You are on page 1of 1

!"#$%&'()' *+*,-."!')/(' 0$ 1"!$23* $ ,$+1$4-"!- "' 5*0$16 4*5 %$+5!7%368 +9.$2+-"!

' 5*0$1:
!"#$%&'"!()*+#"!(+,-!#./'0&-1 ,'2)#3'(,)%)(&/,,'2)#)%1&#)4*/1(5&',/1#)#$)0/1(1,+.#$%1*/'#
()#(+0$),)*1,/1#,/'%!56).)45/7#,1#5' '#"!()* 1,'#8"9:;#

<= $>?@A !"#$%&#'(!#$%)*+,!-!"./"0*+.$*!1"2,34%2#5!."!)672+8"!."9:&#%$%!;+<6!$*$*+;<#%!*$1"2,%&;%=!


!"#$%&' $ ($)!$*&"#& "+ ,-.$!/ *-, 0$),#10'/ 23456 $7!#+.8)&"#& $ ($%#+.+"9: (0+!#& .$ .9%($"$!+"#+ "#&0-8;$:$78#<
"+ 8&*& ,-.$!*+"& 234=6
)>?$%)&"#& ,-.$!9 *-, (0)&,-.$!9 ,-.9"'- :#&%)'+*"&>$
@&."$0$.)#""&>$ 234A6

>? @3!/2"<# !0/*<%(!.".%6)"0+!*$1"2,%&;+=!


2! (0)9(+.'- "#&!9%B+08)+@<8&>$ :#&@%8+ ($"#C&@D '$*&@"& #"E$0:+8@& (0$%)/ ($.+F "+ '+0B'+8; E$0:+B- GH $0+) ($"#C&@ ($.+F *#8),/ #8; %B0$"6

*#8),+ .$.+B'$!98; %B0$" #"E$0:+8@# -)-(&?"#+@<8&@I!JJJJJJJJJ !!!

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
L+B+ $0+) 8)9B&*"9 ($.(#% #"!&%B$0+ *-, $%$,9 -($!+C"#$"&@ .$ .)#+?+"#+ ! @&>$ #:#&"#-

Zał. dodatkowy do formularzy B-1, B-2 i B-3: AM-02-01, AM-02-02, AM-02-03, AM-02-04, AM-02-07, AM-02-09 i AM-02-10 B-4 (XII 2016) strona 1/1

You might also like