Ex. 1 Statement of reconciliation

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Appendix 1 to the offset application No.contract number from date of conclusion of the contract

 

Reconciliation report No.номер from date of drawing up the act

 

Mr. place of signing

  

 

Organizational and legal form and company namein the face Name and position of the person authorized to sign the contractactinghis / her based Of the Charter (for the director of a legal entity) or power of attorney No. [] from [DD.MM.YYYY] (for a representative from a legal entity)Individual entrepreneur, represented by Full name of an individual entrepreneuractinghis / her on the basis of the certificate of state registration No.certificate number from date of issue of certificate («Initiator of offset»), on the one hand, and

Organizational and legal form and company namein the face Name and position of the person authorized to sign the contractactinghis / her based Of the Charter (for the director of a legal entity) or power of attorney No. [] from [DD.MM.YYYY] (for a representative from a legal entity) Individual entrepreneur, represented by Full name of an individual entrepreneuractinghis / her on the basis of the certificate of state registration No.certificate number from date of issue of certificate («Set-off side»), on the other hand, together referred to as the "Parties", carried out a reconciliation of mutual settlements, about which they made this act.

 

1. In accordance with the contract type of contract numberномер from DD.MM.YYYY The initiator of the set-off owes the Party of the set-off amount in figures (amount in words) white rubles.

2. In accordance with the contract type of contract numberномер from DD.MM.YYYY The side of the offset owes to the Initiator of the offset amount in figures (amount in words)White rubles.

 

According to the Initiator of the offset, rubles.

According to the offsetting Party, rub.

number

p / p

Name

operations, documents

Debit

Credit

number

p / p

Name

operations, documents

Debit

Credit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. The parties confirm the existence of debts in the amounts specified in clauses 1 and 2 of this Reconciliation Act, for DD.MM.YYYY.

 

Initiator of offset

 

Set-off side

 

Organizational and legal form and company nameIndividual entrepreneur
Full name of an individual entrepreneur

Organizational and legal form and company name Individual entrepreneur
Full name of an individual entrepreneur

Address: address

Address: address

UNP UNP

UNP UNP

R / s P / s number

R / s P / s number

в Bank's name

в Bank's name

Bank code Bank code

Bank code Bank code

address of the bank address of the bank

address of the bank address of the bank

 

On behalf of the Initiator

 

 

On behalf of the Set-off Party

 

___________

____________________

___________

___________________

signature

full name

signature

full name

Printing

Printing

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  • Offsetting mutual claims

    We present to you samples of an application for offsetting counterclaims and a reconciliation statement, which were developed by Borius Consulting and are available in our program for documents. Samples are suitable only for business entities - legal entities and individual entrepreneurs of the Republic of Belarus. We have taken into account all the requirements of the Belarusian legislation.