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Ex.

_________ Formular tipizat


Anexa 1 la Ordinul Ministerului Finnanelor al Republicii Moldova
Nr. exemplarului nr.115 din 6 septembrie_2010
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115 6 2010 .
FACTUR FISCAL Seria, Nr. AB, nr 8002324
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8. Foaia de parcurs seria: _________ numr:_____________ data _______________


Data eliberrii /data livrrii 19.08.2017 / _______________
/ 9. Transportator c.f./ nr.TVA
../
1. Furnizor: SRLBIROVITS, str.Bnulescu-Bodoni 13, c.c. 123MD8835716 c.f./ nr.TVA 1230000631/ 0002567
../
c.f./ nr.TVA 1230000340/ 0256321
2. Cumprtor: SRLADELINA, str. Miron Costin 23/5, c.c. 128MD3613312 ../

3. Delegaie data _______________ delegatul 4. Documente anexate

5. Punct ncrcare str.Bnulescu-Bodoni 13 6. Punct descrcare str. Miron Costin 23/5 7. Redirijri

10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12
Denumirea mrfurilor, serviciilor i cod Unitate de Cantitatea Pre unitar Valoarea total Cota TVA, Suma Valoarea Alt informaie Tip ambalaj Numr Masa brut, tone
nomenclator al mrfii msur mrfurilor, fr TVA, lei fr TVA, lei % total a mrfurilor, locuri ,
, volumul TVA, lei serviciior, lei -
serviciilor , , %
, , ,
, ,

Hrtie alb A4PAPERMAX pachet 4 70 280 20 56 336
Map mare MONTEX buc 2 50 100 20 20 120
11. TOTAL (pe pagin) / ( ) 380 x 76 456 x x x
12. TOTAL (pe factura fiscal) / ( ) 380 x 76 456 x x x
13. Permis eliberarea: Vnztorul Chiriac Vasile
:________________________________________________________________________________________________________________________________________
Funcia, numele, prenumele i semntura
, ,
14. Predat bunurile (serviciile): Vnztorul Chiriac Vasile
() _______________________________________________________________________________________________________________________
Funcia, numele, prenumele i semntura
L.. , ,
..
15. Primit bunurile intermediarul (transportatorul):
() ef de gospodarie_Gona Alina
, ,
16. Predat bunurile intermediarul (transportatorul):
()__________________________________________________________________________________________________________
Funcia, numele, prenumele i semntura
, ,
17. Primit bunurile (serviciile) cumprtorul:
() __________________________________________________________________________________________________ L..
Funcia, numele, prenumele i semntura ..
, ,

18. Timpul de staionare a mijlocului de transport 19. Ruta i distana de transport, km


,
Operaia Ziua, luna, ora, minutele la Semntura _____________________________________
, , ,
_____________________________________
Sosire Plecare Staionare
_____________________________________
ncrcare _____________________________________
_____________________________________
Descrcare

20. Forma de plat



21. Meniuni

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22. Calculul prestaiilor de transport

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