.k Deklaracja PIT-4R(2)
.k Druk : Omeko druk IX.2008 
.k ostatnei zmiany 19.01.2009
.k ---------------------------------------------------------
.k PIT-4R(2) #1/4
.b 11,12,{:01}.{:16}
.p   3, 9.0,{:13}{L27<}{:14}
.p  95,41.0,{:13}{L104<}{:14}
.k A.Miejsce Skˆadania, korekty
.p  10, 93,{L22}
.p  63,101,{:13}{L105:1}{:14}
.p 103,101,{:13}{L106:1}{:14}
.k B.Dane pˆatnika
.k   B.1 Dane identyfikacyjne
.p  35,126,{:13}{L25:1}{:14}
.p 124,126,{:13}{L26:1}{:14}
.p  10,135,{:04}{L80}{:03}
.p  10,144,{:04}{L81} {L82}{:03}
.k   B.2 Adres Siedziby/Zamieszkania
.p  10,161,{L45}
.p  48,161,{L46}
.p 128,161,{L56}
.p  10,170,{:04}{L47}{:03}
.p  57,170,{L48}
.p 150,170,{L49}
.p 171,170,{L50<}
.p  10,178,{L51}
.p  87,178,{L52}
.p 117,178,{L53}
.k C.Obliczenie pobranego podatku
.k 1.Stosunek w pracy
.p 37,207,{:04}{R119____}  {R120____}  {R121____}  {R122____}  {R123____}  {R124____}{:03}
.p 37,216,{:04}{R125______}{R126______}{R127______}{R128______}{R129______}{R130______}{:03}
.p 37,229,{:04}{R131____}  {R132____}  {R133____}  {R134____}  {R135____}  {R136____}{:03}
.p 37,237,{:04}{R137______}{R138______}{R139______}{R140______}{R141______}{R142______}{:03}
.f{:30}
.k Pit4R(2) #2/4
.b  9,11,.
.k 2.pozostale stosunki
.p 37,25,{:04}{R143______}{R144______}{R145______}{R146______}{R147______}{R148______}{:03}
.p 37,42,{:04}{R149______}{R150______}{R151______}{R152______}{R153______}{R154______}{:03}
.k 3.stosunki razem
.p 37,67,{:04}{R155______}{R156______}{R157______}{R158______}{R159______}{R160______}{:03}
.p 37,84,{:04}{R161______}{R162______}{R163______}{R164______}{R165______}{R166______}{:03}
.k 4.zaliczki ograniczone 
.p 37,110,{:04}{R167______}{R168______}{R169______}{R170______}{R171______}{R172______}{:03}
.p 37,127,{:04}{R173______}{R174______}{R175______}{R176______}{R177______}{R178______}{:03}
.k 5.zaliczki przypadalybujace
.p 37,152,{:04}{R179______}{R180______}{R181______}{R182______}{R183______}{R184______}{:03}
.p 37,169,{:04}{R185______}{R186______}{R187______}{R188______}{R189______}{R190______}{:03}
.k 6.rozliczenie ub.roku
.p 37,194,{:04}{R191______}{R192______}{R193______}{R194______}{:03}
.k 7.nadplaty
.p 37,236,{:04}{R195______}{R196______}{R197______}{R198______}{R199______}{R200______}{:03}
.p 37,253,{:04}{R201______}{R202______}{R203______}{R204______}{R205______}{R206______}{:03}
.f{:30}
.k Pit4R(2) #3/4
.b 10,10,.
.k 8.PFRON
.p 37,25,{:04}{R207______}{R208______}{R209______}{R210______}{R211______}{R212______}{:03}
.p 37,42,{:04}{R213______}{R214______}{R215______}{R216______}{R217______}{R218______}{:03}
.k 9.Aktuwisci
.p 37,67,{:04}{R219______}{R220______}{R221______}{R222______}{R223______}{R224______}{:03}
.p 37,84,{:04}{R225______}{R226______}{R227______}{R228______}{R229______}{R230______}{:03}
.k 10.UZ/UoD
.p 37,110,{:04}{R231______}{R232______}{R233______}{R234______}{R235______}{R236______}{:03}
.p 37,126,{:04}{R237______}{R238______}{R239______}{R240______}{R241______}{R242______}{:03}
.k 11.podatek do przekazania
.p 37,160,{:04}{R243______}{R244______}{R245______}{R246______}{R247______}{R248______}{:03}
.p 37,177,{:04}{R249______}{R250______}{R251______}{R252______}{R253______}{R254______}{:03}
.k 12.nagroda
.p 37,203,{:04}{R255______}{R256______}{R257______}{R258______}{R259______}{R260______}{:03}
.p 37,220,{:04}{R261______}{R262______}{R263______}{R264______}{R265______}{R266______}{:03}
.f{:30}
.k Pit4R(2) #4/4
.b 10,10,.
.k 13.Kwota w studnie
.p 37,33,{:04}{R267______}{R268______}{R269______}{R270______}{R271______}{R272______}{:03}
.p 37,50,{:04}{R273______}{R274______}{R275______}{R276______}{R277______}{R278______}{:03}
.k E.Oswiadczyny
.p 10,137,{:04}{L71}{:03}
.p 70,137,{:04}{L70}{:03}.
.f{:02}
.end