Приложение 2. Форма АДВ-2 "Заявление об изменении анкетных данных зарегистрированного лица, содержащихся в индивидуальном лицевом счете"

ГАРАНТ:

См. форму "Заявление об изменении анкетных данных зарегистрированного лица, содержащихся в индивидуальном лицевом счете (форма АДВ-2)", утвержденную приказом Социального фонда России от 30 октября 2023 г. N 2153

См. порядок заполнения формы

См. данную форму в редакторе MS-Excel и образец ее заполнения

Приложение 2
к постановлению Правления
Пенсионного фонда
Российской Федерации
от 31 октября 2022 г. N 243п

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Форма АДВ-2                                                           Код по ОКУД  |          |

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Заявление об изменении анкетных данных зарегистрированного лица,
содержащихся в индивидуальном лицевом счете

Заполняется зарегистрированным лицом печатными буквами

Страховой номер индивидуального лицевого счета ._._._.-._._._.-._._._._._._.
Данные, указанные в документе, подтверждающем регистрацию в системе индивидуального
(персонифицированного) учета:
Фамилия ._._._._._._._._._._._._._._._._._._._._ ._._._._._._._._._._._._._._._._._._._._.
Имя ._._._._._._._._._._._._._._._._._._._._ ._._._._._._._._._._._._._._._._._._._._.
Отчество (при наличии)._._._._._._._._._._._._._._._._._._._._ ._._._._._._._._._._._._._._._.
Новые анкетные данные (указать только изменившиеся данные):
Фамилия ._._._._._._._._._._._._._._._._._._._._ ._._._._._._._._._._._._._._._._._._._._.
Имя ._._._._._._._._._._._._._._._._._._._._ ._._._._._._._._._._._._._._._._._._._._.
Отчество (при наличии)._._._._._._._._._._._._._._._._._._._._ ._._._._._._._._._._._._._._._.
Пол ._. (м/ж)
Дата рождения "._._." ._._._._._._._._. ._._._._.года
Место рождения:
город (село,
деревня,...) ._._._._._._._._._._._._._._._ ._._._._._._._._._._._._._._._._._._._._.
район ._._._._._._._._._._._._._._._ ._._._._._._._._._._._._._._._._._._._._.
регион (область,
край, республика, ...) ._._._._._._._ ._._._._._._._._._._._._._._._._._._._._.
страна ._._._._._._._._._._._._._._._._._._._._._.
Гражданство ._._._._._._._._._._._._._._._._._._._._._.
Адрес индекс ._._._._._._. адрес ._._._._._._._._._._._.
регистрации ._._._._._._._._._._._._._._._._._._._._._._.
._._._._._._._._._._._._._._._._._._._._._._.
Адрес места индекс ._._._._._._. адрес ._._._._._._._._._._._.
жительства ._._._._._._._._._._._._._._._._._._._._._._.
фактический ._._._._._._._._._._._._._._._._._._._._._._.
(заполнять при отличии от адреса регистрации)
Телефоны ._._._._._._._._._._._._._._._._._._._._._._.
(домашний и/или рабочий)
Документ, удостоверяющий личность
Вид документа ._._._._._._._._._._._._._._._._._._._._ ._._._._._._._._._._._._._._._._._._._.
(указать название документа: паспорт, удостоверение личности или другие документы, удостоверяющие
личность)
Серия, номер ._._._._._._._._._._._._._._._._._._.
Дата выдачи "._._."._._._._._._._._._._._._._._. года
Кем выдан ._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.
Реквизиты акта гражданского состояния о рождении
Номер актовой записи о рождении ._._._._._._._._._._._._._._._._._._._._._._._._._.
Дата составления актовой записи о рождении "._._."._._._._._._._._._._._._._._. года
Наименование органа, которым произведена государственная регистрация акта о рождении._._._._._._.
._._._._._._._._._.._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._.
Идентификационный номер налогоплательщика (при наличии) ._._._._._._._._._._._._._._._.

 Дата заполнения                               Подпись зарегистрированного лица (представителя)

 "._._."._._._._._._._._._._._._._._. года     __________________________________________

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