<?xml version="1.0" encoding="utf-8"?>
<tns:additionalVacationStatement xmlns:tns="http://www.fss.ru/additionalVacationStatement" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
  <tns:vacationStatementCalc>PRIMARYCALC</tns:vacationStatementCalc>
  <tns:insurerInfo>
    <tns:regNum>2222222222</tns:regNum>
    <tns:inn>9606042911</tns:inn>
    <tns:documentsSendPerson>
      <tns:fullName>
        <tns:lastName>Исакова</tns:lastName>
        <tns:firstName>Глафира</tns:firstName>
        <tns:middleName>Макаровна</tns:middleName>
      </tns:fullName>
    </tns:documentsSendPerson>
  </tns:insurerInfo>
  <tns:insuredInfo>
    <tns:fullNamePU />
  </tns:insuredInfo>
  <tns:orderInfo />
  <tns:calculationData>
    <tns:totalSum></tns:totalSum>
    <tns:totalDays></tns:totalDays>
    <tns:totalIncomeSum></tns:totalIncomeSum>
    <tns:vacationSum></tns:vacationSum>
  </tns:calculationData>
  <tns:receivePayment />
</tns:additionalVacationStatement>