[별지 제3호서식]
                             (          )월분징수포상금신청서       

수   신 : 강진군수
발   신 : ○○읍면장
참   조 : 세무팀장
+------------------------+---------+----------------------------------------+------------------+
|                        |         |        금                액            |                  |
|     구       분        |  건 수  +-------------+------------+-------------+    포상금액      |
|                        |         |  세     액  |  가 산 금  |    계       |                  |
+------------------------+---------+-------------+------------+-------------+------------------+
|     과년도체납액징수   |         |             |            |             |                  |
+-----+------------------+---------+-------------+------------+-------------+------------------+
| 숨  |   과 표 초 과    |         |             |            |             |                  |
| 은  +------------------+---------+-------------+------------+-------------+------------------+
| 세  |   미  등   기    |         |             |            |             |                  |
| 원  +------------------+---------+-------------+------------+-------------+------------------+
| 발  |   등기1년초과    |         |             |            |             |                  |
| 굴  +------------------+---------+-------------+------------+-------------+------------------+
|     |   무 단 점 용    |         |             |            |             |                  |
+-----+------------------+---------+-------------+------------+-------------+------------------+
|          계            |         |             |            |             |                  |
+------------------------+---------+-------------+------------+-------------+------------------+
첨   부 : 1. 과년도 체납액 징수 내역 1부
          2. 숨은 세원 발굴 내역 1부

[별지 제3호서식 부표1]
                                        과년도체납액징수내역     
                                                                    세무팀장              (인)
+------------------------------+----------------------------------+--------+---------+---------+
|       징     수     자       |     징    수    내    역         |        |         |         |
+--------+---------+-----------+----------+-----------+-----------+  건수  |  포상금 |   비고  |
| 소  속 |  직 급  |  성   명  |  금  액  |   가산금  |    계     |        |         |         |
+--------+---------+-----------+----------+-----------+-----------+--------+---------+---------+
|        |         |           |          |           |           |        |         |         |
+--------+---------+-----------+----------+-----------+-----------+--------+---------+---------+
|        |         |           |          |           |           |        |         |         |
+--------+---------+-----------+----------+-----------+-----------+--------+---------+---------+
|        |         |           |          |           |           |        |         |         |
+--------+---------+-----------+----------+-----------+-----------+--------+---------+---------+
|        |         |           |          |           |           |        |         |         |
+--------+---------+-----------+----------+-----------+-----------+--------+---------+---------+
|        |         |           |          |           |           |        |         |         |
+--------+---------+-----------+----------+-----------+-----------+--------+---------+---------+
[별지 제3호서식 부표 2]
                              숨  은  세  원  발  굴  내  역      
                                                                      세무팀장           (인)
+---------+------------------------------+---------+-------+-------+--------+---------+--------+
|         |      부과자(제보자)          |         |       | 발 굴 | 징 수  |         | 포 상  |
| 납  기  +---------+-----------+--------+  과 목  | 구 분 |       |        |  건 수  |        |
|         | 소  속  |  직  명   | 성  명 |         |       | 내 역 | 월 일  |         | 금 액  |
+---------+---------+-----------+--------+---------+-------+-------+--------+---------+--------+
|         |         |           |        |         |       |       |        |         |        |
|         |         |           |        |         |       |       |        |         |        |
|         |         |           |        |         |       |       |        |         |        |
|         |         |           |        |         |       |       |        |         |        |
|         |         |           |        |         |       |       |        |         |        |
|         |         |           |        |         |       |       |        |         |        |
|         |         |           |        |         |       |       |        |         |        |
|         |         |           |        |         |       |       |        |         |        |
|         |         |           |        |         |       |       |        |         |        |
+---------+---------+-----------+--------+---------+-------+-------+--------+---------+--------+