ZAHTJEV ZA POVRAT POREZA (TAX REFUND FORM)

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					                                                                                                                      OBRAZAC: ZP-PDV
                                                                                                                      (Form ZP-PDV)

Broj inozemnog poreznog obveznika u Područnom uredu Porezne                                                Datum primitka
uprave nadležnom za povrat poreza inozemnim poduzetnicima (No.                                             (Date of receipt)
of foreign taxpayer at the Branch Office of the tax Administration
competent for tax refund to foreign entrepreneuers)


                                                                          POREZNA UPRAVA-PODRUČNI URED ZAGREB TAX
    Ako je ovo prvi zahtjev                                               ADMINISTRATION-BRANCH OFFICE ZAGREB
    (If this is the first claim)                                          Odjel za povrat poreza inozemnim poduzetnicima
                                                                          Department for tax refund to foreign entrepreneurs

                 ZAHTJEV ZA POVRAT POREZA (TAX REFUND FORM)

1.          IME I PREZIME ILI TVRTKA PODUZETNIKA
            (Name, last name or entrepreneurs company)
2.          ULICA I KUĆNI BROJ
            (Address)
3.          POŠTANSKI BROJ, GRAD, ZEMLJA
            (ZIP code. city, country)
4.          VRSTA DJELATNOSTI ILI OBRTA
            (Type of business or craftsmanship)
5           POREZNA SLUŽBA I BROJ POD KOJIM SE
            PODNOSITELJ ZAHTJEVA VODI U DRŽAVI U KOJOJ
            IMA SJEDIŠTE ILI PREBIVALIŠTE
            (Tax Office and the number under which the applicant is
            entered in the country where his office is registered or is
            domiciled)
6.          RAZDOBLJE ZA POVRAT POREZA
            (Period to be refunded)
7.          UKUPAN IZNOS POVRATA POREZA
            (Total amount of tax refund) (u kunama i lipama)
            (Kunas&Lipas)

8.          POVRAT POREZA IZVRŠITI NA RAČUN
            (Tax refund to be paid to the following account) NAZIV
            BANKE
            (The name of the bank)
9.          BROJ PRILOGA
            (Enclosed number of documents)
10.
            PODUZETNIK IZJAVLJUJE (The entrepreneur hereby states)
            a) da su isporuke dobara i usluga za koje se traži povrat obavljene u poduzetničke svrhe, (that the goods for which tax refund is
            claimed were delivered and the services for which tax refund is claimed were performed for the purpose of entrepreneurship)
            b) da u razdoblju za koje podnosi zahtjev za povrat poreza nema na području Republike Hrvatske sjedište, prebivalište, poslovnu
            upravu, podružnicu niti poslovnu jedinicu, (that in the period for which the tax refund is submitted the entrepreneur does not have
            headquarters, a permanent home, a place of management, a branch office or a business unit on the territory of the Republic of
            Croatia)
            c) pod materijalnom i krivičnom odgovornošću da su navodi u zahtjevu točni. Poduzetnik je obvezan vratiti svaki nezakonito
            primljeni iznos (under financial and criminal liability that the statements in this application are true. The entrepreneur shall return
            illegally received amount)


    Mjesto i datum                                                                                    Potpis i žig poduzetnika
    (Place and date)                                                                                  (Signature and seal of entrepreneur)



    Zastupnik tražitelja povrata
    (Representative of tax refund applicant)
    ime i prezime, tvrtka, matični-porezni broj
    (Name, last name, company, personal identification number- tax number - VAT number)



    Adresa, telefonski broj
    (Address, telephone number)
                                                                        Poleđina obrasca-ZP-PDV
                                                                    (Back page of the ZP-PDV form)

                        POPIS POJEDINAČNIH RAČUNA ZA KOJE SE TRAŽI POVRAT POREZA
                                  (List of invoices for which tax refund is claimed)
Red. br.   ISPORUKE DOBARA I USLUGA                      NAZIV I POREZNI   DATUM I BROJ       POREZ NA
(No)       (deliveres of goods and services performed)   BROJ              RAČUNA             DODANU
                                                         ISPORUČITELJA     (Date and no. of   VRIJEDNOST
                                                         (Name and tax     invoice)           (VAT)
                                                         number of the
                                                         deliverer)




UKUPNO:
(Total:)


        NAPOMENA: Ako je domaći poduzetnik za obavljene usluge inozemnom poduzetniku izdao račun u
 stranoj valuti sukladno propisima o vanjskotrgovinskom poslovanju a inozemni poduzetnik te račune
 prilaže uz zahtjev, Porezna uprava će izvršiti povrat poreza u iznosu plaćenog poreza kojeg je izvršitelj
 usluge - domaći poduzetnik uplatio u Državni proračun.

 (Note: if the national entrepreneur had issued an invoice in foreign currency to a foreign entrepreneur in
 according with the foreign trade regulations and the foreign entrepreneur encloses those invoices to the
 claim, the Tax Administration shall effect the tax refund equal to the amount of the tax paid by the performer
 of services - national entrepreneur to the Inland Revenue).