Appendix № 2

FORM

for determining the due fee under Tariff № 14 for the fees, collected in the system of the Ministry of Regional Development and Public Works and by the Regional governors

Section IV. B. Fees for commissioning of the constructions

Incoming. № …………………………………….
Claimant: ……………………………………………………………………………………………………..
……………………………………………………………………………………………………..…………..
(name, surname, last name/legal entity, represented by)
Personal identification number: ……………………………………………………………………………...;
BULSTAT Unified Identification Code: …………………………………………………………………......
permanent/current address or management address: …………………………………………………………
…………………………………………………………………………………………………………………
(region, municipality, town, street, number, entry, floor, apartment)
Tel. ………………………………………….; e-mail: ………………………………………………………

CONSTRUCTION (*): ………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
The full name of the construction is written, specifying the necessary parameters according to Decree № 321 of the Council of Ministers from 2003 amending and supplementing the Tariff № 14 for the fees, collected in the system of the Ministry of Regional Development and Public Works and by the Regional governors.

Administrative service and norm for determining the fee	Value of the fee *	

Commissioning certificate of constructions of IV category	
- under Art. 31c, Para. ….., item ….	
	
- under Art. 31c, Para. ….., item ….	
	
- under Art. 31c, Para. ….., item ….	
	
- under Art. 31c, Para. ….., item ….	

Commissioning certificate of constructions of V category	
- under Art. 31d, Para. ….., item ….	
	
- under Art. 31d, Para. ….., item ….	
	
- under Art. 31d, Para. ….., item ….	
	
- under Art. 31d, Para. ….., item ….	

(*) Specified by the claimant.

CLAIMANT: ………………………
(signature)

Value of the due fee: …………….…., in words …………………….……………………………………….
The due fee is paid in cash on the counter of the Regional administration Veliko Tarnovo
with receipt № ………………….……………………..
The due fee is paid with payment order № ………………………………………………….
on the account of Regional administration Veliko Tarnovo: IBAN BG26UNCR75273141156401
in bank UniCredit Bulbank Veliko Tarnovo, BIC: UNCRBGSF

The payment document is verified by: …………......
   (signature)
Name: ……………………………………...……….
Position: ……………………………………………