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ORDIN Nr

ORDIN   Nr. 46 din  7 februarie 2005

privind modificarea Ordinului ministrului muncii si solidaritatii sociale nr. 340/2001 pentru aprobarea Normelor de aplicare a prevederilor Legii nr. 19/2000 privind sistemul public de pensii si alte drepturi de asigurari sociale, cu modificarile si completarile ulterioare

ACT EMIS DE: MINISTERUL MUNCII, SOLIDARITATII SOCIALE SI FAMILIEI

ACT PUBLICAT IN: MONITORUL OFICIAL  NR. 138 din 15 februarie 2005


SmartCity3


    Avand in vedere:
    - Legea nr. 346/2002 privind asigurarea pentru accidente de munca si boli profesionale, cu modificarile si completarile ulterioare;
    - Hotararea Guvernului nr. 737/2003 privind organizarea si functionarea Ministerului Muncii, Solidaritatii Sociale si Familiei, cu modificarile si completarile ulterioare;
    - Legea nr. 19/2000 privind sistemul public de pensii si alte drepturi de asigurari sociale, cu modificarile si completarile ulterioare;
    - Hotararea Guvernului nr. 13/2004 privind aprobarea Statutului Casei Nationale de Pensii si Alte Drepturi de Asigurari Sociale, cu modificarile ulterioare;
    - Ordinul ministrului muncii si solidaritatii sociale nr. 340/2001 pentru aprobarea Normelor de aplicare a prevederilor Legii nr. 19/2000 privind sistemul public de pensii si alte drepturi de asigurari sociale, cu modificarile si completarile ulterioare;
    - Ordinul ministrului muncii si solidaritatii sociale nr. 518/2001 privind modificarea si completarea Ordinului ministrului muncii si solidaritatii sociale nr. 340/2001 pentru aprobarea Normelor de aplicare a prevederilor Legii nr. 19/2000 privind sistemul public de pensii si alte drepturi de asigurari sociale, cu modificarile si completarile ulterioare;
    - Ordinul ministrului muncii, solidaritatii sociale si familiei nr. 7/2004 privind modificarea Ordinului ministrului muncii si solidaritatii sociale nr. 340/2001 pentru aprobarea Normelor de aplicare a prevederilor Legii nr. 19/2000 privind sistemul public de pensii si alte drepturi de asigurari sociale, cu modificarile si completarile ulterioare;
    - Ordinul ministrului muncii, solidaritatii sociale si familiei nr. 134/2004 privind modificarea si completarea Ordinului ministrului muncii si solidaritatii sociale nr. 340/2001 pentru aprobarea Normelor de aplicare a prevederilor Legii nr. 19/2000 privind sistemul public de pensii si alte drepturi de asigurari sociale, cu modificarile si completarile ulterioare,

    ministrul muncii, solidaritatii sociale si familiei emite urmatorul ordin:

    Art. 1
    Ordinul ministrului muncii si solidaritatii sociale nr. 340/2001 pentru aprobarea Normelor de aplicare a prevederilor Legii nr. 19/2000 privind sistemul public de pensii si alte drepturi de asigurari sociale, cu modificarile si completarile ulterioare, publicat in Monitorul Oficial al Romaniei, Partea I, nr. 237 din 10 mai 2001, se modifica dupa cum urmeaza:
    - Anexele nr. 1.1, 1.2 si 1.4 la norme se inlocuiesc cu anexele nr. 1, 2 si 3*) care fac parte integranta din prezentul ordin.
------------
    *) Anexele nr. 1, 2 si 3 sunt reproduse in facsimil.

    Art. 2
    Prezentul ordin va fi publicat in Monitorul Oficial al Romaniei, Partea I.

             Ministrul muncii, solidaritatii sociale si familiei,
                                Gheorghe Barbu

    ANEXA 1
    (ANEXA 1.1 la norme)

         _ _ _ _ _ _ _            _ _         _ _         _ _ _ _
    Nr. |_|_|_|_|_|_|_| din ziua |_|_|, luna |_|_|, anul |_|_|_|_|

                                           _                 _
                      DECLARATIE initiala |_| rectificativa |_|
privind evidenta nominala a asiguratilor si a obligatiilor de plata catre bugetul asigurarilor sociale de stat
                                       _ _        _ _ _ _
                          pentru luna |_|_| anul |_|_|_|_|

 _________________________________________________________  ___________________
|                    DENUMIRE ANGAJATOR                   || CUI (COD FISCAL)  |
|_________________________________________________________||___________________|
 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _  _ _ _ _ _ _ _ _ _ _
|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_||_|_|_|_|_|_|_|_|_|_|

                         ____________________________
                        | NR. INREG. REG. COMERTULUI |
                        |____________________________|
                         _ _ _   _ _ _ _ _   _ _ _ _
                        |_|_|_|/|_|_|_|_|_|/|_|_|_|_|

 ______________________________________________________________________________
| ___________   ______________   _                                             |
||           | |Tip           | |_|                                            |
|| NR. CRT.  | |rectificare*)|                                                |
||___________| |______________|                                                |
|        __________________________________________________________            |
|       |                  NUME SI PRENUME ASIGURAT                |           |
|       |__________________________________________________________|           |
|        ___________________________                                           |
|       |  COD ASIGURAT             |                                          |
|       |___________________________|                                          |
|        __________________________________________________________            |
|       |        NUME SI PRENUME ASIGURAT                          |           |
|       |        (inainte de rectificare)                          |           |
|       |__________________________________________________________|           |
|        ______________________________________                                |
|       | COD ASIGURAT (inainte de rectificare)|                               |
|       |______________________________________|                               |
|                                                                              |
| _________       _________                                                    |
||Contract |  _  |Norma    |                                                   |
||de munca | |_| |zilnica*)|                                                   |
||_________|     |_________|                                                   |
| _________                                                                    |
||Contract |                                                                   |
||de munca |  _   _________   _________   _________   _________                |
||cu timp  | |_| | TOTAL   | |ZILE IN  | |ZILE IN  | |ZILE IN  |               |
||partial  |     | ZILE    | |CONDITII | |CONDITII | |CONDITII |               |
||*)     |     |         | |NORMALE  | |DEOSEBITE| |SPECIALE |               |
||_________|     |_________| |_________| |_________| |_________|               |
| _________                                                                    |
||Pensionar|  _   _________   _________   _________   _________   _________    |
||*)    | |_| |TOTAL    | |TOTAL    | |TOTAL    | |din care:| |din care:|   |
||_________|     |ZILE     | |ZILE     | |ZILE     | |ZILE     | |ZILE     |   |
| _________      |PRESTATII| |PRESTATII| |PRESTATII| |PRESTATII| |PRESTATII|   |
||Somer    |  _  |in       | |in       | |in       | |SUPORTATE| |SUPORTATE|   |
||         | |_| |conditii | |conditii | |conditii | |din BASS | |din      |   |
||_________|     |NORMALE  | |DEOSEBITE| |SPECIALE | |         | |FAAMBP   |   |
|                |_________| |_________| |_________| |_________| |_________|   |
| ___________________                                                          |
||TOTAL din care:    |                                                         |
||___________________|                                                         |
| ___________________   ___________________   ___________________              |
||VENIT REALIZAT DE  | |VENIT REALIZAT DE  | |VENIT REALIZAT DE  |             |
||ASIGURAT IN        | |ASIGURAT IN        | |ASIGURAT IN        |             |
||CONDITII NORMALE   | |CONDITII DEOSEBITE | |CONDITII SPECIALE  |             |
||___________________| |___________________| |___________________|             |
| ___________________   ___________________   ___________________              |
||CAD DATORATA DE    | |TOTAL PRESTATII DE | |SUPORTATE DIN BASS |             |
||ASIGURAT           | |ASIGURARI SOCIALE  | |                   |             |
||                   | |din care           | |                   |             |
||___________________| |___________________| |___________________|             |
| _____________________                                                        |
||SUPORTATE DIN FAAMBP |                                                       |
||                     |                                                       |
||                     |                                                       |
||_____________________|                                                       |
|______________________________________________________________________________|

 ______________________________________________________________________________
|  _ _ _ _ _                        _                                          |
| |_|_|_|_|_|  Tip rectificare*)  |_|                                         |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _                   |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|                  |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _                                                 |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|                                                |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _                   |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|                  |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _                                                 |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|                                                |
|                       _      _                                               |
| Contract de munca    |_|    |_|                                              |
|                                                                              |
| Contract de munca     _            __ __   __ __   __ __   __ __             |
| cu timp partial*)  |_|          |__|__| |__|__| |__|__| |__|__|            |
|                       _            __ __   __ __   __ __   __ __   __ __     |
| Pensionar*)       |_|          |__|__| |__|__| |__|__| |__|__| |__|__|    |
|                       _                                                      |
| Somer                |_|                                                     |
|  _ _ _ _ _ _ _ _ _ _                                                         |
| |_|_|_|_|_|_|_|_|_|_|                                                        |
|  _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _             |
| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|            |
|  _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _             |
| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|            |
|  _ _ _ _ _ _ _ _ _ _                                                         |
| |_|_|_|_|_|_|_|_|_|_|                                                        |
|______________________________________________________________________________|

 ______________________________________________________________________________
|  _ _ _ _ _                        _                                          |
| |_|_|_|_|_|  Tip rectificare*)  |_|                                         |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _                   |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|                  |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _                                                 |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|                                                |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _                   |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|                  |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _                                                 |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|                                                |
|                       _      _                                               |
| Contract de munca    |_|    |_|                                              |
|                                                                              |
| Contract de munca     _            __ __   __ __   __ __   __ __             |
| cu timp partial*)  |_|          |__|__| |__|__| |__|__| |__|__|            |
|                       _            __ __   __ __   __ __   __ __   __ __     |
| Pensionar*)       |_|          |__|__| |__|__| |__|__| |__|__| |__|__|    |
|                       _                                                      |
| Somer                |_|                                                     |
|  _ _ _ _ _ _ _ _ _ _                                                         |
| |_|_|_|_|_|_|_|_|_|_|                                                        |
|  _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _             |
| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|            |
|  _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _             |
| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|            |
|  _ _ _ _ _ _ _ _ _ _                                                         |
| |_|_|_|_|_|_|_|_|_|_|                                                        |
|______________________________________________________________________________|

 ______________________________________________________________________________
|  _ _ _ _ _                        _                                          |
| |_|_|_|_|_|  Tip rectificare*)  |_|                                         |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _                   |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|                  |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _                                                 |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|                                                |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _                   |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|                  |
|  _ _ _ _ _ _ _ _ _ _ _ _ _ _                                                 |
| |_|_|_|_|_|_|_|_|_|_|_|_|_|_|                                                |
|                       _      _                                               |
| Contract de munca    |_|    |_|                                              |
|                                                                              |
| Contract de munca     _            __ __   __ __   __ __   __ __             |
| cu timp partial*)  |_|          |__|__| |__|__| |__|__| |__|__|            |
|                       _            __ __   __ __   __ __   __ __   __ __     |
| Pensionar*)       |_|          |__|__| |__|__| |__|__| |__|__| |__|__|    |
|                       _                                                      |
| Somer                |_|                                                     |
|  _ _ _ _ _ _ _ _ _ _                                                         |
| |_|_|_|_|_|_|_|_|_|_|                                                        |
|  _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _             |
| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|            |
|  _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _             |
| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|            |
|  _ _ _ _ _ _ _ _ _ _                                                         |
| |_|_|_|_|_|_|_|_|_|_|                                                        |
|______________________________________________________________________________|

    *) Program normal de lucru (8, 7, 6 ore). Se completeaza numai dupa 01.03.2003
    *) M = modificare; A - adaugare asigurat; S - stergere asigurat
    *) 1 pt. perioada de pana la 01.03.2003; 2 pt. CM timp partial de 2 ore; 3 pt. CM timp partial de 3 ore; 4 pt. CM timp partial de 4 ore; 5 pt. CM timp partial de 5 ore; 6 pt. CM timp partial de 6 ore; 7 pt. CM timp partial de 7 ore; (CM = contract de munca)
    *) 1 pt. perioada de pana la 01.03.2003; 2 pt. CM timp partial de 2 ore; 3 pt. CM timp partial de 3 ore; 4 pt. CM timp partial de 4 ore; 5 pt. CM timp partial de 5 ore; 6 pt. CM timp partial de 6 ore; 7 pt. CM timp partial de 7 ore; 8 pt. CM norma intreaga (CM = contract de munca)

               _ _ _
    Nr. fila: |_|_|_|                                          Semnatura,

    ANEXA 2
    (ANEXA 1.2 la norme/FATA)

         _ _ _ _ _ _ _            _ _         _ _         _ _ _ _
    Nr. |_|_|_|_|_|_|_| din ziua |_|_|, luna |_|_|, anul |_|_|_|_|

                                           _                 _
                      DECLARATIE initiala |_| rectificativa |_|
privind evidenta nominala a asiguratilor si a obligatiilor de plata catre bugetul asigurarilor sociale de stat
                                       _ _        _ _ _ _
                          pentru luna |_|_| anul |_|_|_|_|

    Data stabilita pentru lichidarea drepturilor salariale:
        _ _         _ _       _ _ _ _                        _ _ _ _
    zi |_|_|, luna |_|_|, an |_|_|_|_|            COD CAEN: |_|_|_|_|

    A. Denumire    _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
    angajator:    |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
                                                   _ _ _ _ _ _ _ _ _ _ _ _ _
                                             CNP: |_|_|_|_|_|_|_|_|_|_|_|_|_|

    B. CUI (Cod fiscal):      C. Nr. inreg. Reg. Comert.       D. Nr. mediu
                                                               asigurati:
        _ _ _ _ _ _ _ _ _ _    _ _ _   _ _ _ _ _   _ _ _ _     _ _ _ _ _ _
       |_|_|_|_|_|_|_|_|_|_|  |_|_|_|/|_|_|_|_|_|/|_|_|_|_|   |_|_|_|_|_|_|

    E. Total fond salarii             din care:
    brute realizate:
     _ _ _ _ _ _ _ _ _ _ _ _ _   F. In conditii       _ _ _ _ _ _ _ _ _ _ _ _ _
    |_|_|_|_|_|_|_|_|_|_|_|_|_|  normale de munca:   |_|_|_|_|_|_|_|_|_|_|_|_|_|
                                 G. In conditii       _ _ _ _ _ _ _ _ _ _ _ _ _
                                 deosebite de munca: |_|_|_|_|_|_|_|_|_|_|_|_|_|
                                 H. In conditii       _ _ _ _ _ _ _ _ _ _ _ _ _
                                 speciale de munca:  |_|_|_|_|_|_|_|_|_|_|_|_|_|

    I. Total contributii individuale de asigurari     _ _ _ _ _ _ _ _ _ _ _ _ _
    sociale de virat:                                |_|_|_|_|_|_|_|_|_|_|_|_|_|
                                                      _ _ _ _ _ _ _ _ _ _ _ _ _
    J. Total CAS datorata de angajator:              |_|_|_|_|_|_|_|_|_|_|_|_|_|

    K. Contributia de sanatate aferenta concediilor medicale conform art. 54(2)
    din O.U.G. nr. 150/2002, modificata si completata, suportata de la BASS:

       Total zile prestatii       _ _ _ _ _ _         _ _ _ _ _ _ _ _ _ _ _ _ _
       pentru pct. L1, L2, L3,   |_|_|_|_|_|_| suma: |_|_|_|_|_|_|_|_|_|_|_|_|_|
       L4, L5, L7, folosit la
       calcul contributie de
       sanatate

    L. Total cuantum prestatii de asigurari sociale de suportat din Bugetul
                                                      _ _ _ _ _ _ _ _ _ _ _ _ _
    Asigurarilor Sociale de Stat:                    |_|_|_|_|_|_|_|_|_|_|_|_|_|

                              Numar       Nr. total     Suma din BASS
                              cazuri      zile
                                        prestatii
    1.1 Indemnizatie          _ _ _ _ _   _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _
    pentru incapacitate      |_|_|_|_|_| |_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|
    temporara de munca

    1.2 Prevenire             _ _ _ _ _   _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _
    imbolnaviri              |_|_|_|_|_| |_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|

                              _ _ _ _ _   _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _
    1.3 Sarcina si lauzie    |_|_|_|_|_| |_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|

    1.4 Ingrijire copil       _ _ _ _ _   _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _
    bolnav                   |_|_|_|_|_| |_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|

    1.5 Crestere copil        _ _ _ _ _   _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _
    pana la 2 ani/3 ani      |_|_|_|_|_| |_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|
                              _ _ _ _ _                 _ _ _ _ _ _ _ _ _ _ _ _
    1.6 Ajutoare de deces    |_|_|_|_|_|               |_|_|_|_|_|_|_|_|_|_|_|_|

    1.7 Indemnizatie de       _ _ _ _ _   _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _
    risc maternal            |_|_|_|_|_| |_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|

    M. Total CAS angajator de virat                   _ _ _ _ _ _ _ _ _ _ _ _ _
    (Legea nr. 19/2000, modificata si completata):   |_|_|_|_|_|_|_|_|_|_|_|_|_|

    N. Contributie de asigurari pentru accidente de munca si boli profesionale,
    datorata de angajator (Legea nr. 346/2002, modificata si completata):

                 DA   NU
                 __   __           _    _ _ _         _ _ _ _ _ _ _ _ _ _ _ _ _
     datoreaza: |__| |__| procent |_|, |_|_|_| suma: |_|_|_|_|_|_|_|_|_|_|_|_|_|

    O. Contributia de sanatate aferenta concediilor medicale conform art. 54(2)
    din O.U.G. nr. 150/2002, modificata si completata, suportata de la FAAMBP:

       Total zile prestatii       _ _ _ _ _ _         _ _ _ _ _ _ _ _ _ _ _ _ _
       pentru pct. P1, P2, P3,   |_|_|_|_|_|_| suma: |_|_|_|_|_|_|_|_|_|_|_|_|_|
       P4, folosit la calcul
       contributie de sanatate

    P. Total cuantum prestatii de asigurari sociale
    suportate din FAAMBP (Legea nr. 346/2002,         _ _ _ _ _ _ _ _ _ _ _ _ _
    modificata si completata):                       |_|_|_|_|_|_|_|_|_|_|_|_|_|

                              Numar       Nr. total     Suma din FAAMBP
                              cazuri      zile
                                          prestatii
    P1 Indemnizatie           _ _ _ _ _   _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _
    pentru incapacitate      |_|_|_|_|_| |_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|
    temporara de munca
    datorata accidentelor
    de munca si bolilor
    profesionale

    P2 Indemnizatie           _ _ _ _ _   _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _
    pentru trecerea          |_|_|_|_|_| |_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|
    temporara in alt loc
    de munca datorata
    accidentelor de munca
    si bolilor
    profesionale

    P3 Indemnizatie           _ _ _ _ _   _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _
    pentru reducerea         |_|_|_|_|_| |_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|
    timpului de lucru
    datorata accidentelor
    de munca si bolilor
    profesionale

    P4 Indemnizatie           _ _ _ _ _   _ _ _ _ _ _   _ _ _ _ _ _ _ _ _ _ _ _
    pe durata cursurilor     |_|_|_|_|_| |_|_|_|_|_|_| |_|_|_|_|_|_|_|_|_|_|_|_|
    de calificare si
    reconversie
    profesionala

    R. Contributie de asigurari pentru accidente de
    munca si boli profesionale, de virat              _ _ _ _ _ _ _ _ _ _ _ _ _
    (Legea nr. 346/2002, modificata si completata):  |_|_|_|_|_|_|_|_|_|_|_|_|_|

    ANEXA 2
    (ANEXA 1.2 la norme/VERSO)

    S. Adresa angajator:

                   _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
    Localitatea:  |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
             _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _       _ _ _ _ _ _ _
    Strada: |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_| Nr. |_|_|_|_|_|_|_|
         _ _ _ _ _ _ _       _ _ _ _       _ _       _ _ _ _
    Bl. |_|_|_|_|_|_|_| Sc. |_|_|_|_| Et. |_|_| Ap. |_|_|_|_|
          _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
    Tel. |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
           _ _ _ _ _ _ _ _ _ _ _ _ _ _ _           _ _           ______________
    Judet |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|/Sector: |_|_| E-mail: |______________|

    Sub sanctiunile aplicate falsului in acte publice, declar ca am examinat aceasta declaratie si in conformitate cu informatiile furnizate, o declar corecta si completa

    Numele ___________________ Prenumele _____________________ Data ___________
    Functia*) _________________________________________________________________
                                                                       _ _ _
    Semnatura si stampila ____________   Nr. total de file ANEXA 1.1: |_|_|_|

    *) Director General sau alta persoana autorizata
 ______________________________________________________________________________
|                                            _                        _ _      |
| Declaratie nominala pe suport magnetic    |_| Nr. dischete/CD-ROM: |_|_|     |
| Declaratie nominala transmisa pe cale      _                                 |
| electronica                               |_|                                |
| Verificat corectitudinea fisierelor:          Nume: _______ Semnatura ______ |
|______________________________________________________________________________|

    ANEXA 3
    (Anexa 1.4 la norme)

    Modalitati de transmitere pe cale electronica a Declaratiilor privind evidenta nominala a asiguratilor si a obligatiilor de plata catre bugetul asigurarilor sociale

    Conditii generale
    Declaratiile privind evidenta nominala a asiguratilor si a obligatiilor de plata catre bugetul asigurarilor sociale se vor face numai pe suport electronic.
    Declaratiile in format electronic se depun odata cu declaratiile nominale pe suport de hartie (ANEXA 1.1, ANEXA 1.2 listate la calculator, semnate si stampilate), la Casa Teritoriala de Pensii pe raza careia se afla sediul sau domiciliul angajatorului.

    Conditii tehnice standard pentru formatul electronic
    Declaratiile in format electronic vor fi transmise numai pe suport tip: discheta FD 3,5" Microsoft DOS sau CD+ROM, in dublu exemplar.
    Suporturile vor fi etichetate cu informatiile urmatoare:
    - denumire fisier;
    - Codul unic de inregistrare sau codul fiscal al angajatorului, dupa caz;
    - numarul suportului magnetic in cadrul setului de suporturi ex: 1/3, 2/3, 3/3, daca setul are 3 suporturi.
    Suportul magnetic va contine doua fisiere de tip DBF sau TXT, (inregistrari de lungime fixa) pentru fiecare tip de declaratie, care va avea in mod obligatoriu urmatoarele denumiri si continut:
    A11.DBF sau A11.TXT N (ANEXA 1.1) contine datele aferente asiguratilor
    A12.DBF sau A12.TXT N (ANEXA 1.2) contine datele totalizatoare ale fisierului A11.DBF sau A11.TXT
    Ordinea campurilor din structura fisierelor este obligatorie, indiferent daca acestea se completeaza sau nu si sunt de lungime fixa.
    In descrierea de mai jos "Tip camp" are urmatoarea semnificatie:
    N N numeric, aliniat la dreapta
    C N caracter (alfanumeric), aliniat la stanga, fara :,:,,,.. (semne diacritice)
    In situatia transmiterii fisierelor tip DBF se va respecta obligatoriu denumirea campurilor date in structurile de fisier.

    Descrierea organizarii inregistrarilor din fisiere:
    Fisierul A11.DBF sau A11.TXT (ANEXA 1.1) contine cate o inregistrare pentru fiecare asigurat si are urmatoarea structura:
 ______________________________________________________________________________
|                        | Denumire| Tip |Lung.|            Explicatii         |
|                        | camp    | camp|     |                               |
|________________________|_________|_____|_____|_______________________________|
|Anul                    | AN      | N   |   4 |Se completeaza cu anul pentru  |
|                        |         |     |     |care se intocmeste declaratia  |
|________________________|_________|_____|_____|_______________________________|
|Luna                    | LN      | N   |   2 |Se completeaza cu luna anului  |
|                        |         |     |     |pentru care se intocmeste      |
|                        |         |     |     |declaratia                     |
|________________________|_________|_____|_____|_______________________________|
|Cod unic de inregistrare| CF      | N   |  10 |Se completeaza partea numerica |
|(CUI)/CF pentru         |         |     |     |a codului unic de inregistrare/|
|angajatori persoane     |         |     |     |codului fiscal atribuit        |
|juridice                |         |     |     |angajatorilor - persoane       |
|                        |         |     |     |juridice                       |
|________________________|_________|_____|_____|_______________________________|
|Cod judet din Nr. de    | RJ      | C   |   3 |Contine primele trei caractere |
|inmatriculare in        |         |     |     |din numarul de inmatriculare in|
|Registrul Comertului    |         |     |     |registrul comertului al        |
|                        |         |     |     |angajatorului                  |
|________________________|_________|_____|_____|_______________________________|
|Nr. de inregistrare din | RN      | N   |   5 |Contine caracterele 4 - 8 din  |
|Registrul Comertului    |         |     |     |numarul de inmatriculare in    |
|                        |         |     |     |registrul comertului al        |
|                        |         |     |     |angajatorului (nr. in RC)      |
|________________________|_________|_____|_____|_______________________________|
|Anul din Nr. de         | RA      | N   |   4 |Contine ultimele patru         |
|inmatriculare in        |         |     |     |caractere din numarul de       |
|Registrul Comertului    |         |     |     |inmatriculare in registrul     |
|                        |         |     |     |comertului al angajatorului    |
|________________________|_________|_____|_____|_______________________________|
|Nume si prenume asigurat| NUME    | C   |  29 |Contine numele si prenumele    |
|                        |         |     |     |asiguratului                   |
|________________________|_________|_____|_____|_______________________________|
|Cod asigurat            | CNP     | N   |  13 |Contine codul numeric personal |
|                        |         |     |     |al asiguratului                |
|________________________|_________|_____|_____|_______________________________|
|Contract individual de  | CM      | N   |   1 |Se completeaza cu:             |
|munca                   |         |     |     | 1 pentru asiguratii cu        |
|                        |         |     |     |contract de munca cu norma     |
|                        |         |     |     |intreaga,                      |
|                        |         |     |     | 0 in rest                     |
|________________________|_________|_____|_____|_______________________________|
|Contract individual de  | CV*)    | N   |   1 |Se completeaza cu:             |
|munca cu timp partial   |         |     |     | 1 pentru codificari anterioare|
|                        |         |     |     | 2 pentru asiguratii care      |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 2 ore pe zi;  |
|                        |         |     |     | 3 pentru asiguratii care      |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 3 ore pe zi;  |
|                        |         |     |     | 4 pentru asiguratii care      |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 4 ore pe zi;  |
|                        |         |     |     | 5 pentru asiguratii care      |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 5 ore pe zi;  |
|                        |         |     |     | 6 pentru asiguratii care      |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 6 ore pe zi;  |
|                        |         |     |     | 7 pentru asiguratii care      |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 7 ore pe zi;  |
|                        |         |     |     | 0 in rest                     |
|________________________|_________|_____|_____|_______________________________|
|*) La stabilirea stagiului de cotizare aceste campuri se vor corela cu        |
|campurile TT, NN, DD, SS, PP, PPS, PPD                                        |
|______________________________________________________________________________|
|Pensionar               | PE      | N   |   1 |Se completeaza cu:             |
|                        |         |     |     | 1 pentru codificari           |
|                        |         |     |     |anterioare,                    |
|                        |         |     |     | 2 pentru pensionarii care     |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial 2 ore pe zi;   |
|                        |         |     |     | 3 pentru pensionarii care     |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 3 ore pe zi;  |
|                        |         |     |     | 4 pentru pensionarii care     |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 4 ore pe zi;  |
|                        |         |     |     | 5 pentru pensionarii care     |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 5 ore pe zi;  |
|                        |         |     |     | 6 pentru pensionarii care     |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 6 ore pe zi;  |
|                        |         |     |     | 7 pentru pensionarii care     |
|                        |         |     |     |lucreaza cu contract de munca  |
|                        |         |     |     |cu timp partial, 7 ore pe zi;  |
|                        |         |     |     | 8 pentru pensionarii cu       |
|                        |         |     |     |contract de munca cu norma     |
|                        |         |     |     |intreaga;                      |
|                        |         |     |     | 0 in rest                     |
|________________________|_________|_____|_____|_______________________________|
|Somer                   | SOM     | N   |   1 |Se completeaza numai de        |
|                        |         |     |     |ANOFM/AJOFM cu:                |
|                        |         |     |     | 1 pentru beneficiarii de      |
|                        |         |     |     |ajutor de somaj;               |
|                        |         |     |     | 2 pentru beneficiarii de      |
|                        |         |     |     |alocatie de sprijin;           |
|                        |         |     |     | 3 pentru beneficiarii de plati|
|                        |         |     |     |compensatorii;                 |
|                        |         |     |     | 4 pentru alte beneficii       |
|                        |         |     |     |suportate din fondul de somaj, |
|                        |         |     |     |potrivit legii;                |
|                        |         |     |     | 0 in rest.                    |
|________________________|_________|_____|_____|_______________________________|
|Total zile lucrate      | TT*)   | N   |   2 |Contine suma zilelor lucrate si|
|                        |         |     |     |a zilelor in care asiguratul a |
|                        |         |     |     |beneficiat de prestatii de     |
|                        |         |     |     |asigurari sociale, inclusiv    |
|                        |         |     |     |zilele nelucrate platite din   |
|                        |         |     |     |fondul de salarii si pentru    |
|                        |         |     |     |care se achita contributie de  |
|                        |         |     |     |asigurari sociale, care nu     |
|                        |         |     |     |poate fi mai mare decat numarul|
|                        |         |     |     |de zile lucratoare din luna    |
|                        |         |     |     |stabilit conform               |
|                        |         |     |     |Legii nr. 53/2003 (Codul       |
|                        |         |     |     |muncii)                        |
|________________________|_________|_____|_____|_______________________________|
|Zile lucrate in conditii| NN*)   | N   |   2 |Contine numar zile lucrate de  |
|normale                 |         |     |     |asigurat in conditii normale de|
|                        |         |     |     |munca                          |
|________________________|_________|_____|_____|_______________________________|
|Zile lucrate in conditii| DD*)   | N   |   2 |Contine numar zile lucrate de  |
|deosebite               |         |     |     |asigurat in conditii deosebite |
|                        |         |     |     |de munca                       |
|________________________|_________|_____|_____|_______________________________|
|Zile lucrate in conditii| SS*)   | N   |   2 |Contine numar zile lucrate de  |
|speciale                |         |     |     |asigurat in conditii speciale  |
|                        |         |     |     |de munca                       |
|________________________|_________|_____|_____|_______________________________|
|Total zile prestatii in | PP      | N   |   2 |Contine numarul total de zile  |
|conditii normale        |         |     |     |in care asiguratul a beneficiat|
|                        |         |     |     |de prestatii de asigurari      |
|                        |         |     |     |sociale in conditii normale de |
|                        |         |     |     |munca (numar total zile        |
|                        |         |     |     |lucratoare aferente prestatiei |
|                        |         |     |     |acordate)                      |
|________________________|_________|_____|_____|_______________________________|
|*) In cazul contractelor individuale de munca cu timp partial se completeaza |
|nr. total de zile lucrate indiferent de numar de ore prevazute in contractul  |
|de munca cu timp partial. Stagiul se va calcula corelativ cu campul CV,       |
|functie de numarul de ore prevazut in contractul de munca cu timp partial.    |
|______________________________________________________________________________|
|Total venit realizat de | TV      | N   |  10 |Contine venitul total realizat |
|asigurat                |         |     |     |de asigurat                    |
|________________________|_________|_____|_____|_______________________________|
|Venit realizat de       | TVN     | N   |  10 |Contine venitul realizat de    |
|asigurat in conditii    |         |     |     |asigurat in conditii normale de|
|normale                 |         |     |     |munca                          |
|________________________|_________|_____|_____|_______________________________|
|Venit realizat de       | TVD     | N   |  10 |Contine venitul realizat de    |
|asigurat in conditii    |         |     |     |asigurat in conditii deosebite |
|deosebite               |         |     |     |de munca                       |
|________________________|_________|_____|_____|_______________________________|
|Venit realizat de       | TVS     | N   |  10 |Contine venitul realizat de    |
|asigurat in conditii    |         |     |     |asigurat in conditii speciale  |
|speciale                |         |     |     |de munca                       |
|________________________|_________|_____|_____|_______________________________|
|CAS datorat de asigurat | CASAT   | N   |   9 |Contine Contributia de         |
|                        |         |     |     |asigurari sociale retinuta de  |
|                        |         |     |     |la asigurat                    |
|________________________|_________|_____|_____|_______________________________|
|Total prestatii de      | CASTOT  | N   |   9 |Contine cuantumul aferent      |
|asigurari sociale       |         |     |     |prestatiilor de asigurari      |
|                        |         |     |     |sociale, exclusiv ajutorul de  |
|                        |         |     |     |deces                          |
|________________________|_________|_____|_____|_______________________________|
|Prestatii suportate din | BASS    | N   |   9 |Contine cuantumul aferent      |
|BASS                    |         |     |     |prestatiilor de asigurari      |
|                        |         |     |     |sociale suportat din Bugetul   |
|                        |         |     |     |asigurarilor sociale de stat,  |
|                        |         |     |     |exclusiv ajutorul de deces     |
|________________________|_________|_____|_____|_______________________________|
|Cod unic de inregistrare| CNPA    | N   |  13 |Contine Codul unic de          |
|(CUI) angajator         |         |     |     |inregistrare atribuit prin     |
|persoane fizice         |         |     |     |Certificatul de inregistrare   |
|                        |         |     |     |angajatorilor persoane fizice  |
|                        |         |     |     |si care reprezinta codul       |
|                        |         |     |     |numeric personal al            |
|                        |         |     |     |angajatorului                  |
|________________________|_________|_____|_____|_______________________________|
|Norma zilnica de lucru  | NORMA   | N   |   1 |Se completeaza cu programul    |
|                        |         |     |     |normal de lucru specific       |
|                        |         |     |     |locului de munca al            |
|                        |         |     |     |asiguratului, exprimat in ore. |
|                        |         |     |     |Prin program normal de lucru se|
|                        |         |     |     |intelege programul prevazut la |
|                        |         |     |     |art. 109 alin. (1) din         |
|                        |         |     |     |Legea nr. 53/2003 sau programul|
|                        |         |     |     |normal de lucru sub 8 ore      |
|                        |         |     |     |stabilit cu respectarea        |
|                        |         |     |     |prevederilor Legii nr. 31/1991 |
|                        |         |     |     |sau alin. (2) din art. 109 din |
|                        |         |     |     |Codul Muncii.                  |
|                        |         |     |     |Norma zilnica poate sa fie de  |
|                        |         |     |     |8, 7 sau 6 ore.                |
|________________________|_________|_____|_____|_______________________________|
|Tipul declaratiei       | TIPD    | C   |   1 |Se completeaza cu R pentru     |
|                        |         |     |     |declaratia rectificativa,      |
|                        |         |     |     |spatiu in rest                 |
|                        |         |     |     |Declaratia rectificativa se    |
|                        |         |     |     |completeaza astfel:            |
|                        |         |     |     | a. anexa a11 se completeaza   |
|                        |         |     |     |    numai pentru pozitiile     |
|                        |         |     |     |    modificate fata de         |
|                        |         |     |     |    declaratia initiala        |
|                        |         |     |     |    (inregistrarile cu         |
|                        |         |     |     |    modificari fata de         |
|                        |         |     |     |    declaratia initiala,       |
|                        |         |     |     |    inregistrari noi fata de   |
|                        |         |     |     |    declaratia initiala)       |
|                        |         |     |     | b. anexa a12 se recalculeaza, |
|                        |         |     |     |    tinand cont de modificarile|
|                        |         |     |     |    efectuate fata de          |
|                        |         |     |     |    declaratia initiala.       |
|________________________|_________|_____|_____|_______________________________|
|Tip rectificare         | TIPR    | C   |   1 |Se completeaza cu urmatoarele  |
|                        |         |     |     |caractere:                     |
|                        |         |     |     |M N modificare sume, zile, CNP |
|                        |         |     |     |sau nume asigurat pentru       |
|                        |         |     |     |asiguratii raportati anterior, |
|                        |         |     |     |A N adaugare asigurat nou      |
|                        |         |     |     |S - stergere asigurat existent |
|                        |         |     |     |in declaratia anterioara       |
|________________________|_________|_____|_____|_______________________________|
|Nume inainte de         | NUMEANT | C   |  29 |Nume inainte de rectificare, se|
|rectificare             |         |     |     |completeaza numai daca se      |
|                        |         |     |     |modifica numele (TIPR = M),    |
|                        |         |     |     |spatiu in rest                 | |________________________|_________|_____|_____|_______________________________|
|CNP inainte de          | CNPANT  | N   |  13 |CNP inainte de rectificare, se |
|rectificare             |         |     |     |completeaza numai daca se      |
|                        |         |     |     |modifica CNP-ul (TIPR = M), 0  |
|                        |         |     |     |in rest                        |
|________________________|_________|_____|_____|_______________________________|
|Total zile prestatii in | PPS     | N   |   2 |Contine numarul total de zile  |
|conditii speciale       |         |     |     |lucratoare corespunzatoare     |
|                        |         |     |     |concediului medical pentru     |
|                        |         |     |     |incapacitate temporara de      |
|                        |         |     |     |munca, in situatia in care     |
|                        |         |     |     |asiguratul a lucrat in ziua    |
|                        |         |     |     |premergatoare concediului      |
|                        |         |     |     |medical in conditii speciale de|
|                        |         |     |     |munca.                         |
|                        |         |     |     |(Nu se inregistreaza zilele de |
|                        |         |     |     |concediu de maternitate,       |
|                        |         |     |     |concediu crestere copil,       |
|                        |         |     |     |concediu ingrijire copil sau   |
|                        |         |     |     |prestatii pentru prevenirea    |
|                        |         |     |     |imbolnavirilor si recuperarea  |
|                        |         |     |     |capacitatii de munca, care sunt|
|                        |         |     |     |corespunzatoare in aceste      |
|                        |         |     |     |situatii conditiilor normale de|
|                        |         |     |     |munca)                         |
|________________________|_________|_____|_____|_______________________________|
|Total zile prestatii in | PPD     | N   |   2 |Contine numarul total de zile  |
|conditii deosebite      |         |     |     |lucratoare corespunzatoare     |
|                        |         |     |     |concediului medical pentru     |
|                        |         |     |     |incapacitate temporara de      |
|                        |         |     |     |munca, in situatia in care     |
|                        |         |     |     |asiguratul a lucrat in ziua    |
|                        |         |     |     |premergatoare concediului      |
|                        |         |     |     |medical in conditii deosebite  |
|                        |         |     |     |de munca.                      |
|                        |         |     |     |(Nu se inregistreaza zilele de |
|                        |         |     |     |concediu de maternitate,       |
|                        |         |     |     |concediu crestere copil,       |
|                        |         |     |     |concediu ingrijire copil sau   |
|                        |         |     |     |prestatii pentru prevenirea    |
|                        |         |     |     |imbolnavirilor si recuperarea  |
|                        |         |     |     |capacitatii de munca, care sunt|
|                        |         |     |     |corespunzatoare in aceste      |
|                        |         |     |     |situatii conditiilor normale de|
|                        |         |     |     |munca)                         |
|________________________|_________|_____|_____|_______________________________|
|Zile prestatii suportate| PPBASS  | N   |   2 |Zile lucratoare prestatii      |
|din BASS                |         |     |     |pentru cuantum prestatii       |
|                        |         |     |     |suportat din BASS              |
|________________________|_________|_____|_____|_______________________________|
|Zile prestatii suportate| PPFAAMBP| N   |   2 |Zile lucratoare prestatii      |
|din FAAMBP              |         |     |     |pentru cuantum prestatii       |
|                        |         |     |     |suportat din FAAMBP            |
|________________________|_________|_____|_____|_______________________________|
|Total cuantum prestatii | FAAMBP  | N   |   9 |Contine total cuantum prestatii|
|de asigurari sociale de |         |     |     |de asigurari sociale de        |
|suportat din Fondul     |         |     |     |suportat din Fondul de         |
|pentru accidente de     |         |     |     |accidente de munca si boli     |
|munca si boli           |         |     |     |profesionale. Acest camp este  |
|profesionale            |         |     |     |completat numai pentru         |
|                        |         |     |     |Concediile medicale cauzate de |
|                        |         |     |     |de accidente de munca sau boli |
|                        |         |     |     |profesionale.                  |
|________________________|_________|_____|_____|_______________________________|

    TT = NN + DD + SS + PP + PPD + PPS
    PPBASS + PPFAAMBP </= PP + PPD + PPS
    CASTOT >/= BASS + FAAMBP

    Fisierul A12.DBF sau A12.TXT (ANEXA 1.2) contine o singura inregistrare cu date centralizatoare referitoare la obligatiile de plata ale angajatorului si are urmatoarea structura:
 ______________________________________________________________________________
|                        | Denumire| Tip |Lung.|            Explicatii         |
|                        | camp    | camp|     |                               |
|________________________|_________|_____|_____|_______________________________|
|Anul                    | AN      | N   |   4 |Se completeaza cu anul pentru  |
|                        |         |     |     |care se intocmeste declaratia  |
|________________________|_________|_____|_____|_______________________________|
|Luna                    | LN      | N   |   2 |Se completeaza cu luna anului  |
|                        |         |     |     |pentru care se intocmeste      |
|                        |         |     |     |declaratia                     |
|________________________|_________|_____|_____|_______________________________|
|Ziua lichidarii         | DCZZ    | N   |   2 |Se completeaza cu ziua         |
|drepturilor salariale   |         |     |     |lichidarii drepturilor         |
|                        |         |     |     |salariale                      |
|________________________|_________|_____|_____|_______________________________|
|Luna lichidarii         | DCLL    | N   |   2 |Se completeaza cu luna         |
|drepturilor salariale   |         |     |     |lichidarii drepturilor         |
|                        |         |     |     |salariale                      |
|________________________|_________|_____|_____|_______________________________|
|Anul lichidarii         | DCAA    | N   |   4 |Se completeaza cu anul         |
|drepturilor salariale   |         |     |     |lichidarii drepturilor         |
|                        |         |     |     |salariale                      |
|________________________|_________|_____|_____|_______________________________|
|Denumire angajator      | DEN     | C   |  29 |Contine denumirea angajatorului|
|________________________|_________|_____|_____|_______________________________|
|Cod unic de inregistrare| CF      | N   |  10 |Se completeaza partea numerica |
|CUI/CF pentru angajatori|         |     |     |a codului unic de inregistrare/|
|persoane juridice       |         |     |     |cod fiscal atribuit            |
|                        |         |     |     |angajatorilor - persoane       |
|                        |         |     |     |juridice                       |
|________________________|_________|_____|_____|_______________________________|
|Cod judet din Nr. de    | RJ      | C   |   3 |Contine primele trei caractere |
|inmatriculare in        |         |     |     |din numarul de inmatriculare in|
|Registrul Comertului    |         |     |     |registrul comertului al        |
|                        |         |     |     |angajatorului                  |
|________________________|_________|_____|_____|_______________________________|
|Nr. de inregistrare din | RN      | N   |   5 |Contine caracterele 4 - 8 din  |
|Registrul Comertului    |         |     |     |numarul de inmatriculare in    |
|                        |         |     |     |registrul comertului al        |
|                        |         |     |     |angajatorului (nr. in RC)      |
|________________________|_________|_____|_____|_______________________________|
|Anul din Nr. de         | RA      | N   |   4 |Contine ultimele patru         |
|inmatriculare in        |         |     |     |caractere din numarul de       |
|Registrul Comertului    |         |     |     |inmatriculare in registrul     |
|                        |         |     |     |comertului al angajatorului    |
|________________________|_________|_____|_____|_______________________________|
|Numar mediu asigurati   | NRM     | N   | 8.2 |Numarul mediu de asigurati se  |
|                        |         |     |     |calculeaza cu 2 zecimale prin  |
|                        |         |     |     |rotunjire matematica. Lungimea |
|                        |         |     |     |campului este 8.2 (5 cifre     |
|                        |         |     |     |partea intreaga, respectiv 2   |
|                        |         |     |     |cifre partea zecimala)         |
|                        |         |     |     |Ex.: daca din calcul rezulta   |
|                        |         |     |     |10,172895, atunci numarul mediu|
|                        |         |     |     |de asigurati este 10,17;       |
|                        |         |     |     |Daca din calcul rezulta        |
|                        |         |     |     |10,175110, atunci numarul mediu|
|                        |         |     |     |de asigurati este 10,18        |
|________________________|_________|_____|_____|_______________________________|

    Notatii:
    A = Norma zilnica 1
    B = Norma zilnica 2
    C = Norma zilnica 3
     _
    >_(Suma) se calculeaza dupa numar zile lucrate.

 ______________________________________________________________________________
| Formula pentru calculul numarului mediu de asigurati este:                   |
|        _                                                                     |
|       | _                                                                    |
| NRM = |>_ (Nr. asigurati cu contract de munca cu norma intreaga * A * Zile   |
|       |_  lucrate) +                                                         |
|  _                                                                           |
| >_ (Nr. Asigurati cu contract de munca cu timp partial * 2 ore * Zile        |
|    lucrate) + .............................................................  |
|  _                                                                           |
| >_ (Nr. Asigurati cu contract de munca cu timp partial * 7 ore * Nr. Zile    |
|        _                                 _     _                             |
|         |                                 |   | _                            |
| lucrate)| / (Zile lucratoare din luna * A)| + |>_ (Nr. asigurati cu contract |
|        _|                                _|   |_                             |
|                                                   _                          |
| de munca cu norma intreaga * B * Zile lucrate) + >_ (Nr. Asigurati cu        |
| contract de munca cu timp partial * 2 ore * Zile lucrate) + .............. + |
|  _                                                                           |
| >_ (Nr. Asigurati cu contract de munca cu timp partial * 6 ore * Zile        |
|        _                                          _                          |
|         |                                        | _                         |
| lucrate)| / (Nr. Zile lucratoare din luna * B) + |>_ (Nr. asigurati cu       |
|        _|                                        |_                          |
|                                                            _                 |
| contract de munca cu norma intreaga * C * Zile lucrate) + >_ (Nr. Asigurati  |
| cu contract de munca cu timp partial * 2 ore * Zile lucrate) + .......... +  |
|  _                                                                           |
| >_ (Nr. Asigurati cu contract de munca cu timp partial * 5 ore * Zile        |
|        _                                                                     |
|         |                                                                    |
| lucrate)| / ( Zile lucratoare din luna * C)                                  |
|        _|                                                                    |
| Norma zilnica poate sa fie de 8, 7 sau 6 ore (campul NORMA).                 |
|______________________________________________________________________________|

    Ex.:
    Norma 1 = 8 ore
    Norma 2 = 7 ore

    O firma are 9 angajati in luna martie 2003, din care:
    - cu norma 1
    3 angajati lucreaza 21 zile
    1 angajat lucreaza 10 zile si 11 zile este in concediu medical
    1 angajat lucreaza 21 zile cu contract de munca cu timp partial 3 ore
    1 angajat lucreaza 18 zile cu contract de munca cu timp partial 2 ore

    - cu norma 2
    1 angajat lucreaza 21 zile
    1 angajat lucreaza 15 zile si 6 zile este in concediu medical
    1 angajat lucreaza 21 zile cu contract de munca cu timp partial 4 ore

    NRM = [(((3*8*21) + (1*8*10) + (1*3*21) + (1*2*18)) / (21*8)) +
          (((1*7*21) + (1*7*15) + (1*4*21)) / (21*7))] = 6.35

    Rotunjirea aritmetica se efectueaza la rezultatul final.

 ______________________________________________________________________________
|Total fond salarii brute| FS      | N   |  13 |Contine total fond de salarii  |
|realizate               |         |     |     |brute realizate pe unitate     |
|________________________|_________|_____|_____|_______________________________|
|Total salarii brute     | FSN     | N   |  13 |Contine total salarii brute    |
|realizate in conditii   |         |     |     |realizate in conditii normale  |
|normale de munca        |         |     |     |de munca                       |
|________________________|_________|_____|_____|_______________________________|
|Total salarii brute     | FSD     | N   |  13 |Contine total salarii brute    |
|realizate in conditii   |         |     |     |realizate in conditii deosebite|
|deosebite de munca      |         |     |     |de munca                       |
|________________________|_________|_____|_____|_______________________________|
|Total salarii brute     | FSS     | N   |  13 |Contine total salarii brute    |
|realizate in conditii   |         |     |     |realizate in conditii speciale |
|speciale de munca       |         |     |     |de munca                       |
|________________________|_________|_____|_____|_______________________________|
|Total contributii       | CASS    | N   |  13 |Contine total Contributie      |
|individuale de asigurari|         |     |     |individuala de asigurari       |
|sociale de virat        |         |     |     |sociale de virat               |
|________________________|_________|_____|_____|_______________________________|
|Total CAS datorat de    | CASAN   | N   |  13 |Contine total Contributie de   |
|angajator               |         |     |     |asigurari sociale datorate de  |
|                        |         |     |     |angajator                      |
|________________________|_________|_____|_____|_______________________________|
|Total cuantum prestatii | BASS    | N   |  13 |Contine total cuantum prestatii|
|de asigurari sociale de |         |     |     |de asigurari sociale de        |
|suportat din BASS       |         |     |     |suportat din Bugetul           |
|                        |         |     |     |asigurarilor sociale de        |
|                        |         |     |     |stat, inclusiv ajutorul de     |
|                        |         |     |     |deces                          |
|________________________|_________|_____|_____|_______________________________|
|CASS conform art. 54    | CASS145 | N   |  13 |Contine Contributia de         |
|alin. 2 din             |         |     |     |asigurari de sanatate aferente |
|O.U.G. nr. 150/2002     |         |     |     |Concediilor medicale exclusiv  |
|(exclusiv accidente de  |         |     |     |concediile medicale aferente   |
|munca si boli           |         |     |     |accidentelor de munca si       |
|profesionale)           |         |     |     |bolilor profesionale, conform  |
|                        |         |     |     |art. 54 alin. 2 din            |
|                        |         |     |     |O.U.G. nr. 150/2002            |
|________________________|_________|_____|_____|_______________________________|
|Total CAS angajator de  | CASVIR  | N   |  13 |Contine total CAS angajator de |
|virat                   |         |     |     |virat                          |
|                        |         |     |     |Formula de calcul pentru 2001 -|
|                        |         |     |     |2003:                          |
|                        |         |     |     |CASVIR=CASS+CASAN-BASS-CASS145 |
|                        |         |     |     |                               |
|                        |         |     |     |Formula de calcul pentru =     |
|                        |         |     |     |2004:                          |
|                        |         |     |     |CASVIR=CASAN-CASS145-BASS      |
|                        |         |     |     |                               |
|                        |         |     |     |Formula de calcul pentru =     |
|                        |         |     |     |2005:                          |
|                        |         |     |     |CASVIR=CASAN-CASS145-BASS      |
|________________________|_________|_____|_____|_______________________________|
|Numar total de file de  | NRF     | N   |   3 |Contine numar file de la       |
|la ANEXA 1.1            |         |     |     |ANEXA 1.1                      |
|________________________|_________|_____|_____|_______________________________|
|Banca*)              | B1      | C   |  16 |                               |
|________________________|_________|_____|_____|_______________________________|
|Filiala*)            | F1      | C   |  16 |                               |
|________________________|_________|_____|_____|_______________________________|
|Cont*)               | C1      | C   |  35 |                               |
|________________________|_________|_____|_____|_______________________________|
|Banca*)              | B2      | C   |  16 |                               |
|________________________|_________|_____|_____|_______________________________|
|Filiala*)            | F2      | C   |  16 |                               |
|________________________|_________|_____|_____|_______________________________|
|Cont*)               | C2      | C   |  35 |                               |
|________________________|_________|_____|_____|_______________________________|
|Banca*)              | B3      | C   |  16 |                               |
|________________________|_________|_____|_____|_______________________________|
|Filiala*)            | F3      | C   |  16 |                               |
|________________________|_________|_____|_____|_______________________________|
|Cont*)               | C3      | C   |  35 |                               |
|________________________|_________|_____|_____|_______________________________|
|Banca*)              | B4      | C   |  16 |                               |
|________________________|_________|_____|_____|_______________________________|
|Filiala*)            | F4      | C   |  16 |                               |
|________________________|_________|_____|_____|_______________________________|
|Cont*)               | C4      | C   |  35 |                               |
|________________________|_________|_____|_____|_______________________________|
|Cod unic de inregistrare| CNPA    | N   |  13 |Contine Codul unic de          |
|(CUI) pentru angajatori |         |     |     |inregistrare atribuit prin     |
|persoane fizice         |         |     |     |Certificatul de inregistrare   |
|                        |         |     |     |angajatorilor persoane         |
|                        |         |     |     |fizice si care reprezinta codul|
|                        |         |     |     |numeric personal al            |
|                        |         |     |     |angajatorului                  |
|________________________|_________|_____|_____|_______________________________|
|Contributie asigurari   | CAAMBP  | N   |  13 |Contine contributie asigurari  |
|pentru accidente de     |         |     |     |pentru accidente de munca si   |
|munca si boli           |         |     |     |boli profesionale (art. 140    |
|profesionale (art. 140  |         |     |     |Legea nr. 346/2002 completata  |
|Legea nr. 346/2002)     |         |     |     |si modificata),                |
|                        |         |     |     |Pentru anii 2003, 2004:        |
|                        |         |     |     |CAAMBP=ROUND (FS*0.5 / 100,0)  |
|                        |         |     |     |Incepand cu anul 2005:         |
|                        |         |     |     |CAAMBP=ROUND                   |
|                        |         |     |     |(FS*PCAMBP / 100,0)            |
|________________________|_________|_____|_____|_______________________________|
|Localitatea (oras,      | A_LOCA  | C   |  21 |Adresa sediu angajator -       |
|comuna)                 |         |     |     |localitate (oras sau comuna)   |
|                        |         |     |     |- se completeaza obligatoriu   |
|________________________|_________|_____|_____|_______________________________|
|Strada (strada, satul)  | A_STR   | C   |  21 |Adresa sediu angajator - strada|
|                        |         |     |     |sau sat                        |
|                        |         |     |     |- daca se completeaza orasul,  |
|                        |         |     |     |se completeaza obligatoriu si  |
|                        |         |     |     |strada                         |
|________________________|_________|_____|_____|_______________________________|
|Numar                   | A_NR    | C   |   7 |Adresa sediu angajator - numar |
|________________________|_________|_____|_____|_______________________________|
|Bloc                    | A_BL    | C   |   5 |Adresa sediu angajator - bloc  |
|________________________|_________|_____|_____|_______________________________|
|Scara                   | A_SC    | C   |   4 |Adresa sediu angajator - scara |
|________________________|_________|_____|_____|_______________________________|
|Etaj                    | A_ET    | C   |   2 |Adresa sediu angajator - etaj  |
|________________________|_________|_____|_____|_______________________________|
|Apartament              | A_AP    | C   |   4 |Adresa sediu angajator -       |
|                        |         |     |     |apartament                     |
|________________________|_________|_____|_____|_______________________________|
|Telefon                 | TELEFON | N   |  10 |Telefon de legatura angajator  |
|________________________|_________|_____|_____|_______________________________|
|Judet                   | A_JUD   | C   |   3 |Adresa sediu angajator - Cod   |
|                        |         |     |     |judet - se completeaza         |
|                        |         |     |     |obligatoriu (*)            |
|________________________|_________|_____|_____|_______________________________|
|Sector                  | A_SECT  | N   |   2 |Adresa sediu angajator - sector|
|                        |         |     |     |(numai pentru Bucuresti)       |
|________________________|_________|_____|_____|_______________________________|
|E-mail                  | E_MAIL  | C   |  45 |Adresa e-mail angajator        |
|________________________|_________|_____|_____|_______________________________|
|Tipul declaratiei       | TIPD    | C   |   1 |Se completeaza cu R pentru     |
|                        |         |     |     |declaratia rectificativa,      |
|                        |         |     |     |spatiu in rest.                |
|                        |         |     |     |Declaratia rectificativa pentru|
|                        |         |     |     |anexa a12 se completeaza       |
|                        |         |     |     |astfel:                        |
|                        |         |     |     |- se recalculeaza a12 tinand   |
|                        |         |     |     |cont de modificarile efectuate |
|                        |         |     |     |in anexa a11 fata de declaratia|
|                        |         |     |     |initiala.                      |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri indemnizatie | NRCAZB  | N   |   5 |Nr. total cazuri indemnizatie  |
|pentru incapacitate     |         |     |     |pentru incapacitate temporara  |
|temporara de munca      |         |     |     |de munca la nivel de unitate   |
|                        |         |     |     |exclusiv pentru accidente de   |
|                        |         |     |     |munca si boli profesionale     |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri accidente de | NRCAZA  | N   |   5 |Nr. total cazuri accidente de  |
|munca si boli           |         |     |     |munca si boli profesionale la  |
|profesionale*)       |         |     |     |nivel de unitate pentru anii   |
|                        |         |     |     |(campul nu se mai foloseste din|
|                        |         |     |     |anul 2005)                     |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri prevenire    | NRCAZP  | N   |   5 |Nr. total cazuri prevenire     |
|imbolnaviri             |         |     |     |imbolnaviri la nivel de unitate|
|                        |         |     |     |= suma de cazuri de:           |
|                        |         |     |     |- trecere temporara in alta    |
|                        |         |     |     |  munca                        |
|                        |         |     |     |- reducerea timpului de munca  |
|                        |         |     |     |- carantina                    |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri sarcina si   | NRCAZL  | N   |   5 |Nr. total cazuri sarcina si    |
|lauzie                  |         |     |     |lauzie la nivel de unitate     |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri ingrijire    | NRCAZI  | N   |   5 |Nr. total cazuri ingrijire     |
|copil bolnav            |         |     |     |copil bolnav la nivel de       |
|                        |         |     |     |unitate                        |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri crestere     | NRCAZC  | N   |   5 |Nr. total cazuri crestere copil|
|copil pana la           |         |     |     |pana la 2 ani/3 ani la nivel de|
|2 ani/3 ani             |         |     |     |unitate                        |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri ajutoare de  | NRCAZD  | N   |   5 |Nr. total cazuri ajutoare de   |
|deces                   |         |     |     |deces la nivel de unitate      |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri indemnizatie | NRCAZR  | N   |   5 |Nr. total cazuri cu            |
|de risc maternal        |         |     |     |indemnizatie de risc maternal  |
|                        |         |     |     |la nivel de unitate            |
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPB   | N   |   6 |Nr. total zile lucratoare      |
|indemnizatie pentru     |         |     |     |indemnizatie pentru            |
|incapacitate temporara  |         |     |     |incapacitate temporara de munca|
|de munca                |         |     |     |la nivel de unitate din        |
|                        |         |     |     |certificatele medicale         |
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPA   | N   |   6 |Nr. total zile lucratoare      |
|accidente de munca si   |         |     |     |prestatii accidente de munca si|
|boli profesionale*)  |         |     |     |boli profesionale, la nivel de |
|                        |         |     |     |unitate din certificatele      |
|                        |         |     |     |medicale (campul nu se mai     |
|                        |         |     |     |foloseste din anul 2005)       |
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPP   | N   |   6 |Nr. total zile lucratoare      |
|prevenire imbolnaviri   |         |     |     |prestatii prevenire imbolnaviri|
|                        |         |     |     |la nivel de unitate din        |
|                        |         |     |     |certificatele medicale         |
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPL   | N   |   6 |Nr. total zile lucratoare      |
|sarcina si lauzie       |         |     |     |prestatii sarcina si lauzie la |
|                        |         |     |     |nivel de unitate din           |
|                        |         |     |     |certificatele medicale         |
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPI   | N   |   6 |Nr. total zile lucratoare      |
|ingrijire copil bolnav  |         |     |     |prestatii ingrijire copil      |
|                        |         |     |     |bolnav la nivel de unitate din |
|                        |         |     |     |certificatele medicale         |
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPC   | N   |   6 |Nr. total zile lucratoare      |
|crestere copil pana la  |         |     |     |prestatii crestere copil pana  |
|la 2 ani/3 ani          |         |     |     |2 ani/3 ani la nivel de unitate|
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPR   | N   |   6 |Nr. total zile lucratoare      |
|indemnizatie de risc    |         |     |     |prestatii indemnizatie de risc |
|maternal                |         |     |     |maternal la nivel de unitate   |
|                        |         |     |     |din certificatele medicale     |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pentru   | SUMAB   | N   |  12 |Suma prestatii indemnizatie    |
|indemnizatie pentru     |         |     |     |pentru incapacitate temporara  |
|incapacitate temporara  |         |     |     |de munca la nivel de unitate   |
|de munca suportate din  |         |     |     |suportate din BASS             |
|BASS                    |         |     |     |                               |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pentru   | SUMAA   | N   |  12 |Suma prestatii pentru accidente|
|accidente de munca si   |         |     |     |de munca si boli profesionale  |
|boli profesionale       |         |     |     |la nivel de unitate suportate  |
|suportate din BASS*) |         |     |     |din BASS (campul nu se mai     |
|                        |         |     |     |foloseste din anul 2005)       |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pentru   | SUMAP   | N   |  12 |Suma prestatii pentru prevenire|
|prevenire imbolnaviri   |         |     |     |imbolnaviri la nivel de unitate|
|suportate din BASS      |         |     |     |suportate din BASS             |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pentru   | SUMAL   | N   |  12 |Suma prestatii pentru sarcina  |
|sarcina si lauzie       |         |     |     |si lauzie la nivel de unitate  |
|suportate din BASS      |         |     |     |suportate din BASS             |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pentru   | SUMAI   | N   |  12 |Suma prestatii pentru ingrijire|
|ingrijire copil bolnav  |         |     |     |copil bolnav la nivel de       |
|suportate din BASS      |         |     |     |unitate suportate din BASS     |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pentru   | SUMAC   | N   |  12 |Suma prestatii pentru crestere |
|crestere copil pana la  |         |     |     |copil pana la 2 ani/3 ani la   |
|2 ani/3 ani suportate   |         |     |     |nivel de unitate suportate din |
|din BASS                |         |     |     |BASS                           |
|________________________|_________|_____|_____|_______________________________|
|Suma ajutoare de deces  | SUMAD   | N   |  12 |Suma totala ajutoare de deces  |
|suportata din BASS      |         |     |     |la nivel de unitate suportate  |
|                        |         |     |     |din BASS                       |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pentru   | SUMAR   | N   |  12 |Suma prestatii pentru          |
|indemnizatie de risc    |         |     |     |indemnizatie de risc maternal  |
|maternal suportata din  |         |     |     |la nivel de unitate suportate  |
|BASS                    |         |     |     |din BASS                       |
|________________________|_________|_____|_____|_______________________________|
|Cod CAEN                | CODCAEN | C   |   4 |Se completeaza cu Codul CAEN   |
|                        |         |     |     |al angajatorului conform       |
|                        |         |     |     |nomenclatorului privind        |
|                        |         |     |     |clasificarea activitatilor     |
|                        |         |     |     |economice la nivel national    |
|________________________|_________|_____|_____|_______________________________|
|Total zile prestatii    | TPP     | N   |   6 |Contine nr. total zile         |
|pentru prestatiile de la|         |     |     |prestatii (atat platite de     |
|pct. L1, L2, L3, L4, L5,|         |     |     |angajator cat si suportate din |
|L7, folosit la calcul   |         |     |     |BASS)                          |
|contributie sanatate    |         |     |     |                               |
|________________________|_________|_____|_____|_______________________________|
|Procent contributie de  | PCAMBP  | N   | 5(3)|Procent contributie de         |
|asigurari pentru        |         |     |     |asigurari pentru accidente de  |
|accidente de munca si   |         |     |     |munca si boli profesionale,    |
|boli profesionale       |         |     |     |functie de incadrarea in       |
|                        |         |     |     |clasele de risc (cod CAEN)     |
|________________________|_________|_____|_____|_______________________________|
|Total zile prestatii    | TPPA    | N   |   6 |Contine nr. total zile         |
|pentru prestatiile de la|         |     |     |prestatii pentru accidente de  |
|pct. P1, P2, P3, P4,    |         |     |     |munca si boli profesionale     |
|folosit la calcul       |         |     |     |(atat platite de angajator cat |
|contributie sanatate    |         |     |     |si suportate din FAAMBP)       |
|________________________|_________|_____|_____|_______________________________|
|CASS conform art. 54    | CASS145A| N   |  13 |Contine Contributia de         |
|alin. 2 din             |         |     |     |asigurari de sanatate aferente |
|O.U.G. nr. 150/2002,    |         |     |     |Concediilor medicale cauzate de|
|aferente accidentelor de|         |     |     |accidente de munca si boli     |
|munca si bolilor        |         |     |     |profesionale conform art. 54   |
|profesionale            |         |     |     |alin. 2 din O.U.G. nr. 150/2002|
|________________________|_________|_____|_____|_______________________________|
|Total cuantum prestatii | PFAAMBP | N   |  13 |Contine total cuantum prestatii|
|de asigurari sociale de |         |     |     |de asigurari sociale de        |
|suportat din Fondul de  |         |     |     |suportat din Fondul de         |
|accidente de munca si   |         |     |     |accidente de munca si boli     |
|boli profesionale       |         |     |     |profesionale                   |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri indemnizatie | NRCAZIT | N   |   5 |Nr. total cazuri indemnizatie  |
|pentru incapacitate     |         |     |     |pentru incapacitate temporara  |
|temporara de munca      |         |     |     |de munca cauzate de accidente  |
|cauzate de accidente de |         |     |     |de munca si boli profesionale  |
|munca si boli           |         |     |     |la nivel de unitate            |
|profesionale            |         |     |     |                               |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri indemnizatie | NRCAZTT | N   |   5 |Nr. total cazuri indemnizatie  |
|pentru trecerea         |         |     |     |pentru trecerea temporara in   |
|temporara in alt loc de |         |     |     |alt loc de munca cauzata de    |
|munca cauzate de        |         |     |     |accidente de munca si boli     |
|accidente de munca si   |         |     |     |profesionale la nivel de       |
|boli profesionale       |         |     |     |unitate                        |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri indemnizatie | NRCAZRT | N   |   5 |Nr. total cazuri indemnizatie  |
|pentru reducerea        |         |     |     |pentru reducerea timpului de   |
|timpului de lucru       |         |     |     |lucru cauzata de accidente de  |
|cauzate de accidente de |         |     |     |munca si boli profesionale la  |
|munca si boli           |         |     |     |nivel de unitate               |
|profesionale            |         |     |     |                               |
|________________________|_________|_____|_____|_______________________________|
|Nr. cazuri indemnizatie | NRCAZCC | N   |   5 |Nr. total cazuri indemnizatie  |
|pe durata cursurilor de |         |     |     |pe durata cursurilor de        |
|calificare si           |         |     |     |calificare si reconversie      |
|reconversie profesionala|         |     |     |profesionala cauzata de        |
|cauzate de accidente de |         |     |     |accidente de munca si boli     |
|munca si boli           |         |     |     |profesionale la nivel de       |
|profesionale            |         |     |     |unitate                        |
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPIT  | N   |   6 |Nr. total zile lucratoare      |
|indemnizatie pentru     |         |     |     |prestatii pentru incapacitate  |
|incapacitate temporara  |         |     |     |temporara de munca cauzate de  |
|de munca cauzate de     |         |     |     |accidente de munca si boli     |
|accidente de munca si   |         |     |     |profesionale la nivel de       |
|boli profesionale       |         |     |     |unitate din certificatele      |
|                        |         |     |     |medicale                       |
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPTT  | N   |   6 |Nr. total zile lucratoare      |
|pentru trecerea         |         |     |     |prestatii pentru trecerea      |
|temporara in alt loc de |         |     |     |temporara in alt loc de munca  |
|munca cauzate de        |         |     |     |cauzata de accidente de munca  |
|accidente de munca si   |         |     |     |si boli profesionale la nivel  |
|boli profesionale       |         |     |     |de unitate din certificatele   |
|                        |         |     |     |medicale                       |
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPRT  | N   |   6 |Nr. total zile lucratoare      |
|pentru reducerea        |         |     |     |prestatii pentru reducerea     |
|timpului de lucru       |         |     |     |timpului de lucru cauzata de   |
|cauzate de accidente de |         |     |     |accidente de munca si boli     |
|munca si boli           |         |     |     |profesionale la nivel de       |
|profesionale            |         |     |     |unitate din certificatele      |
|                        |         |     |     |medicale                       |
|________________________|_________|_____|_____|_______________________________|
|Nr. total zile prestatii| NRPPCC  | N   |   6 |Nr. total zile lucratoare      |
|pe durata cursurilor de |         |     |     |prestatii pe durata cursurilor |
|calificare si           |         |     |     |de calificare si reconversie   |
|reconversie profesionala|         |     |     |profesionala cauzata de        |
|cauzate de accidente de |         |     |     |accidente de munca si boli     |
|munca si boli           |         |     |     |profesionale la nivel de       |
|profesionale            |         |     |     |unitate din certificatele      |
|                        |         |     |     |medicale                       |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pentru   | SUMAIT  | N   |  12 |Suma prestatii pentru          |
|incapacitate temporara  |         |     |     |incapacitate temporara de munca|
|de munca cauzata de     |         |     |     |cauzate de accidente de munca  |
|accidente de munca si   |         |     |     |si boli profesionale la nivel  |
|boli profesionale,      |         |     |     |de unitate suportate din FAAMBP|
|suportate din FAAMBP    |         |     |     |                               |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pentru   | SUMATT  | N   |  12 |Suma prestatii pentru trecerea |
|trecerea temporara in   |         |     |     |temporara in alt loc de munca  |
|alt loc de munca cauzate|         |     |     |cauzata de accidente de munca  |
|de accidente de munca si|         |     |     |si boli profesionale la nivel  |
|boli profesionale,      |         |     |     |de unitate suportate din FAMMBP|
|suportate din FAAMBP    |         |     |     |                               |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pentru   | SUMART  | N   |  12 |Suma prestatii pentru reducerea|
|reducerea timpului de   |         |     |     |timpului de lucru cauzata de   |
|lucru cauzate de        |         |     |     |accidente de munca si boli     |
|accidente de munca si   |         |     |     |profesionale la nivel de       |
|boli profesionale,      |         |     |     |unitate suportate din FAMMBP   |
|suportate din FAAMBP    |         |     |     |                               |
|________________________|_________|_____|_____|_______________________________|
|Suma prestatii pe durata| SUMACC  | N   |  12 |Suma prestatii pe durata       |
|cursurilor de calificare|         |     |     |cursurilor de calificare si    |
|si reconversie          |         |     |     |reconversie profesionala       |
|profesionala cauzate de |         |     |     |cauzata de accidente de munca  |
|accidente de munca si   |         |     |     |si boli profesionale la nivel  |
|boli profesionale,      |         |     |     |de unitate suportate din FAAMBP|
|suportate din FAAMBP    |         |     |     |                               |
|________________________|_________|_____|_____|_______________________________|
|Contributie de asigurari| FAMBPV  | N   |  13 |Contine contributia de         |
|pentru accidente de     |         |     |     |asigurari pentru accidente de  |
|munca si boli           |         |     |     |munca si boli profesionale de  |
|profesionale de virat   |         |     |     |virat                          |
|                        |         |     |     |FAMBPV=CAAMBP-PFAAMBP-CASS145A |
|________________________|_________|_____|_____|_______________________________|
|Datoreaza contributie   | DATORAT | N   |   1 |Se completeaza astfel:         |
|pentru accidente de     |         |     |     |1 - datoreaza contributie de   |
|munca si boli           |         |     |     |    accidente de munca si boli |
|profesionale            |         |     |     |    profesionale               |
|                        |         |     |     |0 - nu datoreaza contributie de|
|                        |         |     |     |    accidente de munca si boli |
|                        |         |     |     |    profesionale (pentru       |
|                        |         |     |     |    angajatorii la care nu se  |
|                        |         |     |     |    aplica prevederile         |
|                        |         |     |     |    Legii nr. 346/2002         |
|                        |         |     |     |    modificata si completata)  |
|________________________|_________|_____|_____|_______________________________|

 ______________________________________________________________________________
|Total BASS din a11 = SUMAB+SUMAA+SUMAP+SUMAL+SUMAI+SUMAC+SUMAR (SUMAA = 0     |
|incepand cu anul 2005)                                                        |
|BASS din a12 = SUMAB+SUMAA+SUMAP+SUMAL+SUMAI+SUMAC+SUMAD+SUMAR (SUMAA = 0     |
|incepand cu anul 2005)                                                        |
|______________________________________________________________________________|
|______________________________________________________________________________|
|Total PP+PPD+PPS din a11 = NRPPB+NRPPA+NRPPP+NRPPL+NRPPI+NRPPC+NRPPR+NRPPIT+  |
|NRPPTT+NRPPRT+NRPPCC (NRPPA = 0 din 2005)                                     |
|TPP din a12 = NRPPB+NRPPA+NRPPP+NRPPL+NRPPI+NRPPC+NRPPR (NRPPA = 0 incepand cu|
|anul 2005)                                                                    |
|TPPA din a12 = NRPPIT+NRPPTT+NRPPRT+NRPPCC                                    |
|______________________________________________________________________________|
|Total FAAMBP din a11 = SUMAIT+SUMATT+SUMART+SUMACC                            |
|PFAAMBP din a12      = SUMAIT+SUMATT+SUMART+SUMACC                            |
|Total FAAMBP din a11 = PFAAMBP din a12                                        |
|______________________________________________________________________________|
|*) Nu se completeaza (aceste campuri exista pentru compatibilitate cu      |
|versiunea anterioara a programului)                                           |
|______________________________________________________________________________|

    *) Codurile de judete

     ____________________________
    | Cod judet | Denumire judet |
    |___________|________________|
    |    011    | Alba           |
    |___________|________________|
    |    021    | Arad           |
    |___________|________________|
    |    031    | Arges          |
    |___________|________________|
    |    041    | Bacau          |
    |___________|________________|
    |    051    | Bihor          |
    |___________|________________|
    |    061    | Bistrita       |
    |___________|________________|
    |    071    | Botosani       |
    |___________|________________|
    |    081    | Brasov         |
    |___________|________________|
    |    091    | Braila         |
    |___________|________________|
    |    101    | Buzau          |
    |___________|________________|
    |    111    | Caras-Severin  |
    |___________|________________|
    |    121    | Cluj           |
    |___________|________________|
    |    131    | Constanta      |
    |___________|________________|
    |    141    | Covasna        |
    |___________|________________|
    |    151    | Dambovita      |
    |___________|________________|
    |    161    | Dolj           |
    |___________|________________|
    |    171    | Galati         |
    |___________|________________|
    |    181    | Gorj           |
    |___________|________________|
    |    191    | Harghita       |
    |___________|________________|
    |    201    | Hunedoara      |
    |___________|________________|
    |    211    | Ialomita       |
    |___________|________________|
    |    221    | Iasi           |
    |___________|________________|
    |    231    | Giurgiu        |
    |___________|________________|
    |    241    | Maramures      |
    |___________|________________|
    |    251    | Mehedinti      |
    |___________|________________|
    |    261    | Mures          |
    |___________|________________|
    |    271    | Neamt          |
    |___________|________________|
    |    281    | Olt            |
    |___________|________________|
    |    291    | Prahova        |
    |___________|________________|
    |    301    | Satu Mare      |
    |___________|________________|
    |    311    | Salaj          |
    |___________|________________|
    |    321    | Sibiu          |
    |___________|________________|
    |    331    | Suceava        |
    |___________|________________|
    |    341    | Teleorman      |
    |___________|________________|
    |    351    | Timis          |
    |___________|________________|
    |    361    | Tulcea         |
    |___________|________________|
    |    371    | Vaslui         |
    |___________|________________|
    |    381    | Valcea         |
    |___________|________________|
    |    391    | Vrancea        |
    |___________|________________|
    |    401    | Calarasi       |
    |___________|________________|
    |    411    | Bucuresti      |
    |___________|________________|
    |    471    | Ilfov          |
    |___________|________________|



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