<?xml version="1.0" encoding="utf-8"?>
<n1:disabilityChildrenStatement specVersion="3.0" software="Астрал Отчет" version_software="5.0" author="Воронцов Аникита Иларионович" phone="79999999999" email="njdfhdfjh@mail.ru" regNumSFR="1003631841" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:n1="urn:ru:ecp:integration:wozm:refund:disabilitychildren:sttmnt:v3.0" xmlns:n2="urn:ru:ecp:integration:types:person:v3.0">
  <n1:batch_no>D_1003631841_2025_09_25_1274</n1:batch_no>
  <n1:changeRecalcFlag>false</n1:changeRecalcFlag>
  <n1:insurerInfo>
    <n1:regNumSFR>1003631841</n1:regNumSFR>
    <n1:emplINN>964736001934</n1:emplINN>
    <n1:Empl_Flag>true</n1:Empl_Flag>
    <n1:bankInfo>
      <n1:bik>044525999</n1:bik>
      <n1:accountNum>40802810000000054321</n1:accountNum>
    </n1:bankInfo>
  </n1:insurerInfo>
  <n1:refundSum>
    <n1:totalSum>5000</n1:totalSum>
    <n1:sumForNonBudgetFunds>1523</n1:sumForNonBudgetFunds>
    <n1:sumForAdditionalDays>3477</n1:sumForAdditionalDays>
  </n1:refundSum>
  <n1:numberRecipients>1</n1:numberRecipients>
  <n1:receiversRow>
    <n1:parentInfo>
      <n1:fullName>
        <n2:firstName>Ольга</n2:firstName>
        <n2:lastName>Сидорова</n2:lastName>
        <n2:middleName>Витальевна</n2:middleName>
      </n1:fullName>
      <n1:snils>13611033404</n1:snils>
      <n1:childRelType>1</n1:childRelType>
    </n1:parentInfo>
    <n1:childInfo>
      <n1:fullName>
        <n2:firstName>Максим</n2:firstName>
        <n2:lastName>Сидоров</n2:lastName>
        <n2:middleName>Петрович</n2:middleName>
      </n1:fullName>
      <n1:snils>17313725151</n1:snils>
      <n1:birthDate>2018-12-05</n1:birthDate>
      <n1:certificateOfDisability>
        <n1:series>МСЭ</n1:series>
        <n1:number>654321</n1:number>
        <n1:certificateDate>2024-01-15</n1:certificateDate>
        <n1:disabilityBeginDate>2024-01-15</n1:disabilityBeginDate>
        <n1:disabilityEndDate>
          <n1:notLimited>true</n1:notLimited>
        </n1:disabilityEndDate>
      </n1:certificateOfDisability>
    </n1:childInfo>
    <n1:ORD>
      <n1:number>1</n1:number>
      <n1:date>2024-03-01</n1:date>
    </n1:ORD>
    <n1:periods>
      <n1:additionalPeriods>
        <n1:periodAndCalculationData>
          <n1:year>2024</n1:year>
          <n1:month>3</n1:month>
          <n1:daysAmount>2</n1:daysAmount>
          <n1:dailyAverageSal>1738.50</n1:dailyAverageSal>
        </n1:periodAndCalculationData>
        <n1:providedDays>2</n1:providedDays>
        <n1:providedTotalHour>16</n1:providedTotalHour>
      </n1:additionalPeriods>
    </n1:periods>
  </n1:receiversRow>
</n1:disabilityChildrenStatement>