cu noscand prcvcdcrile art. 292 din Codul penal privind falsul 111 dccla ratii, decla r pc proprio raspunde recii imprcunii ell familia I)detin urmiitourele:

* j ) Prill Iarnilic se In(clege sotul/sotia .5icopiii aflati ill intretinerca accsiora.

1. Bunu ri iniobile

L TcrcnuriNOTA:Sc VOl' declura inclusiv cele allate III alic Uiri.

, .i _ ,"' 'n: 'j.,~ • /~ ,.~ •• ,'>, .. ~drcs~~~'au zona".'!;;;__:' .-. .- " .ii

r----------------------~------------+_----------~------~-------,-----------~------------~rl

I---------~----------~--------+-------.r-----------------------~ I,

j~--------_j

I

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)II___ ..J. .., .l_ ....J --L --'- _-_ .._---

* Catcgoriilc indicate sunt: (1) agricol: (2) forestier; (3) intravilan: (4) luciu de apa; (5) alte caicgorii de terenuri"'(lravj lane, dacfl Sf: anii III circuitul civil.

) La "Titular" sc mcntioncaza, 111 cazul bunurilor proprii, numelc proprietarului (titularul. sotul/sotia, copilul),i.u in cazul bunurilor III coproprierate, Cola-pane ~inumelc coproprictarilor.

2. cu.n.:

NOTA:Se VOl' dcclara inclusiv cele aflatc in aile tari.

I I' Ii1---·----------t------t--------.----t-----jr-, ----jir-------J---l--------f---I,I __--!--_--1---

1

i ~I----.j J

'" Categoriilc indicate sum: (I) apartamcnt; (2) casa de locuit: (3) casa de vacanta: (4) spatii comerciale/deproductic.

*2) La "Ti tular" S~ men] ioncaza, in cazul bunuri for propri i. numclc propricrarulu i (I itularul. SO\l! l/so; ia, copi lul),jar 111 cazul bunurilor In coproprietate, cota-patrc s+nurnele coproprictarilor.

II. BUI111ri mobile1. Autovcb iculc/auroru rismc, tracrua rc, masin i agricolc, salupc, ia h t uri $i altc m ijloucc de transport

care sun t supuse iu mn tr icu ljirii, pctrivit Icgii

II,'~.~~:,i.{,~,i,i~.~."J,t~'.~h~'_~:_,~_~~I_"~'~',~_J~:.,,:_~~:,,~~a.~,L,11~~'C,~·,;.,~~',.'.~~"S.:~~_!"_"_;IJ_'~_r_~~(,I.,_~_~~_~;~~~.:~i_r_i~:_~~I_li~I[~'~~lC~~'~~~b_'I~'i~~~;~~l=~~q:I~I~i_~~~~~i~O~'d~U_I_d_~~~~IO~b~~~ftl_~(~IIL:~~~~~. ~~ ._ I .. .. ·<~i~:; ." ~ . . . I ,,~~_ • ',,!",' ',' -'('~i~ :~"'J",', .:,... ,_ !-~ '. <' t.-".;:;~.{ ,.

~ -I III--------..--+I==========.-I-jl--~_-_-_-_-_~----~~~·----~_-j+-------~---_-_---_-------J__J~

I i

2, Bunu ri sub formi"i de mcrale pretioasc, bijutcrii, obiecte de arti'i ~i de cult, colecrii de arb'! Sinumismatica, obicctc care fac parte din pat runouiul cultural na tiona l sau universal, a caro r valoarcinsuma ta dcp;l~ql c 5.000 de ell 1'0

NOTA:Sc vor mcniiona roatc bunurile aflatc III proprietatc, indifcrent dnc:il clc sc nlla sat! !1U pc lcri!oriu! Romanici

la momentul dcclararii.

1::r:,i';J}}Wfj}~t~:';fJ:~~~'~ii~~';~~~·;·~i~:i~.i~~:~;t1~':';;·17i'.'.:,~,;;~'INr;fif''t'A~ilWl~J?:~ft'il:(i~~'i·i::;'~.i:;;,',;'.i':;!;~::: 'i;;'!t~Ji.f~:~~ft;YW~~$;,~~riJstl!It~.f.~c~,;~~:~·r!t'~,,',,'j

I II I

Ill. Bun uri mobile, a carol' valoare dcpascste 3.000 de curo ficca rc, si bun u ri iniobile instrainarc IIIult imcle 12 lun i

I2

IV. Active tinaucia rc

1. Contu ri .si dcpozite banca re, fouduri de invcstitii, forme cchivalcnte de ecouorntsh-e ~. Iuvcstire,iuclusiv ca rdurilc de credit, dad valoarca IllslIlllata a tuturor uccsro ra depasesre 5.000 de euro

NOTA:Sc vor dcclara incluxix cclc aflaie in bane: sau instituti: financiarc din s{rfliMltatc.

If .' Institutia cure admin isrreazii .\I,cIJut','l '., ,I)'cs"'cill's AlII anul ":'. :':Si'I)/ 1:'; """'1'\ {': '-:--r/' .', . ( ... ,T.ipuI* ,; ';:;;"'\;." ,.0 ( va o~X~ )l:.~L:..; ",

J ,.' :~., '.§l a( resa accstcia, . 'C', ";: '·'U,. .' .',:, :,-:: .c.: .... '. ·,'·.~n1:'·;··;, .. .' ,:i;'.{·"" -, " .',,': .·';, ..)-',"c~.,!''''''':-, , ":'.

rr-I--------------------------I--------~------~------------~--------------------~I I

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"Categorulc uutrcate sunt: (/) coin curent sail echivalcnte (inclnstv card): (2) deposit bancar sauechivalente: (3) _I()JI(/Ilri de investitii \'(11/ echivalcnte, iucl usiv [oudnri privat« de pensi! .\'(/11 {tire sistetne Ci(

actunularc (se \'01' declara celt: aferent« anuluifiscal anterior).

2. PlaSlIIllCIlI'C, illvcsti{ii d ircctc ~iimpru mutu ri acordatc, daea valoarca de pialii lllsumat:'i a tutu ro r

accstora dcpasesrc 5.000 de CUl'O

NOTA:Sc VOl' declara inclusiv invcstitiilc ~iparticiparile 'in strainatate.

,i ;'.:lt11ii,{eM'til-lil(Socictu (eli III' ca re 'persoana este :';, ':i;'T; :;.:I'~:.·;··>'~Nll'Il1U r d lhiO.il d(...·'acriouar suu asociat/bcueficiar dc'Iui,J!:umut'.' .:'": .1Pl!.,':' cora de participarc '.

-

I IIi

"Categorii!« iudiau« .\'II//r: (/) luirtii de valoarc detiuut» (titlur! ell! stat, certificate. ob/igo/illni): (2)(it'filllli ,\'(//1 /)(II'(i sociulc /11 ,\'(lcie/(i{i comerciul«: (3) Imprunnnuri acarclatc ill 1111111('I)(!I'S()II (1/.

3

,'111 :

3. Altc active p rnducii lou rc de vcnituri nctc, care insu marc dcpascsc cch iva lcnru l a 5.000 de euro pc----•••..•. , ••••••••••••••••••••••••••.•• , .••.•••••••••••••••••••••••.• ,., •••••••••• , , e'·· .•••••••••• ' ••

.. -, - .....•....................................................... _, .......•... ", .........••.. ····.0 , .................• _, ..........••....

... _._ .NOT;\.;Sc vor dcclara inclusiv cclc aflate in sirainatatc.

V. DatoriiDebito, ipotcci, garalllii cruise 'in bcncficiul unui tert, bu nu ri ach izitionnte III sistcrn leasillg ~i altc

ascmcnca bunmi, dad va loarca Illsllmala a rururor acesrorn dcpa$c$tc 5.000 de curo

~OTA:Sc VOl' dcclara inclusiv pasivclc financiarc acumulatc in strainarare.

> "Scadent la;, "'," -: ., .... ' .

'.:' :.",;~.4 ".~/.··c .

I!I

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VI. Cadouri, scrvicii sail avantajc primite gratllil san subventionnte fllril de valoarca de piara, dinpa rrca uno:' pcrsoane, organizatii, ~oci(~ti'ili comcrcialc, rcgii autonomc, companii/socictati nationalc Still

inst it u tii publico romancsti sau striiin e, inclusiv bursc, crcdire, ganlntii, dccontari de chcltuicli, allele dedit'cclc ale a ngajatorului, a carer valoarc in dividua la dcpascsre son de curo=

I.! Titular

"~:.Sli.:sii vcnitillui::;":':-:, '::.. Scrviciulprestat/Obicctul :', ':llhmeIe;"adresa -/.:" ,:;~~;" ;: 'ge'ileratol::dcyeilit' .;, ': ".-

II

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'Venitul n'nuaI -,~ • +_ .A .... • •

. ~;c • ),Ilcasat'i"

.. 0.\:;, .' " .. , •. :: . .: . 0:- ;.: .:, .;" f:...,Cine.a realizat vcnitul .. :.,

': ::. ~•••• ,,;.~:. " .: "L· • !.o: .;..:. .~~::....e, .::.

I

Ii 1.3. Copii

"Se exccjJl('(/:;{t de 10 dcclarnre cadouri!e .~'i/1'{[I(I(ii/(' 11::1I({/Cprimite din partca rudclor de gradul l si al l l-lc«

VII. Veniruri ale dccla rautului ~i ale membrilor siii de Ia milie, rcalizarc III ulriruul an fiscal Illcheiat(potrivit art. 41 din Lcgca n r. 57112003 privin d Codul fiscal, CI.I modificarile ~i (;()111pleta rile ulrcriou ro)

NOTA:Sc VOl' dcclara inclusiv veuiiurilc provcnire din strainat:illc.

Cine 11 rcalizatvenirulSursa veil itill IIi:

. 'l1lll11Clc,adresa'-', Serviciul prcstat/Obicctul

.. " ::'.' ':'.' cncrator de venit.' .11. Veuituri din salarii I[rl-.l.-T-i[L-da-r----------~~'~~~~~~=~~QWc~~~--~c-Qn-t-~~·~~------,~I-Jft·~gCb~~~~\

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I I ---------r---------------------+------------~~1.2. So!lso\ie

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Cupit-------------------~~------------------'--~--------------------.------------L

L________________________ ~ L_ ~ ~

12. Venio:!.!..··idin (.{c/il'itafi independenle12 i Titular

I

L--.1-2?-s~'-/-.-----------1----r-" o_t_s_o_lt_e --------1----------------+--

I, I .,., I.).1, j 1l11:11

13. Venituri din cedareafolosintei bunurilor

13.2. Soi/sotie ---------------.,-----------------------~----!r 4. Venituri din investitii

1. ; I'itu lar

i II'-------------------------+---------------------~------------------_,----------~14.1 Sot/so]ie I I !

l:?_:_.!:!~/_·1_1II_-j_(~~_'I_Je_'l1_s_i i-,-------~-----------------l----------.-------;r-----~[:S.L litular I I~------------------------, -------------------~ I I!---~.5.2. Soi/sotic

--------------_,

6. Veuituri dill activitati agricole i(i.I. Titular 1

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".' .:' ..,&. ' ....< ~y:"t,·..~t;·:i 'i' ''';;'.. '" ;~>·?:.':-~~:·~·~t...r·~"a'Tenitl~I.ti\~>~··;:'. "':.·.~erYid.',t1..PJ:<.esta.tlObicctl1i:T yellHi~!anual. IIle a I C.l Iza vent u "_" ", "',>.;.-~, •. ,. d ., .. _, ..., .. ". " '({ .... " .,.~. ''', ..,., .';;::.·....~,i ", . ....... :". ·.·.:;~;:,:-'?·Nume,a rcsa." '.:.'-- '": getlcrator CVCIIlt'·,·· ,"lllcasat \7. Venituri din premii si dinjocuri de 170~'OC

7.1. Titular !I :,

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7.2. Sot/sotie i

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7.3. Copli I_. -. - -I-- -

8. Venituri din alte surse- .JM~~~-~ifU -ft\rL~' j 9G8D~~,8.1. Titular Mlo/'[;J)

1~~'\:!9~ ~Ad),- ~ Ii .jI

8.2. Sot/sotic I <.:J j

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8.3. Copii i II J I

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Prczcnta dcclaratic constituie act public ~I riispund potrivit lcgii pcnalc pcntru incxactitarea sanca racrcrul incomplcr al darelor mentiouate.

Data coru p lctiirii

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? ava nd functiasU bscl11~~ II l/S 1I bS('fl1~,de eelJIJ..[) M<;. 1

cxr • domiciliul

cu nosciind prevcdcrilc <l1,"L 292 din Codul penal privind falsul ln dcclaratii, dcclar pe propria raspundere:

IT. AspCi~t' '~:lll:·U.ctiolla.I" la soci~(a ti. '¢o'l~l~dilile,;~c(iilii5a'iIWsoc~ct~ ri 11<; j'i()liale, .iilS~:1r4HL~J~.sre(F~,'g-r~'pil'1:r4c:., . ." • ..' ..•• ...~.,.< ,.~;.~. ,-••... ' ' '. I' I· . . ,!, .. ,"" ,~.,.~1-.'''' ~ .. ..,'- .,',- .. -_ ,.,.""'\.

j. intercs'ccon omlc; p iC_Eq III §i'li1(~nll)i"ii lif'asod~fii,if~ild.!!tU. sa'li illt'c 'oi·g~~.!i?:.aJ.i.i_!!_~gilV.e,i;ll}lmelltale.:,~:~}.~~:,::,::.~io::,:'" . 'I'" . . f! Nr. de pani I Valoarea totala ai Uniiatca fi Calitatea detinuta i snci.ale sau II partilor sociale!I - dcnumirea :;;i adresa - . ! de <iqiul1i I ~ilsaLl a actiunilort-, 1--'-- -----I-T- -----1---· - i! [.1..... I/ -... --- ---_.- .. ----.-. .- .. -._-- ... roo -- - --"-j---r- .-;i- ------ += _.iL____ _ -1-.-------~-.-------L; - -- -I !-----.---I I :!. . , '. . .' .. .,...... . . ..-..... . .' '.' ... -.' .. . .... . ..I·_}:-_.~~lit~te~·.de' rnembru Ill·"0r.g~~~le.:~,~~~~~ll.~uCe·~~e;;a_q_ll~iJl.i~_trar~·~i con trol ale')Q~~e;!~ti!61:.,(:ql!}~~:cialci:flleI.i j'~~WB!~~::~~t ~JtQ l.l!·C,.al:~' c~ii.~.tl,~.!.i~..~?·~~{~?f!*,t;n~.~~,l;~.~.~.tio~:\a,~~~.a!e~)r_~~.tj~!~t,ii101: ~l~ <:.~·:~~!tfi~!.,~;:t:y.g,~·~g~r~.f~}~t~,l:~.~.;'):!conom Ie; a lC'usocllltlllor sa u funda tnloI:'op al~;a.ltol~:orga,llIzfl tIl. neg llvcrnamentale: .:,L~~~,;-;;< •• _,:~":~~' ,.,,;.; ',) "'ci \. ..i., ,. . i

\...;i narca Calitatea dcunuta Valoarea bencficiilor~IHlmir~lji aC:!Iesa- l_ _! ,

j.}J_. ',".. ~= __ j ._ --_J[- - ---- -.- - -_ ----- . -'-4 -1.. -_....... - --.- 1-.- -.. .-~.---.-. -- .. -- .---1. I I •. ----.- , t -- --I' -----11~'~::b'ifrgrti~~~'1H'e'jirb'T{i';i'i{KR tl i:'ii I :)l~oH~~f-mO'I~'''I;:"N;m'jol~''~{i{siisalli:s'lj'l'd ica'Ic'?r.C"·:·~:i?10·~w;r;;:i-ll'~~~j:~~;~~~k.{;",g;':?l~lil,';ib;\~~}:'~~~;i,W~".;::rj~:.~..I.. f _' "., ,'. ..I' • t" •• ,_ •• ,"',_ ,_~.~ "', ,') ,,:-,.;' • ' " :.,.'~::''..: •.•• -~,·.", .•:·;:·\:(;·'''.:".1::'.~.t.·''';''''·'''(:'''''f'"i';.':~

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!r--,L .~_.. _ __. . __..- ---~, ---:-:-:;-:--,~-:-~-;--~~--,._"..--.-jj·:4. ·.C.a)~~'M~a 'dejriicmbru . III 'oi'gaii~~~':qeT~oIf~ueei~~::a(lil~illis(i'ai~c ':~Ccontrol," !·ctriJfuit~:;:s.·<i~t~.~i·:eff.W~iJc;?:, - ·";.r , ..~ ..... ..~ ' ..... " . I • • • " .,' • ..! ....... • - •.....L·.'.·t-:... ~'.~.-.. ...... ' .~'.', .. _. ( . ., ..... <t -: to,. '. ',,_ !> ' : ,- ~.-~ •• ~, ... " .o;: • ..-.J-i.~''', '~""'" ....-........ -.. ,_.,

;.·d~ i~iu te III 'eitelI'll)' artidclol:_' )olitic'cdtiii~' ii defiittitif'si dC£llimirca ~~tidului' JOliti<;:·,~·;;j;':'::;:-':...\'H~~i:::t>·;;·~;3·.',,~;.:.~':='\4.! ...... !

!------ ._---- :

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[-'5. C9ntnH:-{~~, inclusiv ~cJc de ~Isis('cilta juridicii,' consultaurii juridicii, eo;.s;J!bl~~l ~j ei~'ile, obtinute.ori aflateIll'} d~~:~r~lI~~.II{..t~1l~1PI~I..~~cr~~:al:i.~/l~~~~~j~I(~r~)~~~u~dJ~,~e~OI~,~~~u:.d.~I~lI}.itati!o r I)UI.),I~c~.c!!.n~nf~t,e~c.}~~·..~~~gctt.l!·de.! s.tat; I.?Ctl.I_~~:d!.J,l.iHIl(h.ln cxt:C~·~lC,.~!.·1Ir~,~I~~.I~t~.p~.:S.?-f~l~y~tle(~IJ~c.I,·~!!~I~..cU,~aplt~I.(~~. st~,t.,S.~~U}I.!!,~~.t.~~·~~:~!l}cst~.I·. ;1C 1-10 1l::n~'1ll ilJ O·l'i ta r/rn ill 01'1' til r"" .;~ :,,g·<~··i.,:,\,c ..,<:'·::·.".;· ;,.~, :'>i~··J:<,..;;;,i'\:i;'·':·!f"'i :'.',."'.:,' s> ", ~. :..• "'. ;'t·. . ../:'.' '.: : .,:. '." :'""'.;,, ;:"-1-;:·ir'-;~·~~<::l·.~:." ..~,.';.; . '.' I} C 1 1 , _ ~ _ ,t ."'~' .~\'1 ".',;,\··:".~i,,:)., ..~,:·_~l"·~.·l,~.\"("'\l·,,'Y:)~.~ '•.•••.. ,.. 1,; .," "'\":'~": !c" " , .•• I ,:..,·l:··.i'~k·S····~·""">r;o~ : ,·,.,·.·....e.·!.1'oI~·~~

: 5.1 BCl1cfici~Ul.ll(!cCOI1(~(IC!: nuucle, Insti(utia_ I Pn:x.:cdlll~l p!in, TiplIl.! Dal:l ! Durma Vakxui .."8!1 plenUIl ~clcI<1Ci'll1lr~'ta ~I :ldl1..~: . COIl~(lCi~Ul(~:.._L__~<u\.:_~~~1 .: COlllJ,lC(lIIUI Illdl\;iClii .. ~O!~[J<1C~l.I~li (u(aIJtl

! Socieliiri comerciale/ Persoana fizic3I! autorizalai Asociatii familiale/Cabinete

cOlllmuuill:

I" .i

I indivicaale, cabireie asociate, s<xiciatir civil: ~)lDICsiona~e~IU socje~illjCi\~k:i pro(c,,><;IOJlale ell l'aspunc!cre liml!ara cae! dcs1A~)(u~1pmfesia de [lVlxa(/ Ogani7£1lii ! !L~~~:ell\CI!l1el1~aleiFundaliil J\g_x::ia\i?) .J __.__.-. ._.J __.__ . ...l__

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I II ,___ .__ J. ;l) Prin rude de gradul I se intelege parinti pe linie ascendenta $i copii pe linie descendents.

:-!) Se vor dcclara nume!c. dcnurnirca $i adresa beneficiarului de contract unde, prin calitatca detinuta, tirularul.sotul/sotia $i rudele de gradul r obtin contracte, asa cum sunt definite la punctul 5. Nu se declara contractelesocietatilor comcrcialc pc aciiuni la care declarantul impreuna ell sotul/sotia ~i rudcle de gradu) I dctin mai putin de5%) din capitalul social 81 socierarii, indifercnt de modul de dobandire a actiunilor.

Prezcn ta dcclaratie co nsriruic act public ~l raspllncI potrivi: lcgii peuale pCIIITll incxacriratca sauUi racter ul incornplct a l darclor mcntionarc.

Data complcriirii

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2