name="lp_tamplate_11">
    						<xsl:with-param name="lp_start" select="$lp_start_7"/>
    					</xsl:call-template>
    </div>Gmina</div>
    			<div class="full-width field-value">
    <div class="full-width">				<xsl:choose>
    					<xsl:when test="string(adr:Gmina) != ''">
    						<span class="field-text">
    							<xsl:value-of select="adr:Gmina"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
    				</xsl:choose>
    </div>
    			</div>
    
    </div></td><td style="width:34%;"><div class="field" style="width:100%;">
    			<div class="field-label"><div class="lp-value">					<xsl:call-template name="lp_tamplate_12">
    						<xsl:with-param name="lp_start" select="$lp_start_7"/>
    					</xsl:call-template>
    </div>Miejscowość</div>
    			<div class="full-width field-value">
    <div class="full-width">				<xsl:choose>
    					<xsl:when test="string(adr:Miejscowosc) != ''">
    						<span class="field-text">
    							<xsl:value-of select="adr:Miejscowosc"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
    				</xsl:choose>
    </div>
    			</div>
    
    </div></td>					
    		</tr>
    </table><table style="border:none;width:100%;" cellpadding="0" cellspacing="0">
    		<tr style="vertical-align: top;">		
    			<td style="width:33%;"><div class="field" style="width:100%;">
    			<div class="field-label"><div class="lp-value">					<xsl:call-template name="lp_tamplate_13">
    						<xsl:with-param name="lp_start" select="$lp_start_7"/>
    					</xsl:call-template>
    </div>Kod pocztowy</div>
    			<div class="full-width field-value">
    <div class="full-width">				<xsl:choose>
    					<xsl:when test="string(adr:KodPocztowy) != ''">
    						<span class="field-text">
    							<xsl:value-of select="adr:KodPocztowy"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
    				</xsl:choose>
    </div>
    			</div>
    
    </div></td><td style="width:67%;"><div class="field" style="width:100%;">
    			<div class="field-label"><div class="lp-value">					<xsl:call-template name="lp_tamplate_14">
    						<xsl:with-param name="lp_start" select="$lp_start_7"/>
    					</xsl:call-template>
    </div>Poczta</div>
    			<div class="full-width field-value">
    <div class="full-width">				<xsl:choose>
    					<xsl:when test="string(adr:Poczta) != ''">
    						<span class="field-text">
    							<xsl:value-of select="adr:Poczta"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
    				</xsl:choose>
    </div>
    			</div>
    
    </div></td>					
    		</tr>
    </table><table style="border:none;width:100%;" cellpadding="0" cellspacing="0">
    		<tr style="vertical-align: top;">		
    			<td style="width:66%;"><div class="field" style="width:100%;">
    			<div class="field-label"><div class="lp-value">					<xsl:call-template name="lp_tamplate_15">
    						<xsl:with-param name="lp_start" select="$lp_start_7"/>
    					</xsl:call-template>
    </div>Ulica</div>
    			<div class="full-width field-value">
    <div class="full-width">				<xsl:choose>
    					<xsl:when test="string(adr:Ulica) != ''">
    						<span class="field-text">
    							<xsl:value-of select="adr:Ulica"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
    				</xsl:choose>
    </div>
    			</div>
    
    </div></td><td style="width:22%;"><div class="field" style="width:100%;">
    			<div class="field-label"><div class="lp-value">					<xsl:call-template name="lp_tamplate_16">
    						<xsl:with-param name="lp_start" select="$lp_start_7"/>
    					</xsl:call-template>
    </div>Nr domu</div>
    			<div class="full-width field-value">
    <div class="full-width">				<xsl:choose>
    					<xsl:when test="string(adr:Budynek) != ''">
    						<span class="field-text">
    							<xsl:value-of select="adr:Budynek"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
    				</xsl:choose>
    </div>
    			</div>
    
    </div></td><td style="width:22%;"><div class="field" style="width:100%;">
    			<div class="field-label"><div class="lp-value">					<xsl:call-template name="lp_tamplate_17">
    						<xsl:with-param name="lp_start" select="$lp_start_7"/>
    					</xsl:call-template>
    </div>Nr lokalu</div>
    			<div class="full-width field-value">
    <div class="full-width">				<xsl:choose>
    					<xsl:when test="string(adr:Lokal) != ''">
    						<span class="field-text">
    							<xsl:value-of select="adr:Lokal"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
    				</xsl:choose>
    </div>
    			</div>
    
    </div></td>					
    		</tr>
    </table>
    </div>
    </xsl:for-each>
    </div>
    </div><div class="section">
        <div class="title">
        Oświadczenie
    </div><div class="editable section-indent">
        <div class="wrap field">
    			<div class="field-value">
                            <span class="field-items">
    <span class="radio-item">
                <div class="radioChecker">
                    <xsl:choose>
                        <xsl:when test="wnio:TrescDokumentu/wnio:Deklaracje/wnio:Deklaracja/wnio:Oswiadczenie='T'">X</xsl:when>
                        <xsl:otherwise> </xsl:otherwise>
                    </xsl:choose>
                </div>
                Oświadczam, iż rezygnuję z doręczania pism za pomocą środków komunikacji elektronicznej zgodnie z art. 39¹ k.p.a. §1d Kodeksu postępowania administracyjnego (Dz. U. 2013 poz. 267 z późn. zm.).   
            </span>
                            </span>
    
    			</div>
    
    </div>
    </div>
    </div><div class="section" style="border-top:none;border-bottom:none;">
        <div class="title" style="border-bottom:none;">
        Informacja
    </div>
    </div><xsl:for-each select="wnio:DaneDokumentu/str:Adresaci/meta:Podmiot/inst:Instytucja">
    <div class="wrap section" style="border-top:none;">
        Zgodnie z art. 24 ust. 1 ustawy z dnia 29 sierpnia 1997 r. o ochronie danych osobowych (tekst jednolity:  Dz.U. z 2014 roku, poz. 1182 ze zm), informujemy, że:<ul>
        <li>
        
        administratorem Pani/Pana danych osobowych jest<span> </span><strong>
        <span> </span><span>
        <xsl:choose>
            <xsl:when test="string(inst:Pracownik/inst:Funkcja) != ''">
                <xsl:value-of select="inst:Pracownik/inst:Funkcja"/>
            </xsl:when>
            <xsl:otherwise> </xsl:otherwise>
        </xsl:choose>
    </span>,<span> </span><span> </span>adres:<span> </span><span>
        <xsl:choose>
            <xsl:when test="string(adr:Adres/adr:KodPocztowy) != ''">
                <xsl:value-of select="adr:Adres/adr:KodPocztowy"/>
            </xsl:when>
            <xsl:otherwise> </xsl:otherwise>
        </xsl:choose>
    </span><span> </span><span>
        <xsl:choose>
            <xsl:when test="string(adr:Adres/adr:Miejscowosc) != ''">
                <xsl:value-of select="adr:Adres/adr:Miejscowosc"/>
            </xsl:when>
            <xsl:otherwise> </xsl:otherwise>
        </xsl:choose>
    </span>,<span> </span><span> </span><span>
        <xsl:choose>
            <xsl:when test="string(adr:Adres/adr:Ulica) != ''">
                <xsl:value-of select="adr:Adres/adr:Ulica"/>
            </xsl:when>
            <xsl:otherwise> </xsl:otherwise>
        </xsl:choose>
    </span><span> </span><span>
        <xsl:choose>
            <xsl:when test="string(adr:Adres/adr:Budynek) != ''">
                <xsl:value-of select="adr:Adres/adr:Budynek"/>
            </xsl:when>
            <xsl:otherwise> </xsl:otherwise>
        </xsl:choose>
    </span><xsl:if test="string(adr:Adres/adr:Lokal) != ''">
    			<span>
        <xsl:choose>
            <xsl:when test="string(adr:Adres/adr:Lokal) != ''">
                <xsl:value-of select="adr:Adres/adr:Lokal"/>
            </xsl:when>
            <xsl:otherwise> </xsl:otherwise>
        </xsl:choose>
    </span>
    		</xsl:if>
    </strong>
    </li><br/><li>
        
        posiada Pani/Pan prawo dostępu do treści swoich danych oraz ich poprawiania.
    </li>
    </ul>
    </div>
    </xsl:for-each><table style="border:none;width:100%;" cellpadding="0" cellspacing="0">
    		<tr style="vertical-align: top;">		
    			<td style="border:none;width:70%;"><div style="width:100%;">
        
    </div></td><td style="border:none;"><div style="width:100%;">
        <xsl:for-each select="ds:Signature/ds:SignatureValue">
    <div class="signature-description">
        Dokument został podpisany, aby go zweryfikować należy użyć<br/>oprogramowania do weryfikacji podpisu<br/>Data złożenia podpisu:<div class="signature-date field">
    			<div class="field-value">
    				<xsl:choose>
    					<xsl:when test="string(../ds:Object/descendant::*[local-name() = 'SigningTime']) != ''">
    						<span class="field-text">
    							<xsl:value-of select="../ds:Object/descendant::*[local-name() = 'SigningTime']"/>
    						</span>
    					</xsl:when>
    					<xsl:otherwise> </xsl:otherwise>
    				</xsl:choose>
    
    			</div>
    
    </div><br/><div class="signature-bold">
        Podpis elektroniczny
    </div><br/>
    </div>
    </xsl:for-each>
    </div></td>					
    		</tr>
    </table>
    </div>
                </body>
                </html>
            </xsl:for-each>
        </xsl:template>                           <xsl:template name="lp_tamplate_1">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_2">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+1"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_3">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+2"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_4">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+3"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_5">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+4"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_6">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+5"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_8">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_9">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+1"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_10">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+2"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_11">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+3"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_12">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+4"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_13">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+5"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_14">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+6"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_15">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+7"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_16">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+8"/>.<span> </span>
                               </xsl:template>
                               <xsl:template name="lp_tamplate_17">
                                   <xsl:param name="lp_start" select="1"/><xsl:value-of select="$lp_start+9"/>.<span> </span>
                               </xsl:template>
    
    </xsl:stylesheet>