<?xml version="1.0" encoding="UTF-8"?>
<disabilityChildrenStatement xmlns="urn:ru:ecp:integration:wozm:refund:disabilitychildren:sttmnt:v3.0"
                             xmlns:com="urn:ru:ecp:integration:types:common:v3.0"
                             xmlns:org="urn:ru:ecp:integration:types:organization:v3.0"
                             xmlns:p="urn:ru:ecp:integration:types:person:v3.0"
                             specVersion="3.0"
                             software="Мое дело"
                             version_software="2.1.5"
                             author="Сидоров Петр Алексеевич"
                             phone="+78125556677"
                             email="ip.sidorov@mail.ru"
                             emplRegNo="1003631841">
    <batch_no>D_1003631841_2024_03_15_0001</batch_no>
    <changeRecalcFlag>false</changeRecalcFlag>
    <insurerInfo>
        <regNum>1003631841</regNum>
        <emplKPP xsi:nil="true" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"/>
        <emplINN>964736001934</emplINN>
        <Empl_Flag>true</Empl_Flag>
        <bankInfo>
            <bik>044525999</bik>
            <accountNum>40802810000000054321</accountNum>
        </bankInfo>
    </insurerInfo>
    <refundSum>
        <totalSum>5000</totalSum>
        <sumForNonBudgetFunds>1523</sumForNonBudgetFunds>
        <sumForAdditionalDays>3477</sumForAdditionalDays>
    </refundSum>
    <numberRecipients>1</numberRecipients>
    <receiversRow>
        <parentInfo>
            <fullName>
                <p:lastName>Сидорова</p:lastName>
                <p:firstName>Ольга</p:firstName>
                <p:middleName>Витальевна</p:middleName>
            </fullName>
            <snils>173-137-251 51</snils>
            <childRelType>1</childRelType>
        </parentInfo>
        <childInfo>
            <fullName>
                <p:lastName>Сидоров</p:lastName>
                <p:firstName>Максим</p:firstName>
                <p:middleName>Петрович</p:middleName>
            </fullName>
            <snils>136-110-334 04</snils>
            <birthDate>2018-12-05</birthDate>
            <certificateOfDisability>
                <series>МСЭ</series>
                <number>654321</number>
                <certificateDate>2024-01-15</certificateDate>
                <disabilityBeginDate>2024-01-15</disabilityBeginDate>
                <disabilityEndDate>
                    <notLimited>true</notLimited>
                </disabilityEndDate>
            </certificateOfDisability>
        </childInfo>
        <ORD>
            <number>1</number>
            <date>2024-03-01</date>
        </ORD>
        <periods>
            <additionalPeriods>
                <periodAndCalculationData>
                    <year>2024</year>
                    <month>3</month>
                    <daysAmount>2</daysAmount>
                    <dailyAverageSal>1738.50</dailyAverageSal>
                </periodAndCalculationData>
                <providedDays>2</providedDays>
                <providedTotalHour>16</providedTotalHour>
            </additionalPeriods>
        </periods>
    </receiversRow>
</disabilityChildrenStatement>