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CỘNG HOÀ XÃ HỘI CHỦ NGHĨA VIỆT NAM
Độc lập - Tự do - Hạnh phúc
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TỜ KHAI LỆ PHÍ TRƯỚC BẠ
(Áp dụng đối với nhà, đất)
[01] Kỳ tính thuế: Theo từng lần phát sinh ngày … tháng … năm …
[02] Lần đầu: [03] Bổ sung lần thứ:…
Tổ chức, cá nhân được ủy quyền khai thay cho người nộp thuế
![](data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABoAAAAaCAYAAACpSkzOAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjwv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAACWSURBVEhLvc2xDcNAAALA339pW+hwJuBzEg0FnH97LufnuSXbLmi9l20XtN7Ltgta72XbBa33su2C1nvZdkHrvWy7oPVetl3Qei/bLmi9l20XtN7Ltgta72XbBa33su2C1nvZdkHrvWy7oPVetl3Qei/bLmi9l20XtN7Ltgta72XbBa33su2C1nvZdkHrvWy74Csu5ZwXcDI+MwU5hDkAAAAASUVORK5CYII=)
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[04] Người nộp thuế:...............................................................................................................
[05] Mã số thuế:
[06] Số CMND/CCCD/Hộ chiếu (trường hợp chưa có mã số thuế): ……………………….
[07] Địa chỉ:..............................................................................................................................
[08] Quận/huyện: ................................... [09] Tỉnh/Thành phố: .............................................
[10] Điện thoại: ..................... [11] Fax: .................. [12] Email: ..........................................
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[13] Đại lý thuế; hoặc Tổ chức, cá nhân được ủy quyền khai thay (nếu có): ...................
[14] Mã số thuế:
[15] Hợp đồng đại lý thuế: Số:..................................... ngày ..........................................
ĐẶC ĐIỂM NHÀ ĐẤT:
1. Đất: ......................................................................................................................................
1.1. Thửa đất số (Số hiệu thửa đất): ………………………….; Tờ bản đồ số: ………..……
1.2. Địa chỉ thửa đất:
1.2.1. Số nhà: ………….…. Tòa nhà: ……….…..… Ngõ/Hẻm: ………………………….
Đường/Phố:……………………. Thôn/xóm/ấp: ……………………………………………
1.2.2. Phường/xã: ……………………………………………………………………………
1.2.3. Quận/huyện.. ………………………………………………………………………….
1.2.4. Tỉnh/thành phố ………………………………………………………………………..
1.3. Vị trí thửa đất (mặt tiền đường phố hay ngõ, hẻm):…………………………………….
1.4. Mục đích sử dụng đất: ......................................................................................................
1.5. Diện tích (m2): .................................................................................................................
1.6. Nguồn gốc nhà đất: (đất được Nhà nước giao, cho thuê; đất nhận chuyển nhượng; nhận thừa kế, hoặc nhận tặng cho):
a) Tên tổ chức, cá nhân chuyển giao QSDĐ:
- Tên tổ chức/cá nhân chuyển giao QSDĐ:………………………………………………….
- Mã số thuế:…………………………………………………………………………………
- Số CMND/CCCD/Hộ chiếu (trường hợp chưa có mã số thuế): …………………………..
- Địa chỉ người giao QSDĐ: .................................................................................................
b) Thời điểm làm giấy tờ chuyển giao QSDĐ ngày ........ tháng ....... năm ........
1.7. Giá trị đất thực tế chuyển giao (nếu có):
2. Nhà:
2.1. Thông tin về nhà ở, nhà làm việc, nhà sử dụng cho mục đích khác:
Cấp nhà: ……………........ Loại nhà: …………………………Hạng nhà:......................
Trường hợp là nhà ở chung cư:
Chủ dự án:……………… Địa chỉ dự án, công trình…………….
Kết cấu:………………… Số tầng nổi:…………Số tầng hầm:…….
Diện tích sở hữu chung (m2):…….. Diện tích sở hữu riêng (m2):……..
2.2. Diện tích nhà (m2):
Diện tích xây dựng (m2): …………………………………………………………………..
Diện tích sàn xây dựng (m2): ………………………………………………………………
2.3. Nguồn gốc nhà: ................................................................................................................
a) Tự xây dựng:
- Năm hoàn công (hoặc năm bắt đầu sử dụng nhà): ................................................................
b) Mua, thừa kế, tặng cho:
- Thời điểm làm giấy tờ chuyển giao nhà: Ngày ......... tháng ........ năm ........
2.4. Giá trị nhà (đồng):………………………………………………………………………
3. Giá trị nhà, đất thực tế nhận chuyển nhượng , nhận thừa kế , nhận tặng cho (đồng):
..................................................................................................................................................
4. Tài sản thuộc diện được miễn lệ phí trước bạ (lý do):
..................................................................................................................................................
5. Thông tin đồng chủ sở hữu nhà, đất (nếu có):
STT | Tên tổ chức/cá nhân đồng sở hữu | Mã số thuế | Số CMND/CCCD/Hộ chiếu (trường hợp chưa có mã số thuế) | Tỷ lệ sở hữu (%) |
| | | | |
| | | | |
6. Giấy tờ có liên quan, gồm:
- ................................................................................................................................................
- ................................................................................................................................................
Tôi cam đoan số liệu khai trên là đúng và chịu trách nhiệm trước pháp luật về số liệu đã khai./.
NHÂN VIÊN ĐẠI LÝ THUẾ Họ và tên:................................. Chứng chỉ hành nghề số:......... | ..., ngày....... tháng....... năm....... NGƯỜI NỘP THUẾ hoặc ĐẠI DIỆN HỢP PHÁP CỦA NGƯỜI NỘP THUẾ hoặc TỔ CHỨC, CÁ NHÂN ĐƯỢC ỦY QUYỀN KHAI THAY (Chữ ký, ghi rõ họ tên; chức vụ và đóng dấu (nếu có)/Ký điện tử) |
Nguồn: Thông tư 80/2021/TT-BTC