<?xml version="1.0" encoding="utf-8"?>
<n1:disabilityChildrenStatement specVersion="3.0.0" software="Астрал Отчет" version_software="5.0" author="Симонова Антонина Артемовна" phone="72222222222" email="skdjdkjdskj@mail.ru" regNumSFR="1007645771" 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_1007645771_2025_09_25_1649</n1:batch_no>
  <n1:changeRecalcFlag>false</n1:changeRecalcFlag>
  <n1:insurerInfo>
    <n1:regNumSFR>1007645771</n1:regNumSFR>
    <n1:emplKPP>990010011</n1:emplKPP>
    <n1:emplINN>9647435887</n1:emplINN>
    <n1:Empl_Flag>true</n1:Empl_Flag>
    <n1:bankInfo>
      <n1:bik>121212121</n1:bik>
      <n1:accountNum>12121212211212121212</n1:accountNum>
    </n1:bankInfo>
  </n1:insurerInfo>
  <n1:refundSum>
    <n1:totalSum>100212.22</n1:totalSum>
    <n1:sumForNonBudgetFunds>100212.22</n1:sumForNonBudgetFunds>
    <n1:sumForAdditionalDays>100212.22</n1:sumForAdditionalDays>
  </n1:refundSum>
  <n1:numberRecipients>1</n1:numberRecipients>
  <n1:receiversRow>
    <n1:parentInfo>
      <n1:fullName>
        <n2:firstName>1</n2:firstName>
        <n2:lastName>1</n2:lastName>
        <n2:middleName>1</n2:middleName>
      </n1:fullName>
      <n1:snils>10012677589</n1:snils>
      <n1:childRelType>1</n1:childRelType>
    </n1:parentInfo>
    <n1:childInfo>
      <n1:fullName>
        <n2:firstName>1</n2:firstName>
        <n2:lastName>1</n2:lastName>
        <n2:middleName>1</n2:middleName>
      </n1:fullName>
      <n1:snils>16665301578</n1:snils>
      <n1:birthDate>2025-09-25</n1:birthDate>
      <n1:certificateOfDisability>
        <n1:series>1</n1:series>
        <n1:number>1</n1:number>
        <n1:certificateDate>2025-09-16</n1:certificateDate>
        <n1:disabilityBeginDate>2025-09-16</n1:disabilityBeginDate>
        <n1:disabilityEndDate>
          <n1:notLimited>true</n1:notLimited>
        </n1:disabilityEndDate>
      </n1:certificateOfDisability>
    </n1:childInfo>
    <n1:ORD>
      <n1:number>1</n1:number>
      <n1:date>2025-09-16</n1:date>
    </n1:ORD>
    <n1:periods>
      <n1:additionalPeriods>
        <n1:periodAndCalculationData>
          <n1:year>2021</n1:year>
          <n1:month>1</n1:month>
          <n1:daysAmount>1</n1:daysAmount>
          <n1:dailyAverageSal>1</n1:dailyAverageSal>
        </n1:periodAndCalculationData>
        <n1:providedDays>1</n1:providedDays>
        <n1:providedTotalHour>1</n1:providedTotalHour>
      </n1:additionalPeriods>
      <n1:accumulatedPeriods>
        <n1:accumulatedPeriodData>
          <n1:year>2022</n1:year>
          <n1:month>1</n1:month>
          <n1:daysAmount>1</n1:daysAmount>
        </n1:accumulatedPeriodData>
        <n1:accumulatedDays>1</n1:accumulatedDays>
        <n1:accumulatedTotalHour>1</n1:accumulatedTotalHour>
        <n1:accumulatedProvidedPeriodData>
          <n1:year>2022</n1:year>
          <n1:month>1</n1:month>
          <n1:daysAmount>1</n1:daysAmount>
          <n1:dailyAverageSal>1</n1:dailyAverageSal>
        </n1:accumulatedProvidedPeriodData>
        <n1:accumulatedProvidedDays>1</n1:accumulatedProvidedDays>
        <n1:accumulatedProvidedTotalHour>1</n1:accumulatedProvidedTotalHour>
      </n1:accumulatedPeriods>
    </n1:periods>
  </n1:receiversRow>
</n1:disabilityChildrenStatement>