4137
| ID | 4137 |
|---|
| Data | 2017-05-10 |
|---|
| Symbol | 2017/05/10/4137 |
|---|
| Instytucja | Urząd Gminy Gołcza |
|---|
| Nazwa | Deklaracja o wysokości opłaty za gospodarowanie odpadami komunalnymi |
|---|
| Czy Aktualny | 1 |
|---|
Ustawy (1)
Pliki
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<title>Dokument elektroniczny</title>
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<p>
<strong>
<span style="font-family: verdana, geneva; font-size: medium;">DEKLARACJA O WYSOKOŚCI OPŁATY ZA GOSPODAROWANIE ODPADAMI KOMUNALNYMI</span>
</strong>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;">dla nieruchomości, na których zamieszkują mieszkańcy</span>
</p>
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<span style="font-family: verdana, geneva; font-size: small;">
<strong>Data złożenia deklaracji</strong> <span>
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<xsl:value-of select="wnio:DaneDokumentu/meta:Data/meta:Czas"/>
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<td style="width: 15%;">
<strong>
<span style="font-family: verdana, geneva; font-size: x-small;">Podstawa prawna:</span>
</strong>
</td>
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<span style="font-family: verdana, geneva; font-size: x-small;">
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<xsl:if test="true()">
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<xsl:value-of select="wnio:PodstawaPrawna"/>
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<tr>
<td>
<strong>
<span style="font-family: verdana, geneva; font-size: x-small;">Składający:</span>
</strong>
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<span style="font-family: verdana, geneva; font-size: x-small;">
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<xsl:value-of select="wnio:Skladajacy"/>
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<tr>
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<strong>
<span style="font-family: verdana, geneva; font-size: x-small;">Termin składania:</span>
</strong>
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<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">
<strong>1. MIEJSCE SKŁADANIA DEKLARACJI</strong>
</span>
</span>
<xsl:for-each select="wnio:DaneDokumentu/str:Adresaci/meta:Podmiot/inst:Instytucja">
<xsl:if test="true()">
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<xsl:value-of select="inst:NazwaInstytucji"/>
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</span>, <span>
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<xsl:if test="true()">
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<xsl:value-of select="adr:Adres/adr:KodPocztowy"/>
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<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Miejscowosc"/>
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<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Adres/adr:Budynek"/>
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</td>
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<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">2. CEL ZŁOŻENIA DEKLARACJI</span>
</strong>
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<span style="font-family: verdana, geneva; font-size: x-small;">data zaistnienia zmian</span>
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<p>
<strong>
<span style="font-family: verdana, geneva; font-size: small;">3. PODMIOT ZOBOWIĄZANY DO ZŁOŻENIA DEKLARACJI</span>
</strong>
</p>
<p> </p>
<xsl:for-each select="wnio:TrescDokumentu/wnio:Wartosc/wnio:PodmiotZobowiazany">
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<xsl:if test="true()">
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<xsl:value-of select="wnio:FormaWladania"/>
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</span>
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<xsl:for-each select="wnio:Inne">
<xsl:if test="true()">
<span style="font-family: verdana, geneva; font-size: x-small;">
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<xsl:value-of select="wnio:JakiInny"/>
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<p> </p>
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<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">4. DANE IDENTYFIKACYJNE</span>
</strong>
</td>
</tr>
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<td>
<xsl:for-each select="wnio:DaneDokumentu/meta:Tworcy/meta:Tworca/meta:Podmiot/oso:Osoba">
<xsl:if test="true()">
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<td>
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px; width: 40%;">
<span style="font-family: verdana, geneva; font-size: x-small;">Imię</span>
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<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
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<xsl:if test="true()">
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<xsl:value-of select="oso:Imie"/>
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<span style="font-family: verdana, geneva; font-size: x-small;">Nazwisko</span>
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<xsl:if test="true()">
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<xsl:value-of select="oso:Nazwisko"/>
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</span>
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</td>
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<td>
<xsl:for-each select="adr:Adres">
<xsl:if test="true()">
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px; width: 50%;">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Ulica/@rodzajUlicy"/>
</span>
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</span> <span>
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<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Ulica"/>
</span>
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</span>
</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Budynek / Lokal</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Budynek"/>
</span>
</xsl:if>
</span> / <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Lokal"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Kod pocztowy</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
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<span type="text">
<xsl:value-of select="adr:KodPocztowy"/>
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</span>
</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Miejscowość</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
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<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Miejscowosc"/>
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</span>
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<td>
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
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<td style="border-color: #000000; border-style: solid; border-width: 1px; width: 40%;">
<span style="font-family: verdana, geneva; font-size: x-small;">PESEL</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
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<span type="text">
<xsl:value-of select="oso:IdOsoby/oso:PESEL"/>
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</td>
<td style="width: 30%; border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Nr telefonu</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
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<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Kontakt/adr:Telefon"/>
</span>
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</span>
</td>
<td style="width: 30%; border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Adres e-mail</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
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<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Kontakt/adr:Email"/>
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</span>
</span>
</td>
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</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</xsl:if>
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</td>
</tr>
<tr>
<td>
<xsl:for-each select="wnio:TrescDokumentu/wnio:Wartosc/wnio:AdresOdpady/adr:Adres">
<xsl:if test="true()">
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<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px; width: 50%;" colspan="2">
<span style="font-family: verdana, geneva; font-size: small;">Adres nieruchomości, na której powstają odpady</span>
</td>
</tr>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px; width: 50%;">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Ulica/@rodzajUlicy"/>
</span>
</xsl:if>
</span> <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Ulica"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Budynek / Lokal</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Budynek"/>
</span>
</xsl:if>
</span> / <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Lokal"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Kod pocztowy</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-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 style="border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Miejscowość</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Miejscowosc"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<xsl:for-each select="wnio:TrescDokumentu/wnio:Wartosc/wnio:AdresKorespondencja">
<xsl:if test="true()">
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:choose>
<xsl:when test="contains(concat(concat(' ', normalize-space(wnio:CzyInnyAdres)),' '), ' 1 ' )">
<span>[<b>X</b>]</span>
</xsl:when>
<xsl:otherwise>
<span>[ ]</span>
</xsl:otherwise>
</xsl:choose>
<label>
<span>Adres do korespondencji jest inny niż adres nieruchomości</span>
</label>
</span>
<br/>
</xsl:if>
</span>
</span>
</span>
<xsl:for-each select="adr:Adres">
<xsl:if test="true()">
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="width: 50%; border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Ulica/@rodzajUlicy"/>
</span>
</xsl:if>
</span> <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Ulica"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td style="width: 50%; border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Budynek / Lokal</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Budynek"/>
</span>
</xsl:if>
</span> / <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Lokal"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
<tr>
<td style="width: 50%; border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Kod pocztowy</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-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 style="width: 50%; border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva; font-size: x-small;">Miejscowość</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="adr:Miejscowosc"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<p>
<strong>
<span style="font-family: verdana, geneva; font-size: small;">5. Oświadczam, że na terenie nieruchomości wskazanej w pkt. 4 niniejszej deklaracji odpady będą gromadzone w sposób:</span>
</strong>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: small;">
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</span>
</span>
</p>
</td>
</tr>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<p>
<strong>
<span style="font-family: verdana, geneva; font-size: small;">6. Oświadczam , że nieruchomość wskazana w pkt. 4 niniejszej deklaracji jest wyposażona w kompostownik</span>
</strong>
<span style="font-family: verdana, geneva; font-size: small;">
<span style="font-family: verdana, geneva; font-size: small;">
<br/>
<br/>
</span>
</span>
</p>
<xsl:for-each select="wnio:TrescDokumentu/wnio:Wartosc/wnio:Kompostownik">
<xsl:if test="true()">
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:CzyKompostownik"/>
</span>
</xsl:if>
</span>
</span>
<br/>
<xsl:for-each select="wnio:Jest">
<xsl:if test="true()">
<span style="font-family: verdana, geneva;">
<span style="font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Pojemnosc"/>
</span>
</xsl:if>
</span>
</span>
<span style="font-size: x-small;">m</span>
</span>
<span style="font-family: verdana, geneva; font-size: x-small;">
<sup>3</sup>
</span>
</xsl:if>
</xsl:for-each>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<p>
<strong>
<span style="font-family: verdana, geneva; font-size: small;">7. OPŁATA ZA GOSPODAROWANIE ODPADAMI KOMUNALNYMI WYNOSI:</span>
</strong>
</p>
<table style="width: 95%;" border="0" cellspacing="0" cellpadding="0" align="center">
<tbody>
<tr>
<td>
<xsl:for-each select="wnio:TrescDokumentu/wnio:Wartosc/wnio:WysokoscOplaty">
<xsl:if test="true()">
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td>
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td>
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px; width: 20%;" align="left" valign="top">
<p>
<strong>
<span style="font-family: verdana, geneva; font-size: x-small;">Rodzaj gospodarstwa domowego</span>
</strong>
</p>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px; width: 20%;" align="left" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<strong>Liczba gospodarstw domowych prowadzonych na nieruchomości wskazanej w pkt. 4</strong>
</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="left" valign="top">
<p>
<strong>
<span style="font-family: verdana, geneva; font-size: x-small;">Stawka opłaty za odpady zmieszane</span>
</strong>
</p>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="left" valign="top">
<p>
<strong>
<span style="font-family: verdana, geneva; font-size: x-small;">Stawka opłaty za odpady segregowane</span>
</strong>
</p>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="left" valign="top">
<p>
<strong>
<span style="font-family: verdana, geneva; font-size: x-small;">Wysokość miesięcznej opłaty za gospodarowanie odpadami</span>
</strong>
</p>
</td>
</tr>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="middle">
<span style="font-family: verdana, geneva; font-size: x-small;">1.</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="middle">
<span style="font-family: verdana, geneva; font-size: x-small;">2.</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="middle">
<span style="font-family: verdana, geneva; font-size: x-small;">3.</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="middle">
<span style="font-family: verdana, geneva; font-size: x-small;">4.</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="middle">
<span style="font-family: verdana, geneva; font-size: x-small;">5.</span>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td>
<xsl:for-each select="wnio:Gosp1">
<xsl:if test="true()">
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="left" valign="top">
<p>
<span style="font-family: verdana, geneva; font-size: x-small;">- gospodarstwo domowe 1 lub 2 osobowe</span>
</p>
</td>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Liczba"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaZm"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaSeg"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Kwota"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td>
<xsl:for-each select="wnio:Gosp3">
<xsl:if test="true()">
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="left" valign="top">
<p>
<span style="font-family: verdana, geneva; font-size: x-small;">- gospodarstwo domowe 3 lub 4 osobowe</span>
</p>
</td>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Liczba"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaZm"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaSeg"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Kwota"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td>
<xsl:for-each select="wnio:Gosp5">
<xsl:if test="true()">
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="left" valign="top">
<p>
<span style="font-family: verdana, geneva; font-size: x-small;">- gospodarstwo domowe 5 lub 6 osobowe</span>
</p>
</td>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Liczba"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaZm"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaSeg"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Kwota"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td>
<xsl:for-each select="wnio:Gosp7">
<xsl:if test="true()">
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="left" valign="top">
<p>
<span style="font-family: verdana, geneva; font-size: x-small;">- gospodarstwo domowe 7 lub 8 osobowe</span>
</p>
</td>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Liczba"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaZm"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaSeg"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Kwota"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td>
<xsl:for-each select="wnio:Gosp9">
<xsl:if test="true()">
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="left" valign="top">
<p>
<span style="font-family: verdana, geneva; font-size: x-small;">- gospodarstwo domowe 9 lub 10 osobowe</span>
</p>
</td>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Liczba"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaZm"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaSeg"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Kwota"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td>
<xsl:for-each select="wnio:Gosp11">
<xsl:if test="true()">
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="left" valign="top">
<p>
<span style="font-family: verdana, geneva; font-size: x-small;">- gospodarstwo domowe 11 lub 12 osobowe</span>
</p>
</td>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Liczba"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaZm"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaSeg"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Kwota"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td>
<xsl:for-each select="wnio:Gosp12">
<xsl:if test="true()">
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="left" valign="top">
<p>
<span style="font-family: verdana, geneva; font-size: x-small;">- gospodarstwo domowe powyżej 12 osób</span>
</p>
</td>
<td style="width: 20%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Liczba"/>
</span>
</xsl:if>
</span>
</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaZm"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="width: 15%; border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:StawkaSeg"/>
</span>
</xsl:if>
</span>zł</span>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center" valign="top">
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:Kwota"/>
</span>
</xsl:if>
</span>
</span>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td>
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td>
<table style="width: 100%;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px; width: 70%;" align="right" valign="middle">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">RAZEM</span>
</strong>
</td>
<td style="border-color: #000000; border-style: solid; border-width: 1px;" align="center">
<strong>
<span style="font-family: verdana, geneva; font-size: small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:KwotaRazem"/>
</span>
</xsl:if>
</span>
</span>
</strong>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</xsl:if>
</xsl:for-each>
</td>
</tr>
</tbody>
</table>
<p> </p>
<p>
<span style="font-family: verdana, geneva; font-size: x-small;">Miejscowość, data</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:MiejscowoscDokumentu"/>
</span>
</xsl:if>
</span>, <span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="wnio:TrescDokumentu/wnio:Wartosc/wnio:DataDokumentu"/>
</span>
</xsl:if>
</span>
</span>
</p>
</td>
</tr>
<tr>
<td style="border-color: #000000; border-style: solid; border-width: 1px;">
<span style="font-family: verdana, geneva;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:choose>
<xsl:when test="contains(concat(concat(' ', normalize-space(wnio:TrescDokumentu/wnio:Wartosc/wnio:KorespondencjaElektroniczna)),' '), ' 1 ' )">
<span>[<b>X</b>]</span>
</xsl:when>
<xsl:otherwise>
<span>[ ]</span>
</xsl:otherwise>
</xsl:choose>
<label>
<span>Oświadczam, że rezygnuję z doręczania pism za pomocą środków komunikacji elektronicznej w niniejszym postępowaniu.</span>
</label>
</span>
<br/>
</xsl:if>
</span>
</span> </td>
</tr>
<tr>
<td>
<span style="font-family: verdana, geneva; font-size: small;">Załączniki</span>
</td>
</tr>
<tr>
<td>
<xsl:for-each select="wnio:TrescDokumentu/wnio:Wartosc/str:Zalacznik">
<xsl:if test="true()">
<p>
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span>
<xsl:value-of select="str:DaneZalacznika/../@nazwaPliku"/>
</span>
</xsl:if>
</span>
</p>
<p>
<span style="font-family: verdana, geneva; font-size: x-small;">Opis załącznika</span>
<br/>
<span style="font-family: verdana, geneva; font-size: x-small;">
<span>
<label>
<span/>
</label>
<xsl:if test="true()">
<span type="text">
<xsl:value-of select="str:OpisZalacznika"/>
</span>
</xsl:if>
</span>
</span>
</p>
</xsl:if>
</xsl:for-each>
</td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
</tbody>
</table>
<span style="display: none;"/>
<xsl:call-template name="Podpis"/>
</body>
</html>
</xsl:for-each>
</xsl:template>
<xsl:template name="Podpis">
<div style="float:left;text-align: right;font-size: 10px;font-family: Verdana;line-height: 20px;">
<table style="float: right;">
<tr>
<td style="width: 340px;">
<h2>Podpisy elektroniczne</h2>
<p align="center" style="text-align: center;font-size: 10px;font-family: Verdana;line-height: 20px;">
<xsl:if 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>
<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:if>
</p>
</td>
</tr>
</table>
</div>
</xsl:template>
</xsl:stylesheet>