Постановление Правления ПФ РФ от 11.01.2017 N 2п "Об утверждении форм документов, используемых для регистрации граждан в системе обязательного пенсионного страхования, и Инструкции по их заполнению" (Зарегистрировано в Минюсте России 02.02.2017 N...

Форма АДВ-2

Код по ОКУД
 
 
               Заявление об обмене страхового свидетельства
 
Заполняется застрахованным лицом печатными буквами.
 
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¦Страховой номер ._._._. - ._._._. - ._._._. ._._.                                           ¦
¦Ф.И.О., указанные в страховом свидетельстве                                                 ¦
¦Фамилия  ._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.  ¦
¦Имя      ._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.  ¦
¦Отчество ._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.  ¦
¦Новые анкетные данные (указать только изменившиеся данные)                                  ¦
¦Фамилия  ._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.  ¦
¦Имя      ._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.  ¦
¦Отчество ._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.  ¦
¦Пол      ._. (м/ж)                                                                          ¦
¦Дата рождения "._._." ._._._._._._._._._ ._._._._. года                                     ¦
¦Место рождения:                                                                             ¦
¦   город (село, дер., ...)    ._._._._._._._._._._._._._._._._._._._._._._._._._.           ¦
¦   район                      ._._._._._._._._._._._._._._._._._._._._._._._._._.           ¦
¦   область (край, респ., ...) ._._._._._._._._._._._._._._._._._._._._._._._._._.           ¦
¦   страна                     ._._._._._._._._._._._._._._._._._._._._._._._._._.           ¦
¦Гражданство                   ._._._._._._._._._._._._._._._._._._._._._._._._._.           ¦
¦Адрес постоянного места жительства                                                          ¦
¦Адрес                  индекс ._._._._._._._. адрес ._._._._._._._._._._._._.               ¦
¦регистрации            ._._._._._._._._._._._._._._._._._._._._._._._._._._.                ¦
¦                       ._._._._._._._._._._._._._._._._._._._._._._._._._._.                ¦
¦Адрес места            индекс ._._._._._._. адрес ._._._._._._._._._._._._.                 ¦
¦жительства             ._._._._._._._._._._._._._._._._._._._._._._._._._._.                ¦
¦фактический            ._._._._._._._._._._._._._._._._._._._._._._._._._._.                ¦
¦                           (заполнять при отличии от адреса регистрации)                    ¦
¦Телефоны               ._._._._._._._._._._._._._._._._._._._._._._._._._._._.              ¦
¦                                     (домашний и/или рабочий)                               ¦
¦Документ, удостоверяющий личность                                                           ¦
¦Вид документа ._._._._._._._._._._._._._._._._._._._._._._._._._.                           ¦
¦              (указать название документа: паспорт, удостоверение                           ¦
¦              личности и другие документы, удостоверяющие личность)                         ¦
¦Серия, номер ._._._._._._._._._._____._._._._._._.                                          ¦
¦Дата выдачи  "._._." ._._._._._._._._. ._._._._. года                                       ¦
¦Кем выдан    ._._._._._._._._._._._._._._._._._._._._._._._._._.                            ¦
¦             ._._._._._._._._._._._._._._._._._._._._._._._._._.                            ¦
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Дата заполнения                            Личная подпись
"._._." ._._._._._._._._. ._._._._. года   застрахованного лица ___________
 
 
 
См. данную форму в MS-Excel.
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