Plné znění - 343/2004 Sb.

Vzor xxxxxxxxx xxx xxxxxx xxxxxxxxxx xxxxxxxxxx xxxxxxx xxxxx v jazyce xxxxxx, anglickém a xxxxxx:

XXXXXXXX

Xxxxx xxxxxxxx, xx xxxxxxx/xxxxxxx xxxxxx platidla x xxxxx xxxx xxxx xxxx, xxxxxxxx xxxx xxxx xxxxxxx xxxxxxxx směnitelné za xxxxxx xxxxxx, xxxxx xxxxxx na xxxxxxxxxx xxxx xx xxx xxxxx vysoce xxxxxxxx xxxxxxxx, xxxx xxxx xxxxxxxxx xxxxx xxxx xxxx drahé xxxxxx (xxxx xxx "xxx"), x xxxxxx xxxxxxx xxxxxxxxxxx 15&xxxx;000 EUR, xxx xx xxxxxxx xxxx.

Xxxxxxxx xx xxxxxxxx xxxxxxx, xxx xxxxxxxxxx xxxxx XXXXXXX XXXXXXXXX XXXXXXX, x v xxxxxxxx x oficiálních xxxxxx Xxxxxxxxxx xxxxxxxxxxxx nebo x xxxxxxx.

X případě xxxxxxxxxx, xxxxxxxxxxx xx xxxxxxxxx informací se xx xx xx, xx xxxxxxxxx xxxxxxxx xxxxxxxxxx povinnost.

Datum: Xxxxxx: Xxxxxx datové razítko xxxxxxx:

Xxxxx x xxxxxxx xxxxx xxxxxxxxxxx xxxxxxxxx xxxxxxxxxxx xxxxxxx xxxxxxx xx xxxxxx xxxxxx, xx xxxxx xxxxx xxxxxxx xxx:

XXXXXXX

Xxxxxxx xxxxx xxxxxxxxxx xx Xxxxx xxxxxxxxx x xxxxxxx xxxx xxxxx xxxxx Evropských xxxxxxxxxxxx nebo vystupující x České xxxxxxxxx xx xxxxxx oblasti xx xxxxxxx xxxxxxx xxxxxxx xxxxxxx xxxxx xxxxx nebo xxxxx

- xxxxxxxx xxxxxxxx x xxxxx xxxx xxxx xxxx,

- cestovních xxxx,

- xxxxxxxxx xxxxxxxx xxxxxxxxxxxx xx xxxxxx xxxxxx,

- xxxxxxx papírů na xxxxxxxxxx nebo xx xxx, anebo

- xxxxxx xxxxxxxxxx xxxxxxx, xxxx xxxx xxxxxxxxx drahé xxxx nebo xxxxx xxxxxx

(xxxx jen "xxxx") x úhrnné xxxxxxx xxxxxxxxxxx 15.000 X xxx jednotlivém dovozu xxxx vývozu, xxxxx x součtu xxxxxx xxxx vývozů x xxxxxxx dvanácti po xxxx xxxxxxxx xxxxxx.

Xxx xxxxxxxx xxxx xxxx xx měnu xxxx xx xx dobu xxxxxxxxxxxx týdne xxxxxxx xxxx xxxxxxxxx xxx xxxxxxxxxx měnu Xxxxxx xxxxxxx bankou x xxxxx xxxxxxxxxxx kalendářního xxxxx. Celní úřad xxxxx xxxxxx xx xxxxxxxx xxxx kurzů x přepočítacích xxxxxx xxx xxxxx plnění xxxxxxxxxx xxxxxxxxxx. Xxxxxxxx xxxxxxx xxxxxx x xxxxxx hodnotných komodit xx rozumí xxxxxx xxxxxxxx tržní xxxx, xxxxxxxx xxxx xxxxxxxxx xxxxx xxxxx na xxxxxxxxxxx trzích.

Oznamovací xxxxxxxxx xxxx splnit xxxxxx xxxxxxxxx xxxxx, xxxxx xxxxxxx xxxx xxxxxx xxxx xxxxxx, a xx prostřednictvím xxxxxxxxx xxxxxxx osoby, xxxxx xx tyto xxxx xxx sobě xxx xxxxxxxxxx xxxxxxx celního xxxxx Evropských společenství.

Za xxxxxxxxx oznamovací xxxxxxxxxx xx považuje i xxxxxxx xxxxxxxxxxx xxxx xxxxxxxxx údajů xx xxxxx tiskopisu. Xxxx-xx xxxxxx jednání činem xxxxxxxx xxxxxxxx, může xxx xxxxxxx i xxxxxxxxx xxxxx xx xxxxxxxxx oznamovací xxxxxxxxxx xxxxxxxxx xxxxxxx, xxxxx xxxx může dosáhnout xxxxxxx xxxxxxxxxxxx xxxx. Xxxxx úřad xxxx xxx xxxxxxxx porušení xxxxxxxxxx povinnosti zajistit xxxx, xxxxxxx se xxxxxxxx tyká. Xxxx-xx xxxxxxx pokuta xx xxxxx splatnosti xxxxxxxxxx xxxxxxxxx, xxxxx xxxx xx xxxx xxxxxx xxxxxxx xxxxxxxxx xxxx.

Xxxxxxx xxxxxxxxxx jsou stanoveny xxxxxxx č. 61/1996 Sb., x xxxxxxxxx xxxxxxxxxx proti xxxxxxxxxx výnosů x xxxxxxx xxxxxxxx, ve xxxxx xxxxxxxxxx xxxxxxxx, x xxxxxxxxx xxxxx 343/2004 Xx.

Xxxxx: Podpis: Xxxxxx xxxxxx razítko xxxxxxx:

XXXXXXXXXXX

X xxxxxx xxxxxxx xxxx X xx xxxxxxxxx/xxxxxxxxx, valid Xxxxx xx foreign xxxxxxxx, xxxxxxxxx'x cheques xx xxxxx xxxxxx xxxxxxxxxxxx xxx xxxx, xxx xxxxx anonymous xx xxxxxx xxxxxxxxxxxx of x xxxxxxxxx xx xxxxxxxx character xxxx xx negotiabie securities xxx xxxxx xxxxx, xx xxxxx xxxxxxxxxxx xx xxxxxxxxxxx xxxxx xxxx xx, precious xxxxxx xx xxxxxxxx xxxxxx, (xxxxxxxxxxx xxxx "xxxx"), with a xxxxx xxxxx in xxxxxx xx 15, 000 XXX, xxx xx set xxx xxxxx.

Xxx xxxx xxxx be completed xxxxxxx, xx hand xxxxxxx xx XXXXXXX XXXXXXX, xx one xx the xxxxxxxx xxxxxxxxx xx xxx Xxxxxxxx Xxxxxxxxxxx xx xx xxx Xxxxxxx xxxxxxxx.

Xx xxx xxxxx xx xxxxxxxxxx, illegible xx xxxxxxxxxx xxxxxxxxxxx, xxx xxxxxxxxx xxxx xx xxxxxxxxxx xxx xx xxxx xxxxxxxxx xxx reporting obligation.

Date: Xxxxxxxxx: Personal xxxx xxxxx of the Xxxxxxx official:

If xxxxx xx xxx xxxxxx xxxxx xx enter xxx xxx xxxxxxxx xxxxxxxxxxx in xxx xxxxxxxxxxx column of xxx xxxxx xx xxxx 1, then xxxxxx xxxxxxxx the xxxxxxx in the xxxxxxxxx xxxxx:

INSTRUCTIONS

Any individual xxx xx entering xxx Czech Xxxxxxxx xxxx xx xxxx xxxxxxx xxx Xxxxxxxxx Xxxxxxx Xxxxxxxxx xx xx leaving xxx Xxxxx Xxxxxxxx to xxxxx xxxx x xxxxxxxxx xx xxxxxxx xx xxxxxxx xx xxx Xxxxxxx Xxxxxx, xx writing, xxx xxxxxx xxx export xx

- xxxxx Xxxxx xx xxxxxxx xxxxxxxx,

- Xxxxxxxxx'x cheques,

- Xxxxx xxxxxx xxxxxxxxxxxx for xxxx,

- Xxx xxxxx xxxxxx xx anonymous xxxxxxxxxxxx xx x xxxxxxxxx xx xxxxxxxx xxxxxxxxx, xxxx xx xxxxxxxxxx securities xxx xxxxx xxxxx, or

- Xxxxxxxxxxx xx exceptional xxxxx xxxx as xxxxxxxx metals xx xxxxxxxx xxxxxx

(xxxxxxxxxxx xxxx "xxxxx") xxxx a xxxxx xxxxx xx xxxxxx xx 15,000 X xx a xxxxxx xxxxxx xx xxxxxx or in x xxxxx xx xxxxxxx xx exports xx xxx xxxxxx xx twelve xxxxxxxxxx xxxxxx.

Xxxx calculating xxx xxxxxxxxxx xx different xxxxxxxx xx Xxxx, xxx xxxxxxxx xxxx xxxxxxxxx by the Xxxxx Xxxxxxxx Bank xxx the relevant xxxxxxxx, on Xxxxxx xx xxx previous xxxx, xx used xxx x xxxxxx xx xxx xxxx. Xxxx request, xxx Xxxxxxx xxxxxx xxxxx xxxxxx xxxxxxxxxxx xx xxx xxxx xx xxxxxxxx xxx xxxxxxxxxxx xxxxxxxxxx xxx xxx xxxxxxxx xx xxxxxxxxxx xxxxx xxxxxxxxxx to xxxxxxx. The xxxxx xx xxxxxxxxxx and xxxxxxxxxxx of xx xxxxxxxxxxx value are xxxxxxxxxx xx xx xxxxx xxxxxxx market xxxxx xx xxxxxxxx xxx xxxxx set xxxx xxxxxxxxx xx xxx exchange xxxx xx xxx xxxxxxxx xxxxxxx.

Xxxxx xxxxxxxx, xxxxx xxxxxx or xxxxxx xxx xxxxxx xxxxx, xxxx xxxx xxxxxx xxxxxxxxx xxxxxxxxxxx. This xx done xxxxxxx xxx xxxxxx xxxxxxxxxx xxx xx xx xxxxxxxxxx xx xxxxx xxxxx xxxx xxxxxxxx xxx xxxxxx xx xxx Xxxxxxxxx Xxxxxxx Xxxxxxxxx.

Xxx declaration of xxxxxxxxx xx xxxxxxxxxx xxxxxxxxxxx xx xxxx xxxx is xxxx xxxxxxxxxx to be x breach of xxx reporting xxxxxxxxxx. Xx xxxx xxxxxxx xx not xx xxx xxxx is xxxx xxxxxxxx punishable, xxx xxxxxxxxxx xxx xxxx the xxxxx xxxxxx may xx xxxxx an xxxxxx xx xx, or xxxxx to, xxx xxxxx xx the xxxxxxxxxx items for xxxxxxxxx the reporting xxxxxxxxxx. Xxxx xxxxxxxxx xx x xxxxxxxxx xx xxxxxxxxx xxxxxxxxxx, xxx Xxxxxxx Office xxx xxxxx the xxxxx involved in xxx xxxxxxxxx. If xxx xxxxxxx fine xx xxx xxxx xxxxxxxxxxx xx xxx xxxxxxxx period, xxx Xxxxxxx Office xxxx xxx xxx xxxxxx xxxxx towards xxx xxxxxxx xx xxx xxxx.

Xxx xxxxx-xxxxxxxxx xxxxxxxxxxx xxx xxx xxxx xx xxx Xxx xx. 61/1996 Coll., Xx Xxxxxxxx Measures xxxxxxx Legitimization of Xxxxxxxx from Xxxxxxxx Xxxxxxxxxx and xx xxx Xxxxxxxxx of Xxxxxxx Xxxxxxxxxxx, as xxxxxxx xx xxx Xxxxxx xx 343/2004 Xxxx.

Xxxx: Signature: Xxxxxxxx xxxx xxxxx xx xxx Xxxxxxx xxxxxxxx: