------------------------_.

" UY BAN NHAN DANHUY¥N ViNH THU~N

s6:c}:tf> IUBND-PNV

CONG HOA XA HOI CHU NGHiA VI¥T NAMDQc I~p - T\f do - H~nh phuc

Vlnh Thudn, ngay 15" thang 12 ndm 2020VIv thuc hien kS khai tai san,

thu nhap nam 2020

Kinh giri:- Thu tnrong cac phong, ban chuyen mon/cac don vi S\Inghiep thuoc Dy ban nhan dan huyen;- Chu tich Dy ban nhan dan cac xa, thi tran;- Chu tich cac HQiduoc Dy ban nhan dan huyen giao bien chS;- Hieu tnrong cac tnrong Mam non, TiSu hoc, Trung hoc CO' satren dia ban huyen,

Can cir Luat Phong, chong tham nhiing (PCTN) nam 2018; Nghi dinh sb130/2020/NU-CP ngay 30 thang 10 nam 2020 cua Chinh phu v~ kiem soat taisan, thu nhap cua ngiroi co chirc vu, quyen han trong CO' quan, t6 clnrc, don vi;

• I'" 'Iii

Can cir Cong van sb 367/TTr-PCTN ngay 03 thang 12 nam 2020 cua ~~Thanh tra tinh Kien Giang v~ huang d~n mot sb nQi dung ke khai tai san, thu11 (1fTi.~h " ¥ 2020 \\~I ~h'it.J~"n ap nam . ,,~\ . ·4""//;"

• \~ \ '~~~!!

~hu ~ieh ~Y,ba~ nhan d~ hu~~n yeu cf!u Th? tn:~g cae dan vi neu tren~th\Ic hl~n ke khm tm san, thu nhC;lpnam 2020 thea cac nQl dung sau: .-

1.PhU'O'ngthuc, thOi di~m ke khai va m~u ban ke khai

- Theo quy dinh cua Lu~t PCTN nam 2018, Nghi dinh sb 130/2020IND­CP ngay 30 thang 10 nam 2020 cua Chinh phu v~ kiSm soat tai san, thu nh~pcua nguai co chuc V\l, quy~n hC;lntrong CO' quan, t6 chuc, don vi. Nam 2020 lanam d~u thvc hi~n ke khai tai san, thu nh~p thea quy dinh cua Lu~t PCTN nam2018 va Nghi dinh sb 130/2020IND-CP, tfit ca nguai co nghla V\l ke khai tai san,thu nh~p phai th\Ic hi~n ke khai lfin dfiu.

- Ubi tuqng ke khai thuQc th~m quy~n quan ly cua Dy ban nhan danhuy~n, g6m:

+ Tfit ca can bQ, cong chuc huy~n;

+ Truang, Pho cac dan vi S\I nghi~p tr\Ic thuQc Dy ban nhan dan huy~n;Hi~u truOng, Pho Hi~u truOng cac TruOng M~m non, TiSu hQc, Trung hQc CO' sa.

+ Chu tich, Pho Chu tich HQi d6ng nhan dan, Dy ban nhan dan; cac chucdanh cong chuc cfip xa, thi trfin (tru chuc danh TruOng Cong an la Cong anchinh quy).

2

- M~uban kSkhai: Thuc hien kSkhai tai san, thu nhap theo Phu luc I banhanh kern theo Nghi dinh s6 130/2020/NI)-CP ngay 30 thang 10 nam 2020 cuaChinhphu.

LU'u V:

+ Nam 2020, t~t ca cac d6i nrong co nghia V\1ke khai thirc hien kS khailftn dftu, do do khong phai ke khai M\1cIII "Bi~n dQng tai san, thu nhap, giaitrinh nguon g6c cua tai san, thu nhap tang them" va khong kS tong thu nhap gitra02 lftnkSkhai.

+ Khong nr y thay d6i ten goi, thir tu cac noi dung quy dinh tai m~u, n~unQidung nao khong co thi dS trong.

+ Ngiroi kS khai phai ky ten tirng trang va ky, ghi ra ho ten, ngay thangnam a trang cu6i cling cua ban kSkhai.

+ Viec ke khai (kS ca kS khai b6 sung hoac kS khai Iai trong truang hqpban kS khai khong dung theo m~u ho?c khong dfty du vS nQi dung) phai hoanthanh truac ngay 28 thang 12 nam 2020.

2. T8 chuc vifc ke khai tai san, thu nh~p

CO'quan, t6 chuc, dan vi quan ly, su d\1ngnguai co nghla V\1kS khai t6chuc vi~ckSkhai tai sim, thu nh~p, nhu sau:

- L~p danh sach nguai co nghla V\1 kS khai gui vS Phong NQiV\1 truacngay 22 thang 12 nam 2020;

- Huang d~n vi~c kS khai tai sim, thu nh~p cho nguai co nghla V\1kSkhai·,

- L~p s6 theo dai kSkhai, giao, nh~n ban kSkhai.

3. Ti~p nh~n, quan Iy, ban giao ban ke khai

- Nguai co nghla V\1 kS khai co trach nhi~m nQP 02 ban chinh cho cO'quan, t6 chuc, dan vi trgc ti~p quan ly minh.

- CO'quan, t6 chuc, dan vi trgc ti~p quan ly nguai co nghla V\1kS khaiphan cong can bQ,cong chuc co trach nhi~m ti~p nh~n ban kS khai. Khi nh~n,kiSm tra tinh dftydu cua ban kS khai; ky va ghi ra h<>tSn, ngay thang nam nh~nban kSkhai, C\1thS thgc hi~n cac buac sau:

- f)~i di~n cO'quan, dan vi c~phuy~n, UBND cac xa, thi tdn nh~n 02 bankS khai (ban chinh) cua can bQ,cong chuc, viSn chuc thuQcqUYSnquan ly cuaminh; photo va lUlll~i 01 ban photo t~i dan vi dS thgc hi~n vi~c cong khai bankS khai tai san, thu nh~p theo quy dinh; l~p danh sach nguai da kS khai, gui

3

danh sach kern thea 02 ban ke khai (ban chinh) cua ngiroi ke khai vS Phong NQivu huyen tnroc ngay 05 thang 01 nam 2020.

4. Cong khai ban ke khai

- Viec cong khai ban ke khai co thS duoc thuc hien bang mot trong haihinh thirc: Niem ySt ban ke khai 15 ngay tai co quan, t6 chirc, dan vi noi nguoike khai thirong xuyen lam viec hoac cong khai tai cuoc hop thea quy dinh taidiSm b, c, d Khoan 1 DiSu 11 Nghi dinh 130/20201ND-CP ngay 30/10/2020 cuaChinh phu, C\l thS:

+ Ban ke khai cua Chu tich, Pho Chu tich HQi d6ng nhan dan, Uy bannhan dan huyen diroc niern yet tai tru sa HQi d6ng nhan dan, Uy ban nhan danhoac cong b6 tai cuoc hop bao g6m toan thS can bQ, cong chirc thuoc Van phongHQi d6ng nhan dan va Uy ban nhan dan.

+ Ban ke khai cua ngiroi co nghla V\lke khai thuQc phong, ban, dan vi svnghi~p, HQi c~p huy~n dugc niem ySt t~i tf\! sa co quan ho~c cong khai t~i CUQC

hgp ba: !~::::is ::: :::::~ :;:~ v~nk:h:~i thuQc HQi d6ng nhan dan, ~;~

Oy, ba~ nh~n d~n c,lipxii dugc ni~m y,\t t;J_itf\);6,HQ~d6~g nh~ d~, Oy ban 11!E~nhan dan xa ho~c cong khm t(11 cugc hgp loan the can bg, cong chuc xa; ~~;/;

+ Ban ke khai cua Hi~u truang, Pho Hi~u truang cac truang dugc niem .7ySt t~i cac truang ho~c cong khai t~i cUQch<)ptoan thS vien chuc.

- Thai gian hoan thanh vi~c cong khai ban ke khai cua nguai co nghla V\lke khai ch~m nh~t ngay 10 thang 02 nam 2021.

Qua trinh thvc hi~n co kho khan, vuang m~c, cac co quan, dan vi phananh vS Uy ban nhan dan huy~n (qua ale [Joan ehuyen vien Phong N(ji v~ huy¢n)s6 di~n tho~i 0918 614 151 dS dugc trao d6i, huang dan.! ~

NO'inh{in:- Nhu tren;- CT, PCT UBND huy~n;- LDVP+CYNC;- Website VTnhThu~n;- Luu: VT, tnda.

, .UBNDTiNHC

BCONG HOA xA HOI em)NGHiA VIET NAM. . .

DQc l~p - TV do - H~nh phuc

BAN ICEKHAI TAl sAN, THU NH~P LAN DAu(Ngay ..... thang ..... nam 2020)

I. THONG TIN CHUNG

1. Ngiroi ke khai tai san, thu nhap

Ho a, ten Nga tha - inh- . v e: , yang nam Sl : .

- Chirc vu/chirc danh cong tac: ..

- Ca quanl dan vi cong tac: .

- Nai thuong tru: .

- S6 din circe cong dan hoac giay chirng minh nhan dan: ., ,ngay cap noi cap: .

2. Vq hoac chong cua ngiroi ke khai tai san, thu nhap: khong co

H 't~ N ' tha - inh- Q va en: gay ang nam Sl :

- NghS nghiep: ..

N '1' .~- a1 am V1~C: ..

- Nai thuong tru: ..

- S6 din circe cong dan hoac gi~y clnrng minh nhan dan: ., ,ngay cap noi cap ..

3. Con chua thanh nien (con de, con nuoi thea quy dinh cua phap luat):

3.1. Con thtr nhat:

H 't~ N ' tha am sinh- Q va en: gay ang na Sl :

- Nai thirong tru: .

- S6 can circe cong dan hoac gi~y clurng minh nhan dan: ., ,ngay cap noi cap ..

3.2. Con thir hai :

II. THONG TIN MO TA VE TAl SAN

1. Quyen sir dung thirc tS d6i voi d~t:

1.1. f)~t 6:

2, '

1.1.1. Thua thir nh~t:

- Dia chi: Duong D, Khu ph6 A, thi tr~n B, Huyen B, tinh C

- Dien tich: 500m2

- Gia tri: 100.000.000 d6ng

- Gi~y clnrng nhan quyen sir dung: AVOOOO,s6 thira 10, to ban d6 11, doSa Tai nguyen - Moi tnrong tinh Kien Giang c~p ngay 10110/2010, ten ngiroisir dung d~t Nguyen Van A.

- Thong tin khac (neu co): dang cho thue

1.1.2. Thira thir 2 (tro len): Ke khai nrong tu nhu thira thir nhat,

1.2. Cac loai d~t khac:

1.2.1. Thira tlnr nhat:

- Loai d~t: d~t nong nghiep, Dia chi: Khu ph6 A, thi tr~n B, Huyen B, tinhC

- Dien tich: 1000m2

- Gia tri: 200.000.000 dong

- Gi~y clnrng nhan quyen su dung: AVOOO1, s6 thira 11, to ban d6 12, doSa Tai nguyen - Moi tnrong tinh Kien Giang c~p ngay 05/5/2015, ten nguoi sirdung d~t Nguyen Thi B.

- Thong tin khac (neu co): dang cho thue

1.2.2. Thira thir 2 (tro len): Kc khai nrong nr nhu thira thu nh~t.

2. Nha a, cong trinh xay d\fllg: khong co

2.1. Nha a:2.1.1. Nha thu nh~t:

- Dja chi: s6777, DuOng D, Khu ph6 A, thj tr~n B, Huy~n B, tinh C

- Lo~i nha: c~p 4

- Di~n tich su d\lng: 100m2

- Gia trj: 200.000.000 d6ng

- Gi~y chUng nh~n quySn sa hfru: chua duQ'cc~p gi~y

- Thong tin khac (nSu co): :.

2.1.2. Nha thu 2 (tralen): Ke khai tuang t\1'nhu nha thu nh~t.

2.2. Cong trinh xay d\fllg khac:

4, '

T " A h';" S;" 1 G' , t .- en co p leu: 0 UQllg: la rl: .

T " A h';" S;..I G' , t .- en co p leu: 0 UQllg: la rl: .

6.2. Tnii phieu:

T" tra hi J.. S J.. I G' , t .- en ral p leu: 0 UQllg: Ia q: .

T " tra h';" S;.. I G' , t .- en ral p leu: 0 UQllg:........... la rr .

6.3. V6n gop:

- Hinh tlnrc gop v6n: dAutu kinh doanh, Gia tri: 50.000.000 d6ng

6.4. Cac loai gifiy to' co gia khac:,

T" ." t' , .r G' , .- en glay a co gla: la tn: ..,

T" ." " , . , G' , .- en glay to co gla: la tri: .

7. Tai san khac rna m6i tai san co gia tri tir 50 trieu d6ng tro len, bao gorn:

7.1. Tai san thea quy dinh cua phap luat phai dang ky srr dung va diroccfip gifiy dang ky (tAu bay, tAu thuy, thuyen, may ui, may xuc, 0 to, mo to, xeg~ may ...):

- Ten tai san: xe mo to, S6 dang ky: 68-V1 00001Gia tri: 30.000.000d6ng

- Ten tai san: xe mo to, S6 dang ky: 68-VI 00002 Gia tri: 20.000.000d6ng

- Ten tai san: may xuc, S6 dang ky: IIIIIIII Gia tri: 50.000.000d6ng

7.2. Tai san khac (d6 my ngh~, d6 th0' cung, ban ghS, cay canh, tranh, anh,cac lo~i tai san khac )C25):

- Ten tai san: ban trim, Nam b~t dAusa hfru: 2015 Gia tri: 30.000.000d6ng

- Ten tai san: ghS sofa, Nam b~t dAusa hfru: 2015 Gia tri: 25.000.000d6ng

- Ten tai san: cay canh (3 cay mai) Nam b~t dAu sa hfru: 2019 Gia tri:50.000.000d6ng

8. Tai Siill a nuoc ngoai.

9. Tai khoan a nuoc ngoai:

T" h? t" kh ? ;..t" kho?- en c u al oan: , so al an: .

- Ten ngan hang, chi nhanh ngan hang, t6 chilc nai rna tai khoan: .

10. T6ng thu nh~p gifra hai IAnke khai:A nh"'? " . k" kh .- Tong thu ~p cua ngum e al: ..

- T6ng thu nh~p cua vg (ho~c ch6ng): .

- T6ng thu nh~p cua con chua thanh nien: ..

3

2.2.1. Cong trinh thir nhat:

- Ten cong trinh: nha kho, Dia chi: Duong D, Khu ph6 A, thi tran B,Huyen B, tinh C

- Loai cong trinh: nha, c&pcong trinh: IV

- Dien tich: 100m2

- Gia tri: 50.000.000 d6ng

- Gi&yclnrng nhan quyen So' htru: .

- Thong tin khac (neu co): dang cho rmron2.2.2. Cong trinh thir 2 (tro len): Ke khai nrong tu nhu cong trinh thir

nh&t.

3. Tai san khac g~n liSn voi d&t:

3.1. Cay lau nam:

..Loai cay: cay dira, s6 IUQ'Ilg:10 cay, Gia trj(10):30.000.000 d6ng

- Loai cay: ca cao, S6IuQ'Ilg: .10 cay, Gia trj(10):25.000.000 d6ng

3.2.Rung san xuat:L ., . D·" , h: G· , ·(10).- O~lrung. l~n tIC la tn .

L ., . D·" , h: G· , ·(10).- O~lrung. l~n tIC la tn .

3.3. V~t kiSn true khac g~n liSn voi d&t:" .. ;.. . , ·(10);- Ten gQ1. So IUQ'Ilg Gla tri ." .. ;.. ., ·(10).- Ten gQ1. So IUQ'Ilg Gla tri .

4. Yang, kim cirong, bach kim va cac kim loai quy, da quy khac co tonggia tri til 50 trieu d6ng tra len:

- 05 chi yang 24k: 20.000.000 d6ng

- 1nhftn kim cuong (5Iy): 30.000.000 d6ng

5. TiSn (tiSn Vi~t Nam, ngo~i t~) g6m tiSn m~t, tiSn cho yay, tiSn tratruac, tiSn gui ca nhan, t6 chuc trong nuac, t6 chuc nuac ngoai t~i Vi~t Nam rnat6ng gia trj quy d6i til 50 tri~u d6ng tra len:

- TiSn m~t: 10.000.000 d6ng

- TiSn gui ngan hang A: 40.000.000 d6ng

6. C6 phiSu, trai phiSu, v6n gop, cac lo~i gi&yto' co gia khac rna t6ng giatrj til 50 tri~u d6ng tra len (khai theo timg lo~i):

6.1. C6 phiSu:

5

- T6ng cac khoan thu nhap chung: .

III. BIEN DONG TAl sAN, THU N~P; GIA.I TRINH NGUONGOC eVA TAl SAN,THU NH~P TANG THEM (niu la ke khai tai scm, thunhdp Idn ddu thi khong phai ke khai Muc nay): .

Tiing (30)/ghim(31) N{}i dung giaitrinh ngu8n g8e

Loai tai san, thu nh~p S81U'Q'ngGia tr] tai ciia tai san tiingsan, thu them vil tAng thutai sannh~p nh~p

1.Quyen sfr dung thirc te doi voi dat .-

1.1. f)~t a " I

1.2. Cac loai d~t khac

2. Nha a, cong trinh xay dung

2.1. Nha a ' ,.;

2.2. Cong trinh xay dung khac

3. Tai san khac gftn liSn voi d~t

3.1. Cay lau nam, nrng san xuat

3.2. V?t kiSn true gftn liSn voi d~t

4. Vang, kim cuong, bach kim va cackim loai quy, da quy khac co tong~ia tri tir 50 trieu d6ng tro len

5. TiSn (tiSn Viet Nam, ngoai t~)g6m tien mat, tiSn cho yay, tiSn traruac, tiSn gui ca nhan, t6 chilc trongInuac, t6 chilc nuac ngoai t~i Vi~tlNam rna t6ng gia tri quy d6i tiI 50I~ri~ud6ng tra len.

6. C6 phiSu, tfai phiSu, v6n gop, caclo~i gi~y to co gia khac rna t6ng giaI~ritir 50 tri~u d6ng tra len (khai theoirng lo~i):

6.1. C6 phiSu

6.2. Trai phiSu ,

6.3. V6n gop

6.4. Cac loai giay to- co gia khac

7. Tai san khac co gia tri nr 50 trieu~6ng tra len:

7.1. Tai san theo quy dinh cua phaplu~t phai dang ky sir dung va duocc~p gi~y dang leY (tftu bay, tftu thuy,huyen, may ui, may xuc, ° to, mo to,~e g~n may ...).

7.2. Tai san khac (d6 my nghe, d6ho cung, ban ghS, cay canh, tranhanh, cac loai tai san khac),

8. Tai san amroc ngoai.

9. T6ng thu nhap gifra hai lftn keikhai(32).

, h r ~..... ngay .... tang ... nam ....

NGUm NHAN BAN KE KHAI.(Ky, ghi ro ho ten, chuc vu/chuc danh)

6

Kien Giang, ngay ... thong .. ndm 2020

NGUm KE KHAI TAl SAN

(Ky, ghi ro ho ten)