№ of payment order

Queue, First name, middle initial, last name (in the presence) / name of the creditor

Individual Identification Number / Business-identifikatsionny Number (IIN/BIN) of the creditor

Amount of shown
requirements (tenge)

Documents, confirmatory
justification accepted by the administrator
decisions (name, date, number), date of emergence of debt

Note

1

2

3

4

5

6

1.

First priority

1

2

3

4

5

6

1)

Requirements of citizens before which the debtor bears responsibility for damnification of life and to health, determined by capitalization of the corresponding time payments

Total:

2)

Requirements for collection of the alimony

...

Total:

3)

Requirements for compensation and payment of compensations to persons working according to the employment contract at the rate of no more average monthly salary which developed at the debtor for twelve calendar months preceding one year before initiation of proceeedings about rehabilitation

...

Total:

1

2

3

4

5

6

4)

Debt on social contributions to the State Social Insurance Fund at the rate of the average monthly salary which developed at the debtor for twelve calendar months preceding one year before initiation of proceeedings about rehabilitation

Total:

5)

Debt on the compulsory pension contributions compulsory for professional pension contributions withheld from the salary at the rate of the average monthly salary which developed at the debtor for twelve calendar months preceding one year before initiation of proceeedings about rehabilitation

1

2

3

4

5

6

…

Total:

6)

Debt on the income tax withheld from the salary at the rate of the average monthly salary which developed at the debtor for twelve calendar months preceding one year before initiation of proceeedings about rehabilitation