¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ налог на доходы ¦03 ¦ ¦ ¦ ¦ ¦
¦ ¦ физических лиц (___%) ¦ ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ профсоюз (___%) ¦04 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ исполнительный лист ¦05 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ прочие удержания ¦06 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ ¦07 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦К выдаче по ст. 211 ___, ¦08 ¦ ¦ ¦ ¦ ¦
¦ ¦всего ¦ ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦В том числе: ¦ ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ зарплата ¦09 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ отпускные ¦10 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ премия ¦11 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ материальная помощь ¦12 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ больничный лист (2 дня) ¦13 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ ¦14 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦Из них: ¦ ¦ ¦ ¦ ¦ ¦
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¦ ¦ наличные ¦15 ¦ ¦ ¦ ¦ ¦
¦ +---------------------------+------+----------+---------+-----------+---------------+
¦ ¦ на лицевые счета ¦16 ¦ ¦ ¦ ¦ ¦
¦ ¦ в банках ¦ ¦ ¦ ¦ ¦ ¦
+-------------+---------------------------+------+----------+---------+-----------+---------------+
¦Ст. 212 _
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