39
| ID | 39 |
|---|
| Data | 2008-10-01 |
|---|
| Symbol | 2008/10/01/39 |
|---|
| Instytucja | Główny Urząd Statystyczny |
|---|
| Nazwa | Wniosek o skreślenie podmiotu z Krajowego Rejestru Urzędowego Podmiotów Gospodarki Narodowej |
|---|
| Czy Aktualny | 0 |
|---|
Ustawy (1)
Pliki
Styl
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<font face="Arial" color="#292526">
<font face="TimesNewRomanCE-Bold" color="#292526">
<div>
<font color="#000000">
<font face="Times New Roman">
<strong>GŁÓWNY URZĄD STATYSTYCZNY a</strong>l. Niepodległości 208, 00-925 Warszawa</font>
</font>
</div>
</font>
</font>
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</td>
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<tr style="MIN-HEIGHT: 27px">
<td colSpan="6" style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt solid; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: middle; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt solid">
<div>
<font face="Times New Roman">Podstawa prawna: rozporządzenie Rady Ministrów z dnia 27 lipca 1999 r. (Dz. U. Nr 69, poz. 763 z późn. zm.)</font>
</div>
</td>
</tr>
<tr>
<td colSpan="4" style="BORDER-TOP: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid">
<div>
<font face="Times New Roman"/> </div>
</td>
<td colSpan="2" style="BORDER-TOP: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid">
<div>
<font face="Times New Roman"/> </div>
</td>
</tr>
<tr>
<td colSpan="4" style="BORDER-RIGHT: #000000 1pt solid; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid">
<div>
<font face="Times New Roman">Nazwa podmiotu zgłaszającego</font>
</div>
<div>
<font face="Times New Roman"><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL27" style="WIDTH: 100%; FONT-FAMILY: Times New Roman">
<xsl:value-of select="Dokument/Naglowek/Nadawca"/>
</span>
</font>
</div>
</td>
<td colSpan="2" style="BORDER-RIGHT: #000000 1pt solid; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid">
<div align="center">
<font face="Times New Roman" size="4">
<strong>RG-2</strong>
</font>
</div>
<div align="center">
<strong>
<font face="Times New Roman"/>
</strong> </div>
<div align="center">
<font face="Times New Roman">
<strong>WNIOSEK O SKREŚLENIE PODMIOTU Z KRAJOWEGO REJESTRU URZĘDOWEGO PODMIOTÓW GOSPODARKI </strong>
<strong>NARODOWEJ </strong>
</font>
</div>
</td>
</tr>
<tr style="MIN-HEIGHT: 8px">
<td colSpan="6" style="BORDER-TOP: #000000 1pt solid">
<div align="left">
<em>
<font face="Times New Roman"/>
</em> </div>
</td>
</tr>
<tr style="MIN-HEIGHT: 51px">
<td colSpan="6" style="BORDER-BOTTOM: #000000 1pt solid">
<div align="left">
<font face="Times New Roman">
<em>Informacje odnoszące się do osoby prawnej, jednostki organizacyjnej nie mającej osobowości prawnej oznaczone są </em>
<em>
<strong>literą P</strong>, dotyczące osoby fizycznej prowadzącej działalność gospodarczą - <strong>literą F</strong>, a jednostki lokalnej <a class="xdDataBindingUI" title="Jednostka lokalna jest to zorganizowana całość (zakład, oddział filia itp.) położona w miejscu zidentyfikowanym odrębnym adresem, pod którym lub z którego prowadzona jest działalność przez co najmniej jedną osobę pracujacą, przy czym wyjątkowo: /n 1. zakłady samodzielne" href="" xd:disableEditing="yes">
<font color="#000000"> </font>
</a>ww. podmiotów - <strong>l</strong>
<strong>iterą L</strong>
</em>
</font>
</div>
</td>
</tr>
<tr style="MIN-HEIGHT: 20px">
<td colSpan="6" style="BORDER-RIGHT: #000000 1pt solid; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid">
<div>
<font face="Times New Roman">
<strong>01. (P,F,L) Rodzaj zgłoszenia </strong>
<em>(zaznacz właściwą odpowiedź):</em>
</font>
</div>
</td>
</tr>
<tr style="MIN-HEIGHT: 23px">
<td style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt solid; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt">
<div align="left">
<font face="Times New Roman"> <span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL47" xd:binding=""1"" style="WIDTH: 10px; FONT-FAMILY: Times New Roman">
<xsl:value-of select=""1""/>
</span>
</font><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL29" xd:binding=""X"">
<xsl:attribute name="style">WIDTH: 20px; FONT-FAMILY: Times New Roman;<xsl:choose>
<xsl:when test="Dokument/Tresc/Zgloszenie/@rodzaj != 1">DISPLAY: none</xsl:when>
</xsl:choose>
</xsl:attribute>
<xsl:value-of select=""X""/>
</span>
</div>
</td>
<td colSpan="5" style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt solid; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt">
<div align="left">
<font face="Times New Roman">skreślenie osoby prawnej/jednostki organizacyjnej nie mającej osobowości prawnej prowadzącej działalność wyłącznie w miejscu siedziby</font>
</div>
</td>
</tr>
<tr style="MIN-HEIGHT: 23px">
<td style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt">
<div align="left">
<font face="Times New Roman"> <span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL48" xd:binding=""2"" style="WIDTH: 10px; FONT-FAMILY: Times New Roman">
<xsl:value-of select=""2""/>
</span>
</font><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL43" xd:binding=""X"">
<xsl:attribute name="style">WIDTH: 20px; FONT-FAMILY: Times New Roman;<xsl:choose>
<xsl:when test="Dokument/Tresc/Zgloszenie/@rodzaj != 2">DISPLAY: none</xsl:when>
</xsl:choose>
</xsl:attribute>
<xsl:value-of select=""X""/>
</span>
</div>
</td>
<td colSpan="5" style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt">
<div>
<font face="Times New Roman">skreślenie osoby prawnej/jednostki organizacyjnej nie mającej osobowości prawnej i wszystkich jej jednostek lokalnych</font>
</div>
</td>
</tr>
<tr style="MIN-HEIGHT: 23px">
<td style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt">
<div align="left">
<font face="Times New Roman"> <span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL49" xd:binding=""3"" style="WIDTH: 10px; FONT-FAMILY: Times New Roman">
<xsl:value-of select=""3""/>
</span><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL44" xd:binding=""X"">
<xsl:attribute name="style">WIDTH: 20px; FONT-FAMILY: Times New Roman;<xsl:choose>
<xsl:when test="Dokument/Tresc/Zgloszenie/@rodzaj != 3">DISPLAY: none</xsl:when>
</xsl:choose>
</xsl:attribute>
<xsl:value-of select=""X""/>
</span>
</font>
</div>
</td>
<td colSpan="5" style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt">
<div>
<font face="Times New Roman">skreślenie osoby fizycznej prowadzącej działalność gospodarczą tylko w jednym lub z jednego miejsca</font>
</div>
</td>
</tr>
<tr style="MIN-HEIGHT: 23px">
<td style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt">
<div align="left">
<font face="Times New Roman"> <span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL50" xd:binding=""4"" style="WIDTH: 10px; FONT-FAMILY: Times New Roman">
<xsl:value-of select=""4""/>
</span><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL45" xd:binding=""X"">
<xsl:attribute name="style">WIDTH: 20px; FONT-FAMILY: Times New Roman;<xsl:choose>
<xsl:when test="Dokument/Tresc/Zgloszenie/@rodzaj != 4">DISPLAY: none</xsl:when>
</xsl:choose>
</xsl:attribute>
<xsl:value-of select=""X""/>
</span>
</font>
</div>
</td>
<td colSpan="5" style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt">
<div>
<font face="Times New Roman">skreślenie osoby fizycznej prowadzącej działalność gospodarczą i wszystkich jej jednostek lokalnych</font>
</div>
</td>
</tr>
<tr style="MIN-HEIGHT: 23px">
<td style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt solid">
<div align="left">
<font face="Times New Roman"> <span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL51" xd:binding=""5"" style="WIDTH: 10px; FONT-FAMILY: Times New Roman">
<xsl:value-of select=""5""/>
</span><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL46" xd:binding=""X"">
<xsl:attribute name="style">WIDTH: 20px; FONT-FAMILY: Times New Roman;<xsl:choose>
<xsl:when test="Dokument/Tresc/Zgloszenie/@rodzaj != 5">DISPLAY: none</xsl:when>
</xsl:choose>
</xsl:attribute>
<xsl:value-of select=""X""/>
</span>
</font>
</div>
</td>
<td colSpan="5" style="BORDER-RIGHT: #000000 1pt solid; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt solid">
<div>
<font face="Times New Roman">skreślenie jednostki lokalnej</font>
</div>
</td>
</tr>
<tr style="MIN-HEIGHT: 14px">
<td colSpan="6" style="BORDER-RIGHT: #000000 1pt; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt; BORDER-BOTTOM: #000000 1pt solid">
<div>
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<div align="left">
<strong>
<font face="Times New Roman">02. (P,F,L) Numer identyfikacyjny REGON podmiotu, którego zgłoszenie dotyczy</font>
</strong>
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<font face="Verdana">
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<strong>
<div align="center"><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL33" style="WIDTH: 100%; FONT-FAMILY: Times New Roman">
<xsl:value-of select="Dokument/Tresc/Podmiot/REGON"/>
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<strong>
<font face="Times New Roman">03. (P,F,) Nazwa podmiotu, którego zgłoszenie dotyczy</font>
</strong>
<font face="Verdana">
<font face="Times New Roman">
<font face="Times New Roman">
<strong>
<br/><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL34" style="WIDTH: 100%; FONT-FAMILY: Times New Roman">
<xsl:value-of select="Dokument/Tresc/Podmiot/Nazwa"/>
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</strong>
</font>
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<td colSpan="6" style="BORDER-RIGHT: #808080 6pt; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #808080 6pt; BORDER-BOTTOM: #000000 1pt solid">
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<font face="TimesNewRomanCE-Bold" color="#292526">
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<font color="#000000">
<font face="Times New Roman">04. (P) Podmiot został zlikwidowany <i>(zaznacz właściwą odpowiedź):</i>
</font>
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<em>
<font face="Times New Roman" color="#000000"/>
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<colgroup>
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<col style="WIDTH: 645px"/>
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<tbody vAlign="top">
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<div align="left">
<font face="Times New Roman"> <span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL52" xd:binding=""1"" style="WIDTH: 10px; FONT-FAMILY: Times New Roman">
<xsl:value-of select=""1""/>
</span><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL35" xd:binding=""X"">
<xsl:attribute name="style">WIDTH: 20px; FONT-FAMILY: Times New Roman;<xsl:choose>
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<xsl:value-of select=""X""/>
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<font face="Times New Roman">całkowicie</font>
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<div align="left">
<font face="Times New Roman" color="#292526"> <span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL53" xd:binding=""2"" style="WIDTH: 10px; FONT-FAMILY: Times New Roman">
<xsl:value-of select=""2""/>
</span><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL36" xd:binding=""X"">
<xsl:attribute name="style">WIDTH: 20px; FONT-FAMILY: Times New Roman;<xsl:choose>
<xsl:when test="Dokument/Tresc/SposobLikwidacji/@wartosc != 2">DISPLAY: none</xsl:when>
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<xsl:value-of select=""X""/>
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<td style="PADDING-RIGHT: 1px; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: top; BORDER-LEFT: #000000 1pt solid; PADDING-TOP: 1px">
<font color="#292526">
<font face="Times New Roman" color="#000000">
<div align="left">w wyniku podziału, połączenia i innych przekształceń; podaj w poz. poniżej 9-cyfrowe numery identyfikacyjne REGON oraz nazwy następców prawnych (maksymalnie 4 - najważniejszych):</div>
</font>
</font>
</td>
</tr>
</tbody>
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<div>
<div>
<font face="Times New Roman"/> </div>
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<div>
<table class="xdRepeatingTable msoUcTable" title="" style="TABLE-LAYOUT: fixed; WIDTH: 694px; BORDER-TOP-STYLE: none; BORDER-RIGHT-STYLE: none; BORDER-LEFT-STYLE: none; BORDER-COLLAPSE: collapse; WORD-WRAP: break-word; BORDER-BOTTOM-STYLE: none" border="1" xd:CtrlId="CTRL38">
<colgroup>
<col style="WIDTH: 129px"/>
<col style="WIDTH: 565px"/>
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<tbody class="xdTableHeader">
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<td style="BORDER-RIGHT: #000000 1pt solid; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid; BACKGROUND-COLOR: transparent">
<strong>
<font face="Times New Roman">REGON</font>
</strong>
</td>
<td style="BORDER-RIGHT: #000000 1pt solid; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid; BACKGROUND-COLOR: transparent">
<strong>
<font face="Times New Roman">Nazwa</font>
</strong>
</td>
</tr>
</tbody><tbody xd:xctname="repeatingtable">
<xsl:for-each select="Dokument/Tresc/SposobLikwidacji/NastepcaPrawny">
<tr>
<td style="BORDER-RIGHT: #000000 1pt solid; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid; BACKGROUND-COLOR: transparent"><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL37" style="WIDTH: 100%; FONT-FAMILY: Times New Roman">
<xsl:value-of select="REGON"/>
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</td>
<td style="BORDER-RIGHT: #000000 1pt solid; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid; BACKGROUND-COLOR: transparent"><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL39" style="WIDTH: 100%; FONT-FAMILY: Times New Roman">
<xsl:value-of select="Nazwa"/>
</span>
</td>
</tr>
</xsl:for-each>
</tbody>
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</div>
</div>
</td>
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<tr style="MIN-HEIGHT: 9px">
<td colSpan="6" style="BORDER-RIGHT: #000000 1pt solid; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid">
<div>
<table class="xdLayout" style="BORDER-RIGHT: medium none; TABLE-LAYOUT: fixed; BORDER-TOP: medium none; BORDER-LEFT: medium none; WIDTH: 537px; BORDER-BOTTOM: medium none; BORDER-COLLAPSE: collapse; WORD-WRAP: break-word" borderColor="buttontext" width="undefined" border="1">
<colgroup>
<col style="WIDTH: 395px"/>
<col style="WIDTH: 142px"/>
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<tbody vAlign="top">
<tr style="MIN-HEIGHT: 28px">
<td rowSpan="2" style="BORDER-RIGHT: #000000 1pt; PADDING-RIGHT: 1px; BORDER-TOP: #808080 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: middle; BORDER-LEFT: #808080 1pt; PADDING-TOP: 1px; BORDER-BOTTOM: #808080 1pt">
<div>
<font face="Times New Roman" size="2">
<div align="left">
<strong>05. (P,F) Data skreślenia z rejestru / ewidencji</strong>
</div>
</font>
</div>
</td>
<td style="BORDER-RIGHT: #808080 1pt; PADDING-RIGHT: 1px; BORDER-TOP: #808080 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: middle; BORDER-LEFT: #000000 1pt; PADDING-TOP: 1px; BORDER-BOTTOM: #000000 1pt">
<div>
<font size="2">
<div align="center"><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL40" style="WIDTH: 100%; FONT-FAMILY: Times New Roman">
<xsl:value-of select="Dokument/Tresc/DataSkreslenia/Rok"/>
</span>
</div>
</font>
</div>
</td>
</tr>
<tr style="MIN-HEIGHT: 20px">
<td style="BORDER-RIGHT: #808080 1pt; PADDING-RIGHT: 1px; BORDER-TOP: #000000 1pt; PADDING-LEFT: 1px; PADDING-BOTTOM: 1px; VERTICAL-ALIGN: middle; BORDER-LEFT: #000000 1pt; PADDING-TOP: 1px; BORDER-BOTTOM: #808080 1pt">
<div align="center">
<font face="Times New Roman">
<font size="2">rok - </font>
<font size="2">miesiąc - </font>
<font size="2">dzień</font>
</font>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div>
<strong>
<font face="Times New Roman"/>
</strong> </div>
</td>
</tr>
<tr style="MIN-HEIGHT: 24px">
<td colSpan="5" style="BORDER-RIGHT: #000000 1pt; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt; BORDER-BOTTOM: #000000 1pt">
<div><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL23" style="FONT-FAMILY: Times New Roman">
<xsl:value-of select="concat(Dokument/Naglowek/OsobaZglaszajaca/Imie, " ", Dokument/Naglowek/OsobaZglaszajaca/Nazwisko)"/>
</span>
<font face="Times New Roman"> , </font><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL24" xd:binding="Dokument/Naglowek/OsobaZglaszajaca/Telefon/Kierunkowy" style="FONT-FAMILY: Times New Roman">
<xsl:value-of select="Dokument/Naglowek/OsobaZglaszajaca/Telefon/Kierunkowy"/>
</span>
<font face="Times New Roman"> </font><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL25" xd:binding="Dokument/Naglowek/OsobaZglaszajaca/Telefon/Bezposredni" style="FONT-FAMILY: Times New Roman">
<xsl:value-of select="Dokument/Naglowek/OsobaZglaszajaca/Telefon/Bezposredni"/>
</span>
<font face="Times New Roman"> </font><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL26" xd:binding="Dokument/Naglowek/OsobaZglaszajaca/Telefon/Wewnetrzny" style="FONT-FAMILY: Times New Roman">
<xsl:value-of select="Dokument/Naglowek/OsobaZglaszajaca/Telefon/Wewnetrzny"/>
</span>
</div>
</td>
<td style="BORDER-RIGHT: #000000 1pt; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt; BORDER-BOTTOM: #000000 1pt">
<div align="right">
<font face="Times New Roman"><span class="xdExpressionBox xdDataBindingUI" title="" tabIndex="-1" xd:disableEditing="yes" xd:xctname="ExpressionBox" xd:CtrlId="CTRL41" style="WIDTH: 100%; FONT-FAMILY: Times New Roman">
<xsl:value-of select="Dokument/Naglowek/DataZlozenia"/>
</span>
</font>
</div>
</td>
</tr>
<tr style="MIN-HEIGHT: 9px">
<td colSpan="3" style="BORDER-RIGHT: #000000 1pt; BORDER-TOP: #000000 1pt; BORDER-LEFT: #000000 1pt; BORDER-BOTTOM: #000000 1pt">
<div>
<font face="Times New Roman">Imię i nazwisko osoby zgłaszającej wniosek, numer telefonu</font>
</div>
</td>
<td colSpan="3" style="BORDER-RIGHT: #000000 1pt; BORDER-TOP: #000000 1pt; BORDER-LEFT: #000000 1pt; BORDER-BOTTOM: #000000 1pt">
<div align="right">
<font face="Times New Roman">Data</font>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div>
<font face="Times New Roman"/> </div>
<div>
<font face="Times New Roman" size="3">
<strong>Załączniki</strong>
</font>
</div>
<div>
<table class="xdRepeatingTable msoUcTable" title="" style="TABLE-LAYOUT: fixed; WIDTH: 696px; BORDER-TOP-STYLE: none; BORDER-RIGHT-STYLE: none; BORDER-LEFT-STYLE: none; BORDER-COLLAPSE: collapse; WORD-WRAP: break-word; BORDER-BOTTOM-STYLE: none" border="1" xd:CtrlId="CTRL54">
<colgroup>
<col style="WIDTH: 192px"/>
<col style="WIDTH: 504px"/>
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<tbody class="xdTableHeader">
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<td style="BORDER-RIGHT: #000000 1pt solid; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid; BACKGROUND-COLOR: transparent">
<div>
<strong>
<font face="Times New Roman">Załącznik</font>
</strong>
</div>
</td>
<td style="BORDER-RIGHT: #000000 1pt solid; BORDER-TOP: #000000 1pt solid; BORDER-LEFT: #000000 1pt solid; BORDER-BOTTOM: #000000 1pt solid; BACKGROUND-COLOR: transparent">
<div>
<strong>
<font face="Times New Roman">Typ</font>
</strong>
</div>
</td>
</tr>
</tbody><tbody xd:xctname="RepeatingTable">
<xsl:for-each select="Dokument/Tresc/Zalaczniki/Zalacznik">
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<xsl:value-of select="@typ"/>
</span>
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