‫اﻟﺠﻤﻬﻮرﻳﺔ اﻟﺘﻮﻧﺴﻴﺔ‬

‫وزارة اﻟﻤﺎﻟﻴﺔ‬

‫ﺗﺼﺮﯾــــﺢ ﺑﺘﺮﻛـــﺔ‬
‫ﺘﺭﻜﺔ ﺍﻟﺴﻴﺩ)ﺓ(‪................................................................................................‬‬
‫ﺇﻥ ﺍﻟﻤﻤﻀﻲ ﺃﺴﻠﻔﻪ ‪ :‬ﺍﻻﺴﻡ ‪ ........................................‬ﺍﻟﻠﻘﺏ‪.....................................‬‬
‫ﺍﻟﻌﻨﻭﺍﻥ ‪................................................................ :‬ﺍﻟﺘﺭﻗﻴﻡ ﺍﻟﺒﺭﻴﺩﻱ‬
‫ﻭﻜﻴﻼ‬ ‫ﻤﻘﺩﻡ ﻋﻠﻰ ﻭﺍﺭﺙ‬ ‫ﻤﺼﻔﻲ ﺘﺭﻜﺔ‬ ‫ﻤﻭﺼﻰ ﻟﻪ‬ ‫ﻭﺍﺭﺜﺎ‬ ‫ﺒﺼﻔﺘﻲ)‪: (1‬‬
‫ﺃﺼﺭﺡ ﺒﺄﻥ ﺍﻟﺴﻴﺩ)ﺓ( )ﺍﺴﻡ ﺍﻟﻤﺘﻭﻓﻰ ﻭﻟﻘﺒﻪ( ‪.....................................................................‬‬
‫ﺠﻨﺴﻴﺘﻪ)ﻫﺎ(‪.............................‬ﻭﺍﻟﻜﺎﺌﻥ ﻤﻘﺭﻩ )ﻫﺎ( ﺒـ‪................................................‬‬
‫ﻤﻬﻨﺘﻪ )ﻫﺎ(‪...................................................................................................‬‬
‫ﺍﻟﺴﻨـﺔ‬ ‫ﺍﻟﺸﻬﺭ‬ ‫ﻗﺩ ﻭﺍﻓﺎﻩ )ﻫﺎ( ﺍﻷﺠل ﺒـ ‪..........................‬ﻓﻲ ‪ :‬ﺍﻟﻴﻭﻡ‬

‫ﻤﻌﻠﻭﻤﺎﺕ ﺨﺎﺼﺔ ﺒﺎﻟﻭﺭﺜﺔ ﺃﻭ ﺍﻟﻤﻭﺼﻰ ﻟﻬﻡ‬

‫ﺍﻟﻤﻌﺭﻑ ﺍﻟﺠﺒﺎﺌﻲ ﺃﻭ ﺭﻗﻡ‬ ‫ﺼﻠﺔ ﺍﻟﻘﺭﺍﺒﺔ ﻤﻊ‬ ‫ﺍﺴﻡ ﺍﻟﻭﺭﻴﺙ ﺃﻭ ﺍﻟﻤﻭﺼﻰ‬
‫ﺍﻟﻤﻨﺎﺏ ﻓﻲ ﺍﻟﺘﺭﻜﺔ‬ ‫ﺍﻟﻌﻨــﻭﺍﻥ‬
‫ﺒﻁﺎﻗﺔ ﺍﻟﺘﻌﺭﻴﻑ ﺍﻟﻭﻁﻨﻴﺔ‬ ‫ﺍﻟﻤﺘﻭﻓﻰ‬ ‫ﻟﻪ ﻭﻟﻘﺒﻪ )‪(2‬‬
‫‪.....................‬‬ ‫‪.....................‬‬ ‫‪...................‬‬ ‫‪.....................‬‬ ‫‪.....................‬‬

‫‪07-5.010-02‬‬
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‫‪----------------------------‬‬
‫)‪ (1‬ﻀﻊ ﻋﻼﻤﺔ )×( ﻓﻲ ﺍﻟﻘﺴﻴﻤﺔ ﺍﻟﻤﻨﺎﺴﺒﺔ ‪.‬‬
‫)‪ (2‬ﻴﺭﻓﻕ ﺍﻟﺘﺼﺭﻴﺢ ﺒﺎﻟﺭﺴﻡ ﺍﻟﺫﻱ ﻴﺨﻭل ﺍﻹﺭﺙ ﺃﻭ ﺍﻟﻭﺼﻴﺔ )ﺤﺠﺔ ﺍﻟﻭﻓﺎﺓ ﺃﻭ ﺍﻟﻭﺼﻴﺔ( ‪.‬‬

‫‪1‬‬
 ‫ﺍﻟﻌﻨﺎﺼــﺭ ﺍﻟﻤﻜﻭﻨــﺔ ﻟﻠﺘﺭﻜــﺔ‬
‫ﺩﻴـــﻥ ﺍﻟﺘﺭﻜـﺔ‬
‫ﺍﻟﻤﺒﻠﻎ‬ ‫ﺍﻟﺩﻴﻥ‬
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‫‪................‬‬ ‫ﺍﻟﻤﺠﻤﻭﻉ‪................‬‬
‫)*( ﻻﻴﻤﻜﻥ ﺃﻥ ﺘﻜﻭﻥ ﻗﻴﻤﺔ ﺍﻷﺜﺎﺙ ﺍﻟﺨﺎﻀﻌﺔ ﻟﻠﻤﻌﻠﻭﻡ ﺃﻗل ﻤﻥ ‪ % 5‬ﻤﻥ ﺍﻟﻘﻴﻤﺔ ﺍﻟﺨﺎﻡ ﻟﺠﻤﻠﺔ ﺍﻷﻤﻼﻙ ﺍﻟﻤﻭﺭﻭﺜﺔ ﺍﻷﺨﺭﻯ ﺇﻻ ﺇﺫﺍ ﺘﻡ ﺇﺜﺒﺎﺕ ﻋﻜﺱ ﺫﻟﻙ ‪.‬‬
‫ﺃﺼـــل ﺍﻟﺘﺭﻜـــــﺔ‬
‫ﺍﻟﻘﻴﻤﺔ ﺍﻟﺘﺠﺎﺭﻴﺔ‬ ‫ﺍﻷﻤﻼﻙ ﺍﻟﻤﻨﻘﻭﻟﺔ ﻭﺍﻟﺜﺎﺒﺘﺔ‬
‫ﺍﻟﻌﻘﺎﺭﺍﺕ ﺍﻟﻤﺒﻨﻴﺔ‬ ‫ـ‬
‫‪..........................‬‬ ‫‪.........................‬‬ ‫‪-‬‬
‫‪.......................... ......................... -‬‬
‫‪.......................... ......................... -‬‬
‫ﺍﻟﻌﻘﺎﺭﺍﺕ ﻏﻴﺭﺍﻟﻤﺒﻨﻴﺔ‬ ‫ـ‬
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‫ﺍﻷﺭﺍﻀﻲ ﺍﻟﻔﻼﺤﻴﺔ‬ ‫ـ‬
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‫ﺃﻤﻼﻙ ﺜﺎﺒﺘﺔ ﺃﺨﺭﻯ‬ ‫ـ‬
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‫ﺍﻷﺼﻭل ﺍﻟﺘﺠﺎﺭﻴﺔ‬ ‫ـ‬
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‫ﺍﻷﺴﻬﻡ ﻭﺍﻟﻤﻨﺎﺒﺎﺕ‬ ‫ـ‬
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‫ﻭﺩﺍﺌﻊ ﺒﺎﻟﺒﻨﻭﻙ‬ ‫ـ‬
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‫ﺍﻷﺜﺎﺙ )*(‬ ‫ـ‬
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‫ﺃﻤﻼﻙ ﻤﻨﻘﻭﻟﺔ ﺃﺨﺭﻯ‬ ‫ـ‬
‫‪.......................... ......................... -‬‬
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‫‪..........................‬‬ ‫ﺍﻟﻘﻴﻤﺔ ﺍﻟﺨﺎﻡ ﻟﺠﻤﻠﺔ ﺍﻷﻤﻼﻙ ﺍﻟﻤﻭﺭﻭﺜﺔ‬
‫‪------------------------‬‬
‫‪2‬‬
 ‫ﻀﺒﻁ ﻗﺎﻋﺩﺓ ﻤﻌﻠﻭﻡ ﺍﻟﺘﺴﺠﻴل‬

‫‪.....................................................‬‬ ‫ﺍﻟﻘﻴﻤﺔ ﺍﻟﺨﺎﻡ ﻟﺠﻤﻠﺔ ﺍﻷﻤﻼﻙ ﺍﻟﻤﻭﺭﻭﺜﺔ‬

‫ﻴﻁﺭﺡ ‪:‬‬
‫ﻗﻴﻤﺔ ﺍﻷﻤﻼﻙ ﺍﻟﻤﻌﻔﺎﺓ ‪:‬‬
‫)‪(1‬‬
‫‪.....................................................‬‬ ‫‪ -‬ﺍﻟﻤﺴﻜﻥ ﺍﻟﺭﺌﻴﺴﻲ‬
‫)‪(2‬‬
‫‪....................................................‬‬ ‫‪ -‬ﺍﻷﺭﺍﻀﻲ ﺍﻟﻔﻼﺤﻴﺔ‬
‫‪......................................................‬‬ ‫‪ -‬ﺃﻤﻼﻙ ﺃﺨﺭﻯ ﻤﻌﻔﺎﺓ‬
‫‪.....................................................‬‬ ‫‪ -‬ﺍﻟﺩﻴﻭﻥ ﺍﻟﻘﺎﺒﻠﺔ ﻟﻠﻁﺭﺡ‬
‫‪......................................................‬‬ ‫ﺍﻟﻘﻴﻤﺔ ﺍﻟﺼﺎﻓﻴﺔ ﻟﺠﻤﻠﺔ ﺍﻷﻤﻼﻙ ﺍﻟﻤﻭﺭﻭﺜﺔ ﺍﻟﺨﺎﻀﻌﺔ ﻟﻤﻌﻠﻭﻡ ﺍﻟﺘﺴﺠﻴل‬

‫ﺍﺤﺘﺴﺎﺏ ﻤﻌﻠﻭﻡ ﺍﻟﺘﺴﺠﻴل‬

‫)‪(4‬‬ ‫ﺍﻟﺒﺎﻗﻲ ﺍﻟﺨﺎﻀﻊ‬ ‫ﺍﻟﻤﻨﺎﺏ ﻓﻲ‬ ‫ﺍﻟﻭﺍﺭﺙ ﺃﻭ‬
‫ﺍﻟﻤﻌﻠﻭﻡ‬ ‫ﺍﻟﻨﺴﺒﺔ‬ ‫)‪(3‬‬ ‫ﺍﻟﻤﻨﺎﺏ ﻓﻲ ﺍﻟﺘﺭﻜﺔ‬
‫ﻟﻠﻤﻌﻠﻭﻡ‬ ‫ﺍﻟﺘﺨﻔﻴﺽ‬ ‫ﺍﻟﻤﻭﺼﻰ ﻟﻪ‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
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‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬ ‫‪..............‬‬
‫ﺍﻟﻤﺠﻤـــﻭﻉ ‪..............‬‬
‫‪-----------------------------------------‬‬
‫ﻴﻌﻔﻰ ﺍﻟﻤﺴﻜﻥ ﺍﻟﺭﺌﻴﺴﻲ ﻟﻠﻤﺘﻭﻓﻰ ﻋﻨﺩ ﻨﻘﻠﻪ ﺒﻴﻥ ﺍﻷﺴﻼﻑ ﻭﺍﻷﻋﻘﺎﺏ ﺃﻭ ﺒﻴﻥ ﺍﻷﺯﻭﺍﺝ ﺸﺭﻴﻁﺔ ﺃﻥ ﻴﻘﺩﻡ ﺍﻟﻭﺭﺜﺔ ﺸﻬﺎﺩﺓ ﻤﻥ ﺍﻟﻭﺍﻟﻲ ﺃﻭ ﺭﺌﻴﺱ ﺍﻟﺒﻠﺩﻴﺔ ﺍﻟﻤﺨﺘﺹ ﺘﺭﺍﺒﻴﺎ‬ ‫)‪(1‬‬
‫ﺘﺜﺒﺕ ﺃﻥ ﺍﻟﻌﻘﺎﺭ ﺍﻟﻤﻌﻨﻲ ﺒﺎﻷﻤﺭ ﻜﺎﻥ ﻤﺴﻜﻨﺎ ﺭﺌﻴﺴﻴﺎ ﻟﻠﻤﺘﻭﻓﻰ ﻭﻴﻤﻨﺢ ﻫﺫﺍ ﺍﻹﻋﻔﺎﺀ ﻓﻲ ﺤﺩﻭﺩ ‪ 1000‬ﻤﺘﺭ ﻤﺭﺒﻊ ‪.‬‬
‫ﺘﻌﻔﻰ ﺇﺤﺎﻟﺔ ﺍﻟﻌﻘﺎﺭﺍﺕ ﺫﺍﺕ ﺍﻟﺼﺒﻐﺔ ﺍﻟﻔﻼﺤﻴﺔ ﺒﻴﻥ ﺍﻷﺴﻼﻑ ﻭﺍﻷﻋﻘﺎﺏ ﺃﻭ ﺒﻴﻥ ﺍﻷﺯﻭﺍﺝ ﺃﻭ ﺒﻴﻥ ﺍﻷﺨﻭﺓ ﻭﺍﻷﺨﻭﺍﺕ ﺸﺭﻴﻁﺔ ﺃﻥ ﻴﻘﺩﻡ ﺍﻟﻭﺭﺜﺔ ﺍﻟﺘﺯﺍﻤﺎ ﻴﻨﺹ ﻋﻠﻰ‬ ‫)‪(2‬‬
‫ﺍﻟﻤﺤﺎﻓﻅﺔ ﻋﻠﻰ ﺍﻟﻤﻠﻜﻴﺔ ﺍﻟﻤﺸﺘﺭﻜﺔ ﻟﻠﻌﻘﺎﺭﺍﺕ ﺍﻟﻔﻼﺤﻴﺔ ﺍﻟﻤﻌﻨﻴﺔ ﻭﺍﺴﺘﻐﻼﻟﻬﺎ ﺠﻤﺎﻋﻴﺎ ﻟﻤﺩﺓ ﻻ ﺘﻘل ﻋﻥ ﺨﻤﺱ ﻋﺸﺭﺓ ﺴﻨﺔ ‪.‬‬
‫ﺍﻟﺘﺨﻔﻴﺽ ‪:‬‬ ‫)‪(3‬‬
‫· ‪ 5000‬ﺩﻴﻨﺎﺭﺍ ﻋﻥ ﻜل ﺍﺒﻥ ﺃﻭ ﺒﻨﺕ ﺒﺎﻕ ﻋﻠﻰ ﻗﻴﺩ ﺍﻟﺤﻴﺎﺓ ﻭﻋﻥ ﻜل ﺴﻠﻑ ﻓﻲ ﻜﻔﺎﻟﺔ ﺍﻟﻤﺘﻭﻓﻰ ﻭﻋﻥ ﻜل ﺯﻭﺝ ﺒﺎﻕ ﻋﻠﻰ ﻗﻴﺩ ﺍﻟﺤﻴﺎﺓ ﻤﻊ ﺤﺩ ﺃﻗﺼﻰ‬
‫ﻴﺴﺎﻭﻱ ‪ 30000‬ﺩﻴﻨﺎﺭ‪،‬‬
‫· ‪ 10000‬ﺩﻴﻨﺎﺭﺍ ﺘﺨﻔﻴﺽ ﺇﻀﺎﻓﻲ ﻴﻁﺭﺡ ﻤﻥ ﺍﻟﻤﻨﺎﺏ ﺍﻟﺭﺍﺠﻊ ﻟﻜل ﺸﺨﺹ ﻤﻌﺎﻕ‪,‬‬
‫· ﻴﺘﻌﻴﻥ ﺇﺠﺭﺍﺀ ﺍﻟﺘﺨﻔﻴﺽ ﺍﻟﺠﻤﻠﻲ ﻓﻲ ﺍﻟﻤﻘﺎﻡ ﺍﻷﻭل ﻋﻠﻰ ﺍﻟﻤﻨﺎﺏ ﺍﻟﺭﺍﺠﻊ ﻟﻠﻘﺭﻴﻥ ﺍﻟﺒﺎﻗﻲ ﻋﻠﻰ ﻗﻴﺩ ﺍﻟﺤﻴﺎﺓ‪،‬‬
‫· ﻴﻘﺴﻡ ﺍﻟﺒﺎﻗﻲ ﺇﻥ ﻭﺠﺩ ﺒﻴﻥ ﺍﻟﻤﺴﺘﺤﻘﻴﻥ ﺍﻵﺨﺭﻴﻥ ﺤﺴﺏ ﻗﻭﺍﻋﺩ ﺍﻟﻔﺭﻴﻀﺔ ﺍﻟﻘﺎﻨﻭﻨﻴﺔ ‪،‬‬
‫ﻨﺴﺒﺔ ﺍﻟﻤﻌﻠﻭﻡ ‪:‬‬ ‫)‪(4‬‬
‫· ﺒﻴﻥ ﺍﻷﺴﻼﻑ ﻭﺍﻷﻋﻘﺎﺏ ﻭﺒﻴﻥ ﺍﻷﺯﻭﺍﺝ ‪، % 2,5 :‬‬
‫· ﺒﻴﻥ ﺍﻹﺨﻭﺓ ﻭﺍﻷﺨﻭﺍﺕ‪، % 5 :‬‬
‫· ﺒﻴﻥ ﺍﻷﻋﻤﺎﻡ ﻭﺍﻟﻌﻤﺎﺕ ﻭﺃﺒﻨﺎﺀ ﺃﻭ ﺒﻨﺎﺕ ﺍﻹﺨﻭﺓ ﻭﻜﺒﺎﺭ ﺍﻷﻋﻤﺎﻡ ﻭﺍﻟﻌﻤﺎﺕ ﻭﺼﻐﺎﺭ ﺃﺒﻨﺎﺀ ﺃﻭ ﺒﻨﺎﺕ ﺍﻹﺨﻭﺓ ﻭﺃﺒﻨﺎﺀ ﺍﻷﻋﻤﺎﻡ ‪، % 25 :‬‬
‫ﺒﻴﻥ ﺍﻷﻗﺎﺭﺏ ﺒﻌﺩ ﺍﻟﺩﺭﺠﺔ ﺍﻟﺭﺍﺒﻌﺔ ﻭﺒﻴﻥ ﺍﻷﺸﺨﺎﺹ ﻤﻥ ﻏﻴﺭ ﺍﻷﻗﺎﺭﺏ ‪. % 35 :‬‬

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 ‫ﺍﻟﺨﻼﺼـــﺔ‬

‫ﺍﻟﻤﺒﺎﻟـــﻎ ﺍﻟﻤﺴﺘﻭﺠﺒـــﺔ‬
‫ﺍﻟﻤﺠﻤـــﻭﻉ‬ ‫ﺍﻟﺨﻁﺎﻴــﺎ‬ ‫ﺍﻷﺼـــل‬

‫‪..................................‬‬ ‫‪................................‬‬ ‫‪.................................‬‬

‫ﻗﺒﺎﻀﺔ ﺍﻟﻤﺎﻟﻴﺔ ‪....................................‬‬

‫ﺭﻗـﻡ ﺍﻟﻭﺼـل‬ ‫ﺭﻤﺯ ﺍﻟﻘﺒﺎﻀــﺔ‬

‫ﺘﺎﺭﻴﺦ ﺍﻟﻭﺼـل‬ ‫ﺭﻤــﺯ ﺍﻟﺩﻓــﻊ )*(‬

‫ﺍﻟﺴﻨﺔ‬ ‫ﺍﻟﺸﻬﺭ‬ ‫ﺍﻟﻴﻭﻡ‬

‫ﺇﻨﻲ ﺍﻟﻤﻤﻀﻲ ﺃﺴﻔﻠﻪ ﺃﺸﻬﺩ ﺒﺼﺤﺔ ﺍﻟﺒﻴﺎﻨﺎﺕ ﺍﻟﺘﻲ ﺘﻀﻤﻨﻬﺎ ﻫﺫﺍ ﺍﻟﺘﺼﺭﻴﺢ ‪.‬‬
‫ﺒـ ‪ ..............................‬ﻓﻲ ‪.............................‬‬

‫ﺍﻟﻤﺼــﺭﺡ‬

‫‪---------------------------------‬‬

‫)*( ﻀﻊ ‪ 1 :‬ﻓﻲ ﺼﻭﺭﺓ ﺍﻟﺩﻓﻊ ﺍﻟﻜﻠﻲ‬

‫‪ 2‬ﻓﻲ ﺼﻭﺭﺓ ﺍﻟﺩﻓﻊ ﺍﻟﻤﺅﺠل ‪.‬‬

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