Name of the person service organization

Number and date of registration of the declaration

Organization address

City Postal Code

First name Name of the service recipient

Address

City Postal Code

ANNUAL TAX CERTIFICATE

I, the undersigned, [First name, Last name, Function of the representative of the organization, Name of the organization] certifies that [First name, Beneficiary name, Address, debit account number if applicable] , has benefited from personal services: [specify the exact nature of the service(s)] .

In [year] , the amount of invoices actually paid shall be a total of: [Amount €] , of which [Amount €] paid by means of pre-financed Universal Service Employment Check(s) (UESC) *.

Speakers:

[ID, Last Name, First Name, Number of Hours] for [month year]

Hourly price of the service or, where appropriate, flat-rate price: [Hourly or fixed price €]

[ID, Last Name, First Name, Number of Hours] for [month year]

Hourly price of the service or, where appropriate, flat-rate price: [Hourly or fixed price €]

...

Made in order to assert what is right,

The [DD/MM/YYYY] .

[First name, Last name, capacity of signatory]

Signature

* For those using the pre-funded Eusc, only the amount financed personally qualifies for a tax benefit. A certificate is issued by the institutions that pre-finance the Cesu allowing the declaration of this sum to the tax authorities by the taxpayer.