REVOCATION

of the appointment as the responsible representative

Data Protection (Privacy) Policy available at english.bmf.gv.at/services/data-protection.html or in paper form at all tax and customs offices

Data Protection (Privacy) Policy available at english.bmf.gv.at/services/data-protection.html or in paper form at all tax and customs offices

Page 1 of 2

Transaction / reference number

Transaction / reference number

1. Employer

Company _{(name / full commercial firm name)}

Postal code _{(company headquarters)}

City

Address _{(street, house no.)}

2. The appointment of the responsible person

Mr./Ms.

Mr. Ms.

pre-nominal title

post-nominal title

Family or last name

First name(s)

Date of birth _(DD.MM.YYYY)

is revoked.

3. Spatial (local) area of responsibility

Place of work / Construction site _{(throughout Austria / Federal State)}

Construction work

Yes No

 

4. Date of revocation

Revocation _(DD.MM.YYYY)

Withdrawal from the company _(DD.MM.YYYY)