Ex.

_________
Nr. exemplarului
.

Formular tipizat
Anexa 1 la Ordinul Ministerului Finnanelor al
Republicii Moldova
nr.115 din 6 septembrie_2010

1
115 6 2010 .

FACTUR FISCAL

Data eliberrii /data livrrii

/

Seria, Nr.
,

_______________ / _______________

1. Furnizor:

2. Cumprtor:

3. Delegaie
data _______________

5. Punct ncrcare

10.1
Denumirea mrfurilor, serviciilor i cod
nomenclator al mrfii
,

8. Foaia de parcurs

9. Transportator

delegatul

10.2
Unitate de
msur

6. Punct descrcare

seria: _________ numr:_____________ data _______________

c.f./ nr.TVA
../
c.f./ nr.TVA
../
c.f./ nr.TVA
../
4. Documente anexate

7. Redirijri

10.3
10.4
10.5
10.6
10.7
Cantitatea
Pre unitar
Valoarea
Cota TVA, Suma
mrfurilor, fr TVA, lei total fr
%
total a
volumul

TVA, lei

TVA, lei
serviciilor
, %

, ,

,
,

11. TOTAL (pe pagin) / ( )

12. TOTAL (pe factura fiscal) / ( )

x
x

10.8
Valoarea
mrfurilor,
serviciior, lei

, ,

10.9
Alt informaie

10.10
Tip ambalaj

x
x

x
x

10.11
10.12
Numr Masa brut,
locuri
tone

x
x

13. Permis eliberarea:

:________________________________________________________________________________________________________________________________________
Funcia, numele, prenumele i semntura
, ,

14. Predat bunurile (serviciile):

()
_______________________________________________________________________________________________________________________
Funcia, numele, prenumele i semntura

L..
, ,
..
15. Primit bunurile intermediarul (transportatorul):

()________________________________________________________________________________________________________
Funcia, numele, prenumele i semntura
, ,

16. Predat bunurile intermediarul (transportatorul):

()__________________________________________________________________________________________________________
Funcia, numele, prenumele i semntura
, ,

17. Primit bunurile (serviciile) cumprtorul:

() __________________________________________________________________________________________________
L..
Funcia, numele, prenumele i semntura

..
, ,

18. Timpul de staionare a mijlocului de transport

Operaia
Ziua, luna, ora, minutele la

, , ,
Sosire
Plecare

ncrcare

Descrcare

20. Forma de plat

21. Meniuni

19. Ruta i distana de transport, km

,
Semntura

Staionare

_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________

______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
22. Calculul prestaiilor de transport

______________________________________________________________________________________
______________________________________________________________________________________