TO BE SUBMITTED TO THE MINISTRY OF FINANCE

… REVENUE OFFICE

ASKING FOR TIME :

Address :

TAX AUTHORITY :

REGISTER NO. :

Subject: Time prompt.

INSTRUCTIONS

1 -) I am in hospital as a result of a traffic accident. Therefore, it is impossible for me to fulfill my obligation to make a declaration that must be fulfilled within the month and to pay the second installment of Income Tax.

2 -) VUK. m. I respectfully supply and demand that a period be given until the date of 17. …/…/…

(First Name, Last Name, Signature)