B A O H I E M X A H O I V I E T N A M

S6: /BHXH-TCKT V/v hiro-ng dan chi bo sung thu nliap

cho cong chuc, vien ciiuc

CONG HOA XA HOI CHU NGHIA VIET NAM Doc lap - Tu' do - Hanh phiic

Ha Not, ngay A A thdngOSndm 2016

>HC1 Bil.̂ H THUAM

^".Xmlisui : •ao hiem xa hoi cac tinh, thanh pho tru'c thuoc Trung uoiig;

" ^ a n phong Bao hiem xa hoi Viet Nam; GIAM HOi^^^ nghiep true thuoc Bao hiem xa hoi Viet Nam.

Ngay^<:<.thang..i.Dam.^^

_De Bao hiem xa hoi (BHXH) cac tinh, thanh pho true thuoc Trung uong (goi chung la B H X H tinh), Van phong B H X H Viet Nam va cac don v i su nghiep true thuoc B H X H Viet Nam (goi chung la cac don v i true thuoc BTIXH Viet

) thong nhat phuang phap chi bo sung thu nhap cho cong chiic, vien chuc; IP̂ CO so Quy§t dinh s6 298/QD-BHXH ngay 25/02/2016 cua T6ng Giam d6c B B J X H Viet Nam ve viec ban hanh Quy che chi tieu noi bo va trich lap cac quy

6i voi cac don v i thuoc he th6ng B H X H Viet Nam va Quylt dinh s6 299/QD-/ , ^ j ^ . B f f X H ngay 25/02/2016 cua Tong Giam d6c B H X H Viet Nam ve viec ban hanh

' ^ ^ ^ ^ ^ Q u y che quan ly va su dung cac quy d6i vai cac dan v i thuoc he th6ng B H X H '"*''̂ et Nam, B H X H Viet Nam huang dan chi bo sung thu nhap cho cong chuc,

n chuc nhu sau:

1. Doi tuong dirac hirang thu nhap bo sung

;oijg^nuc, vien_cjiu%4«CTT}6hg Tigp dong theo Nghi dinh so 68/2000/ND-^ay,T7/t172000 ciia Chinh phu ve thuc hien che dp hop dong mot so loai

56rig viec trong ca quan hanh chinh nha nuac, don v i su nghiep va lao dong hop dong tam tuyen trong chi tieu bien che theo quy dinh cua B H X H Viet Nam (goi chung la CCVC).

2. Can cu chi bo sung thu nhap

2.1. Ket qua danh gia, xep loai tap the, ca nhan

Thuc hien theo Quyet dinh s6 09/QD-BHXH ngay 06/01/2016 cua Tong Giam doc B H X H Viet Nam quy dinh ve danh gia va xep loai thuc hien chi tien thuang, chi bo sung thu nhap doi vai dan v i , CCVC he thong B H X H Viet Nam.

2.2. Tien luang, phu cap lam can cu tinh thu nhap bo sung

Tien luang theo Nghi dinh 204/2004/ND-CP ngay 14/12/2004 cua Chinh phu ve ch8 do ti^n luang d6i vai CCVC va luc lugng via trang (luang 01 Ian) bao gom luang theo ngach, bac, chta'c vu va cac Idioan phu cap sau:

a) Phu cap tham nien vugt khung. Quy dinh tai Thong tu s6 04/2005/TT-BNV ngay 05/01/2005 cua Bo Noi

V U huong dan thuc hien che do phu cap tham nien vugt khung doi vai can bg, cong chuc, vien chiic.

b) Phu cap khu vuc Quy dinh tai Thong tu lien tich s6 11/2005/TTLT-BNV-BLDTBXH-BTC-

UBDT ngay 05/01/2005 cua Bg Ngi vu - Bg Lao dong Thuang binh va xa hgi -Bg Tai chinh va Uy ban dan tgc huong dan thuc hien che do phu cap khu vuc.

r

c) Phu cap dac biet Quy dinh tai Thong tu s6 09/2005/TT-BNV ngay 05/01/2005 cua Bo Noi vu

huang dan thuc hien che do phu cap dac biet doi vai CCVC va luc lugng via trang. d) Phu cap dgc hai, nguy hiem Quy dinh tai Thong tu s6 07/2005/TT-BNV ngay 05/01/2005 cua Bg Ngi

vu huang dan thuc hien che do phu cap dgc hai nguy hiem doi vai can bg, cong chuc, vien chuc va Cong van s6 2939/BNV-TL ngay 04/10/2005 cua Bg Noi vu

•y f r n r

ve viec che do phu cap dgc hai, nguy hiem doi vai can bg, cong chuc, vien chuc nganh Luu tru. BHXH Viet Nam quy dinh cu the tai Cong van so 4200/BHXH-TCCB ngay 08/11/2007 sua d6i muc huang phu c4p dgc hai doi vai can bg, cong chuc lam viec tai bg phan tiep nhan va tra ket qua va Cong van so 4164/BHXH-TCCB ngay 04/12/2008 vh thuc hien phu c4p dgc hai, nguy hiem doi vai cong chuc, vien chuc.

d) Phu cap trach nhiem cong viec Quy dinh tai Thong tu s6 05/2005/TT-BNV ngay 05/01/2005 cua Bg Ngi

vu huang dan thuc hien che do phu cap trach nhiem doi vai can bg, cong chiic vien chuc. BHXH Viet Nam quy dinh cu th i tai Cong van s6 583/BHXH-TCCB ngay 27/02/2006 ve viec huang dan mot so che do phu cap trong nganh BHXH.

e) Phu cap trach nhiem ke toan truong va phu trach ke toan Quy dinh tai Thong tu lien tich s6 163/2013/TTLT-BTC-BNV ngay

15/11/2013 cua Bg Tai chinh - Bg Ngi vu quy dinh ve viec huong dan tieu chuan, dieu kien, thu tuc bo nhiem, bo nhiem lai, bo tri, mien nhiem, thay the va xep phu cap trach nhiem cong viec ke toan truong, phu trach ke toan trong cac don vi ke toan thuoc ITnh vuc ke toan nha nuac. BHXH Viet Nam quy dinh cu the tai Cong van s6 2565/BHXH-TCCB ngay 15/7/2014 vh viec huong dan thuc

/ r r

hien phu cap trach nhiem ke toan truong, phu trach ke toan. g) Phu cap chuc danh To truong, Pho To truong To Nghiep vu thuoc

BHXH huyen Quy dinh tai Quylt dinh so 148/QD-BHXH ngay 29/01/2016 cua T6ng

r r r r

Giam doc BHXH Viet Nam quy dinh che do phu cap chuc vu lanh dao doi voi chuc danh To truong, Pho To truong To Nghiep vu thuoc BHXH cap huyen.

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2.3. Cac loai phu cap khong dugc dung de tinh thu nhap bo sung ' r r r

a) Phu cap thu hut, cac loai phu cap, trg cap quy dinh tai Nghi dinh so 116/2010/ND-CP ngay 24/12/2010 cua Chinh phu ve chinh sach doi voi can bo, CCVC va nguoi huong luong trong luc lugng via trang cong tac o vung c6 dieu kien kinh te dac biet kho khan.

b) Cac loai phu cap trach nhiem: Phu cap trach nhiem doi voi cap uy vien cac cap; phu cap doi voi CCVC dugc giao nhiem vu lam cong tac quan tri mang.

c) Cac loai phu cap kiem nhiem: Phu cap kiem nhiem chuc danh lanh dao cua Truong ban Bien tap va Pho Truong ban Bien tap Website BHXH Viet Nam; phu cap kiem nhiem doi voi chuc danh Bi thu Dang uy, Chu tich cong doan, Bi thu Doan thanh nien; phu cap kiem nhiem doi voi Chu tich, pho Chu tich Hoi Cuu chien binh; phu cap ciia CCVC lam viec kiem nhiem tai cac Ban Quan ly du an.

d) Cac che do boi duong bang hien vat. d) Phu cap lam dem, lam them gio. 3. Mire chi Muc chi tu quy bo sung thu nhap dam bao theo dung quy dinh tai Quy che

quan ly va su dung cac quy doi voi cac don vi thuoc he thong BHXH Viet Nam ban hanh kern theo Quyet dinh s6 299/QD-BHXH.

4. Cac ky hieu quy dinh tai van ban - Hi : He so thu nhap bo sung cua BHXH tinh, cac don vi true thuoc BHXH

Viet Nam tuong ling voi ket qua xep loai cua BHXH Viet Nam doi vol tung don vi theo quy dinh tai Quy§t dinh so 09/QD-BHXH (Hi nhan cac gia tri 1; 0,9; 0,8 tuong ung voi ket qua xep loai hang nam ciia tung don vi theo 03 loai A, B, C).

- H2: He so huong thu nhap bo sung cua BHXH huyen va cac phong thuoc BHXH tinh tuong ung voi ket qua xep loai ciia BHXH tinh doi voi tung don vi theo quy dinh tai Quy^t dinh so 09/QD-BHXH (H2 nhan cac gia tri 1; 0,9; 0,8 tuong ung voi ket qua xep loai hang quy ciia tung don vi theo 03 loai I , I I , III).

- H 3 : He s6 huong thu nhap b6 sung ciia tung CCVC tuong ling vol danh gia, xip loai tung CCVC theo quy dinh tai Quyet dinh s6 09/QD-BHXH ( H 3

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nhan cac gia tri 1,3; 1; 0,7; 0 tuong ung voi ket qua xep loai hang quy ciia tung CCVC theo 4 loai A l , A2, B, C).

- Q l : Tong quy tien luong (luong 01 Ian) ciia don vi trong nam (bao gom luong theo ngach, bac, chiic vu va cac khoan phu cap lam can cu tinh thu nhap bo sung neu tai Tiet 2.2, Muc 2 Cong van nay).

- Q2: Tong quy bo sung thu nhap ciia toan don vi . - Q3: Quy du phong chi b6 sung thu nhap tai don vi . - THi : He so thu nhap bo sung quy doi ciia tung CCVC.

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«

- THi : He so thu nhap bo sung quy doi toan don vi . - G2: Dan gia thu nhap bo sung. - K2: So kinh phi tiet kiem danh trich lap quy bo sung thu nhap dugc su

dung tai don vi. - T I / J : Chi tam ung thu nhap bo sung cua tung CCVC hang quy.

" TNf: Tong chi bo sung thu nhap thuc te cua tung CCVC cua nam truoc lien ke.

• TNf: Thu nhap bo sung dugc huong cua tung CCVC trong nam.

- TNi: Thu nhap bo sung tiep tuc chi cho tung CCVC trong nam.

- HSi! Tong he so luong va phu cap ciia tung CCVC trong quy. - HSLj: Tong he so thu nhap bo sung va phu cap thuc da quy doi thuc hien

trong quy ciia CCVC. - Li! Ty le giiia ngay cong di lam thuc te dugc cham cong vai ngay cong

phai lam viec theo quy dinh hang quy trong nam. - n: So CCVC theo danh sach chi tra thu nhap bo sung cua khoi cac phong

thuoc BHXH tinh va BHXH huyen, cac don vi true thuoc BHXH Viet Nam ( i = K n ) .

5. Phircng phap tinh bo sung thu nhap tir quy bo sung thu nhap cua don vi

•

Bu'ffc 1: Hang quy, BHXH tinh, BHXH huyen, cac dan vi true thuoc BHXH Viet Nam lap Bang tam ling thu nhap b6 sung theo Phu luc so 01/TNBS de chi thu nhap bo sung cho tung CCVC trong quy va to chiic chi tra, thanh toan, hach toan ke toan theo quy dinh.

TNf TlTi = 60% X — X 3

12 Rieng nam 2016, cac don vi thuc hien tam ling chi bo sung thu nhap quy

toi da bang 60% quy tien luong, ngach, bac, chuc vu va cac khoan phu cap theo quy dinh tai Khoan 2.2, Muc 2 Cong van nay.

Buo'c 2: Hang quy, can cii vao ket qua cong tac, BHXH tinh to chiic danh gia, xep loai cac phong true thuoc tinh va BHXH huyen theo 3 loai va dugc huang theo cac muc thu nhap bo sung voi he so quy doi (H2).

Bu'O'c 3: Hang quy, can cii vao k§t qua cong tac, cac phong truC thuoc BHXH tinh, BHXH huyen va cac don vi true thuoc BHXH Viet Nam t6 chiic

r r

danh gia, xep loai tung CCVC trong don vi minh tren co so ket qua hoan thanh cong viec dugc giao; CCVC trong don vi dugc xep thanh 4 loai de xet huong thu nhap bo sung theo cac he so huong thu nhap bo sung (H3).

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Biroc 4:

- Hang quy, BHXH huyen, cac phong thuoc BHXH tinh va cac dan vi true thuoc BHXH Viet Nam bao cao ket qua xep loai cua CCVC trong dan vi; tong quy ti§n luang theo Nghi dinh 204/2004/ND-CP ngay 14/12/2004 cua Chinh phii ve che do tien luang doi vai CCVC va luc lugng vu trang (quy tien luang 01 Ian bao gom luang theo ngach, bac, chuc vu va cac khoan phu cap, trir phu cap lam dem, lam them gia) da nhan cua tung nguai (Ql) va cham cong nhung ngay lam viec trong quy de xac dinh he so Li va he so thu nhap bo sung quy doi cho tung CCVC (THi), lap Phu luc s6 02/TNBS. BHXH huyen va cac phong true thuoc BHXH tinh gui Phu luc s6 02/TNBS cho BHXH tinh.

n THi = X H S i x L i x H s i

- Hang quy, cac don vi true thuoc BHXH Viet Nam; BHXH tinh can cu kit qua danh gia, xep loai cua CCVC va bao cao tai Phu luc s6 02/TNBS cua BHXH huyen va cac phong true thuoc BHXH tinh t6ng hgp chi thu nhap bo sung, ket qua xep loai va he so thu nhap bo sung (TH2) cua timg quy lap Phu luc s6 03/TNBS.

T H 2 = I H 2 x T H ,

Biro-c 5: Hang nam, BHXH tinh, cac dan vi true thuoc BHXH Viet Nam can cu vao he so xep loai dan vi (Hi) do BHXH Viet Nam thong bao va so kinh phi tiet kiem danh trich lap quy bo sung thu nhap dugc su dung tai don vi ( K 2 ) ; Quy du phong chi bo sung thu nhap tai don vi ( Q 3 ) ; tong quy tien luong (Ql) de xac dinh quy bo sung thu nhap ciia toan don vi ( Q 2 ) .

Q 2 = 0,7 x Q l x Hi

- Truong hgp K 2 > Q 2 thi quy bo sung thu nhap trong nam tai don vi bang Q2 .

- Truong hgp K 2 < Q 2 thi quy bo sung thu nhap trong nam tai don vi bang K 2 + Q 3 nhung khong dugc vugt qua Q 2 .

Biroc 6: BHXH tinh, cac don vi true thuoc BHXH Viet Nam can cu quy bo sung thu nhap dugc sii dung trong nam ciia toan don vi ( Q 2 ) va he so thu nhap bo sung (TH2) de xac dinh don gia thu nhap bo sung ciia toan don vi trong nam ( G 2 ) ,

G 2 = Q2/TH2

Biroc 7: BHXH tinh thong bao cho BHXH huyen, cac phong true tliugc BHXH tinh tong so kinh phi tiet Idem dugc K 2 , tong quy tien luong (luong 01 Ian) Q l , tong thu nhap bo sung ciia toan don vi Q 2 , he so thu nhap bo sung quy doi toan dan vi (TH2), don gia thu nhap bo sung ( G 2 ) theo Phu luc so 04/TNBS.

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Bu'6-c 8: BHXH huyen, cac phong true thuoc BHXH tinh, cac don vi true thuoc BHXH Viet Nam lap Bang thanh toan thu nhap bo sung theo Phu luc so 05/TNBS de xac dinh thu nhap b6 sung dugc huong cho tung CCVC trong nam ( T N \ va thanh toan ti8p thu nhap bo sung con dugc huong cho tung CCVC (TNi); to chuc chi tra, thanh toan, hach toan ke toan theo quy dinh.

T N \ T H 2 X H I X G 2

TNi = T i V f - T l / i

Truong hgp TNJ < TlTithi tru vao s6 kinh phi tiet kiem danh trich lap quy bo sung thu nhap cua nam sau; truong hgp nam sau khong c6 tiet kiem, thi tru vao quy tien luong nam sau cua don vi. Dong thoi, bao cao BHXH Viet Nam va phai xac dinh cu the nguyen nhan chu quan, khach quan.

Truong hgp trong nam don vi c6 chi tien luong truy ITnh thi xac dinh tien luong, thu nhap b6 sung va chi theo nguyen tac tien luong truy ITnh cua thoi gian nao thi tinh theo don gia thu nhap bo sung cua thoi gian do nhung hach toan va quyet toan vao quy, nam hien tai.

6. Phuong phap tinh bo sung thu nhap khuyen khich doi voi cac don vi CO thanh tich xuat sac trong boat dong quan ly tir quy du phong bo sung thu nhap chung ciia Nganh

Can cu muc ho trg do Tong Giam doc BHXH Viet Nam quyet dinh, can cu ket qua cong tac, muc do dong gop cua timg tap the; ca nhan, ket qua xep loai cua tap the; ca nhan, Giam doc BHXH tinh va Thu truong cac don vi true thuoc BHXH Viet Nam xem xet, quyet dinh viec chi bo sung thu nhap cho CCVC.

Cac buoc thuc hien tuong tu Buoc 2, 3, 4, 6, 8 tai Muc 5 Cong van nay.

7. To chiic thuc hien • •

a) Giam doc BHXH tinh va Thii truong cac don vi true thuoc BHXH Viet Nam thuc hien danh gia, xep loai CCVC theo quy dinh tai Quyet dinh so 09/QD-BHXH.

b) Xac dinh chinh xac so kinh phi tiet kiem trong nam de trich lap quy bo sung thu nhap theo quy dinh tai Quy che chi tieu ngi bg va trich lap cac quy doi voi cac don vi thuoc he thong BHXH Viet Nam ban hanh kem theo Quyet dinh so

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298/QD-BHXH va Quy che quan ly va sii dung cac quy doi voi cac don vi thuoc he th6ng BHXH Viet Nam ban hanh kem theo Quyet dinh s6 299/QD-BHXH.

c) Cac van ban dan chieu de ap dung tai van ban nay dugc sua doi, bo sung, thay the bang van ban moi thi ap dung theo cac van ban moi do.

d) Van ban nay dugc thuc hien tir nam tai chinh 2016, thay the Cong van so 3295/BHXH-BC ngay 22/8/2013 ciia BHXH Viet Nam vh viec huong dan chi bo sung thu nhap cho CCVC.

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Trong qua trinh thuc hien, n8u c6 phat sinh vuoTig mac, cac do'n vi bao cao kip thai v§ B H X H Viet Nam de xem xet, giai quyet./

Nffinhan: - Nhu tren; - Tong Giam doc (de bao cao); - Cac Pho Tong Giam doc; - Ban TCCB; - Lu-u: VT, TCKT ( 4 b ) ^

K T . T O N G G I A M D O C G I A M D O C

uyen Dinh Khuong

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B A O H I E M X A H O I T I N H , T H A N H P H O . .

B A O H I E M X A H O I H U Y E N . . .

Phu luc so 0 1 / T N B S

B A N G T A M I f N G T H U NHAP B6 SUNG Q U Y . . . N A M ...

(Ban hanh kem theo Cong van so %Z /BHXH-TCKT ngay Ai / Oi> /2016 cua BHXH Viet Nam)

S T T H O V A T E N

T O N G C H I B 6 S U N G T H U N H A P T H U C T E

C U A N A M T R U O C L I E N K E

M U C C H I B 6 S U N G T H U N H A P T H U C T E B I N H Q U A N C H U N G T H E O

T H A N G C U A N A M T R U O C L I E N K E

T A M U N G T H U N H A P B 6 S U N G (TU'i)

A B 1 2=1/12 thang 3=60%*(2*3 thang) 1 Nguyen Van A 2 Nguyen Van B J

Cong:

Ngay... thdng ... nam... N G U O I L A P B I E U P H U T R A C H K E T O A N T H U T R U O Q V G D O N V I

(Ky, ho ten) (Ky, ho ten) (Ky, ho ten, dong ddii)

B A O H I E M X A H O I T I N H , T P . .

B A O H I E M X A H O I H U Y E N . . .

Phu luc so 0 2 / T N B S

B A O C A O C H I T I E N L U O N G , K E T Q U A X E P L O A I V A C H A M C O N G L A O D O N G

C U A C O N G CHirC, V I E N CHlTC Q U Y . . . . N A M . . .

(Ban hanh kem theo Cong van s6 ^bl /BHXH-TCKT ngay M / 05/2016 cua BHXH Viet Nam)

S T T H O V A T E N

Tong he so lu'ong va phu cap thyc hien trong quy

(HSi)

Tien lu-ffng da chi trong quy (01 !an)

So ngay lam viec trong quy Xep loai C B C C V C He so bo sung thu nhap ( T H I ) :

T H l = H i s * L i * H 3 i S T T H O V A T E N

Tong he so lu'ong va phu cap thyc hien trong quy

(HSi)

Tien lu-ffng da chi trong quy (01 !an)

So ngay He so L i Loai He so H3

He so bo sung thu nhap ( T H I ) :

T H l = H i s * L i * H 3 i

A B 1 2 3 4 5 6 7=1*4*6 1 Nguyen Van A

Nguyen Van B - - - - - -

—

-2

Nguyen Van A Nguyen Van B

- - - - - -

—

-3

—

-

Cong:

* Ghi chu:

Cot so 4 (he so Li) dicac xdc dinh bang Cot so 3 (so ngay Idm viec trong quy theo bang chdm cong) chia cho 66 ngay (Id so ngay cong phdi lam viec theo quy dinh hang quy trong nam).

Ngay ... thdng ... nam ... P H U T R A C H K E T O A N T H U T R U Q N G D O ' N V I

(Ky, ho ten) (Ky, ho ten, dong ddu)

BAO HIEM XA HQl VIET NAM BAO HIEM XA HOI TINH, THANH PHO..

Phu luc so 03/TNBS

T O N G H O P C H I T I E N L I / O N G , K E T Q U A X E P L O A I V A H E so B6 S U N G T H U N H A P Q U Y . . . N A M . . .

(Ban hanh kem theo Cong van s6 t5lBHXH-TCKT ngay //// / 03/20]6 cua BHXH Viet Namjy/

STT BON VI

Tong he so luong va phu cSp da quy d6i thuc hien trong quy

(HSLi)

Tdng luong da chi trong quy

(01 \kn)

Tong he s6 thu nhap b6

Xep loai don vj BHXH huyen He s6 bo sung thu nhap (TH2)

Tong he so luong va phu cSp da quy d6i thuc hien trong quy

(HSLi)

Tdng luong da chi trong quy

(01 \kn) sung (THI) Loai He s6 H2

He s6 bo sung thu nhap (TH2)

A B 1 2 3 4 5 6=3*5 1 2

BHXH huyen A BHXH huyen B

- •

3 — - - -

Phong ... Phong ...

' - • - - - -

- -

Cong:

NGUOI LAP BIEU (Ky, ho ten)

PHU TRACH K E TOAN (Ky, ho ten)

Ngay ... thdng... nam THU TRUONG DON VI

(Ky, ho ten, dong ddu)

B A O H I E M X A H O I V I E T N A M

B A O H I E M X A H O I T I N H , T H A N H P H O . .

Phu luc s6 04/TNBS

BANG T H A N H T O A N T H U NHAP BO SUNG QUY.. . NAM ...

(Ban hanh kem theo Cong van sS 9U/BHXH-TCKT ngay / Oi /2016 ciia BHXH Viet Nam)

1. Don vi dugc-BHXH V N xep loai ... (HI = ) 2. Tong kinh phi tam chi bo sung thu nhap cho CCVC ( ^ T l / i - •••)

3. S6 kinh phi tiet kiem danh tn'ch lap quy bo sung thu nhap dugc su dung tai dan vi (K2 = . . . ) 4. Tong quy tien luang 1 Ian (Ql = . . . ) va Tong he so bo sung thu nhap quy doi (TH2) 5. Tong quy bo sung thu nhap cua toan do'n vi (Q2) 6. Quy du phong chi bo sung thu nhap tai don vi (Q3) 7. Don gia thu nhap b6 sung dugc xac dinh la .... ( G2 = )

S T T H O vA T E N T O N G H E so T H U

NHAP B O S U N G Q U Y D 6 I (TH2)

T O N G Q U Y T H U N H A P B O S U N G D U O C H U O N G

G H I C H U

A B 1 2 = 1 * H 1 * G 2 3

1 " 2 ^

BHXH huyen A 1 " 2 ^ BHXH huyen B

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Phong ... Phong ...

Cong:

N G U C J I L A P B I E U

(Ky, ho ten) P H U T R A C H K E T O A N

(Ky, ho ten)

Ngay ... thdng ... nam .... T H U T R U O N G D O N V I

(Ky, ho ten, dong ddu)

BAO H I E M X A HOI TINH, THANH PHO. . BAO H I E M X A HOI H U Y E N . . .

Phu luc so OS/TNBS

B A N G T H A N H T O A N T H U NHAP B6 S U N G QUY.. .NAM .. .

(Ban hanh kem theo Cong van s6 /BHXH-TCKT ngay M / 03 /2016 cua BHXH Viet Nam)

1. Dan v i cap tren dugc B H X H V N xep loai ... ( H I = ) 2. Dan gia thu nhap bo sung dugc xac dinh la .. . . (G2 = )

S T T H O V A T E N H E S O T H U N H A P

B 6 S U N G Q U Y D 6 I ( T H 2 )

T H U N H A P B O S U N G D U O C

H U O N G

T A M U N G T H U N H A P B 6 S U N G

' (TU'i)

T H U N H A P B 6 S U N G C O N D U O C

H U O N G (TNi)

A B 1 = H 2 * T H 1 2 = T H 2 * H 1 * G 2 3 4=2-3

1 Nguyen Van A 1 Nguyen Van B

3

Cong: - — -

NGUOI LAP BIEU (Ky, ho ten)

P H U T R A C H K E T O A N

(Ky, ho ten)

....Ngay thdng nam .... T H U T R U O N G D O N V I

(Ky, ho ten va dong ddu)