You are on page 1of 3

Wage tax statement

Check if this form has been filled in with the correct information.

Information:
Surname & initial : Vasilica Teodora (V.T.) Padurean
Social security number (BSN) : 525309780
Address : Hagelkruisakker 9
Zip code & City : 2990 WUUSTWEZEL
Country : België
Date of birth : 27-09-2001

Apply wage tax credit;


Do you want your employer or benefits agency take the wage tax credit into account? You can only have the wage
tax credit applied by one employer of benefits agency at the same time.

Employe chooses TO take the wage tax credit into account.


From 22-01-2024.

City: BREDA Date: 19-01-2024


Signature Olympia Services B.V. Signature employee

______________________________ _____________________________
Janis Noventa Vasilica Teodora Padurean
Intercedent

Loonbelastingsverklaring
METAGEGEVENS DIGITALE ONDERTEKENING

type document: LB
naam document: Loonbelastingverklaring

Loonbelastingsverklaring
Disclaimer: This is a translated document. The dutch version of this document is leading.

Loonbelastingsverklaring

You might also like