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  <Meta>
    <DocumentType>BEK H#LOKDOK04</DocumentType>
    <Rank>B</Rank>
    <AccessionNumber>B19860045605</AccessionNumber>
    <DocumentId>AN011713</DocumentId>
    <UniqueDocumentId>163294</UniqueDocumentId>
    <DocumentTitle>Bekendtgørelse om afgiftsberigtigelse af elektricitet til opvarmning af helårsboliger</DocumentTitle>
    <Year>1986</Year>
    <DiesSigni>1986-07-10</DiesSigni>
    <DateOfSubmit id="submit_1" />
    <StartDate REFid="submit_1">2014-06-05</StartDate>
    <EndDate REFid="submit_1">2026-06-24</EndDate>
    <Status>Historic</Status>
    <Number>456</Number>
    <AnnouncedIn>Lovtidende A</AnnouncedIn>
    <DiesEdicti>2016-05-19</DiesEdicti>
    <DateOfHistoricMark>2016-05-18</DateOfHistoricMark>
    <Concerns id="concerns_1" />
    <Ref_Accn REFid="concerns_1">B19860060405</Ref_Accn>
    <Ref_Af REFid="concerns_1">1986-09-12</Ref_Af>
    <Ref_Text REFid="concerns_1">Bekendtgørelse om ikrafttræden af lov om ændring af færdselsloven (* 1) </Ref_Text>
    <Republished>Nej</Republished>
    <Sign id="sign" />
    <Signature REFid="sign">ISI FOIGHEL</Signature>
    <Sub-Sign id="subsign" />
    <Signature REFid="subsign">S. Ladegaard Pedersen</Signature>
    <PlaceOfSignature>Ministeriet for skatter og afgifter</PlaceOfSignature>
    <JournalNumber>Min. f. skatter og afgifter, D.T.J.A. 2288/1986 </JournalNumber>
    <Ministry>Skatte- og Vækstministeriet</Ministry>
  </Meta>
  <TitelGruppe>
    <Titel>
      <Linea>
        <Char>Bekendtgørelse om afgiftsberigtigelse af elektricitet til opvarmning af helårsboliger</Char>
      </Linea>
    </Titel>
  </TitelGruppe>
  <DokumentIndhold>
    <Indledning>
      <Exitus>
        <Linea>
          <Char>I medfør af § 6, stk. 2, og § 15, stk. 2, i lov om afgift af elektricitet, jfr.</Char>
        </Linea>
        <Linea>
          <Char>lovbekendtgørelse nr. 604 af 28. juni 1986, fastsættes:</Char>
        </Linea>
      </Exitus>
    </Indledning>
    <Afsnit id="Afs0">
      <Kapitel id="Kap0">
        <ParagrafGruppe id="Kap0_X1">
          <Paragraf id="Par1" localId="1">
            <Explicatus>§ 1.</Explicatus>
            <Stk id="Par1_Stk1">
              <Exitus>
                <Linea>
                  <Char>For at elektricitet til opvarmning af helårsboliger kan afgiftsberigtiges efter den særlige sats for elvarme i elafgiftslovens § 6, stk. 1, nr. 1, skal boligenheden være registreret i Bygnings- og Boligregistret (BBR) som elopvarmet helårsbolig.</Char>
                </Linea>
              </Exitus>
            </Stk>
            <Stk id="Par1_Stk2">
              <Explicatus>Stk. 2.</Explicatus>
              <Exitus>
                <Linea>
                  <Char>Kun forbrug af elektricitet, der overstiger 4.000 kWh årligt pr. boligenhed kan afgiftsberigtiges efter den særlige elvarmesats.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
          <Paragraf id="Par2" localId="2">
            <Explicatus>§ 2.</Explicatus>
            <Stk id="Par2_Stk1">
              <Exitus>
                <Linea>
                  <Char>Det påhviler virksomhederne, som er registreret efter elafgiftsloven (elforsyningsselskaberne), at registrere de elinstallationer, der er installeret i boliger, der opfylder betingelsen efter § 1.</Char>
                </Linea>
              </Exitus>
            </Stk>
            <Stk id="Par2_Stk2">
              <Explicatus>Stk. 2.</Explicatus>
              <Exitus>
                <Linea>
                  <Char>Registrering foretages efter anmodning fra den, der hæfter for betaling af elleverancen.</Char>
                </Linea>
                <Linea>
                  <Char>Anmodningen skal fremsættes over for elforsyningsselskabet, der indhenter attestation efter § 3.</Char>
                </Linea>
              </Exitus>
            </Stk>
            <Stk id="Par2_Stk3">
              <Explicatus>Stk. 3.</Explicatus>
              <Exitus>
                <Linea>
                  <Char>Anmodningen skal fremsættes på en attest som den i bilaget gengivne eller på anden skriftlig måde, der indeholder de i attesten angivne oplysninger.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
          <Paragraf id="Par3" localId="3">
            <Explicatus>§ 3.</Explicatus>
            <Stk id="Par3_Stk1">
              <Exitus>
                <Linea>
                  <Char>Elforsyningsselskabet kan kun registrere en elinstallation efter § 2, hvis kommunen attesterer, at den pågældende installation er i en bolig, der er registreret i BBR som elopvarmet helårsbolig, eller at den pågældende bolig vil kunne registreres i BBR som sådan.</Char>
                </Linea>
              </Exitus>
            </Stk>
            <Stk id="Par3_Stk2">
              <Explicatus>Stk. 2.</Explicatus>
              <Exitus>
                <Linea>
                  <Char>Elforsyningsselskabet skal over for kommunen entydigt identificere den eller de boliger, der omfattes af den elinstallation, der ønskes registreret.</Char>
                </Linea>
                <Linea>
                  <Char>Elforsyningsselskabet skal samtidig give oplysning om, hvor meget elektricitet, der er leveret til den pågældende installation i den seneste 12 måneders periode, der foreligger oplysninger om.</Char>
                </Linea>
              </Exitus>
            </Stk>
            <Stk id="Par3_Stk3">
              <Explicatus>Stk. 3.</Explicatus>
              <Exitus>
                <Linea>
                  <Char>Elforsyningsselskabet skal over for toldvæsenet kunne dokumentere, at elinstallationer, der er registreret efter § 2, er installeret i boliger, der opfylder betingelserne efter § 1.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
          <Paragraf id="Par4" localId="4">
            <Explicatus>§ 4.</Explicatus>
            <Stk id="Par4_Stk1">
              <Exitus>
                <Linea>
                  <Char>Den, der hæfter for betalingen af elleverancen til en elinstallation registreret efter § 2, skal straks give elforsyningsselskabet meddelelse, hvis betingelsen for registreringen i BBR som elopvarmet helårsbolig ikke længere er til stede.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
          <Paragraf id="Par5" localId="5">
            <Explicatus>§ 5.</Explicatus>
            <Stk id="Par5_Stk1">
              <Exitus>
                <Linea>
                  <Char>Den særlige elvarmesats finder anvendelse på elleverancer, der finder sted fra det tidspunkt, hvor den pågældende elinstallation er blevet registreret efter § 2, jfr.</Char>
                </Linea>
                <Linea>
                  <Char>dog stk. 2 og 3.</Char>
                </Linea>
              </Exitus>
            </Stk>
            <Stk id="Par5_Stk2">
              <Explicatus>Stk. 2.</Explicatus>
              <Exitus>
                <Linea>
                  <Char>Den særlige elvarmesats kan dog finde anvendelse fra tidspunktet for elforsyningsselskabets modtagelse af anmodningen om registrering efter § 2 eller fra tidspunktet, hvor boligen efter oplysninger fra elinstallatøren til elforsyningsselskabet, jfr.</Char>
                </Linea>
                <Linea>
                  <Char>den mellem elinstallatører og elleverandør fastlagte forretningsgang, har fået tilsluttet elvarme, hvis registreringen i BBR finder sted senest 2 måneder efter.</Char>
                </Linea>
              </Exitus>
            </Stk>
            <Stk id="Par5_Stk3">
              <Explicatus>Stk. 3.</Explicatus>
              <Exitus>
                <Linea>
                  <Char>Den særlige elvarmesats kan finde anvendelse på leverancer, der har fundet sted fra og med 1. april 1986, hvis den pågældende installation er registreret efter § 2 senest den 1. september 1986.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
          <Paragraf id="Par6" localId="6">
            <Explicatus>§ 6.</Explicatus>
            <Stk id="Par6_Stk1">
              <Exitus>
                <Linea>
                  <Char>Er afregningsperioden for leverancen en anden end året, udgør den del af leverancen, der efter loven ikke kan afgiftsberigtiges efter den særlige elvarmesats, forholdsmæssigt så meget, som afregningsperioden udgør af året.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
          <Paragraf id="Par7" localId="7">
            <Explicatus>§ 7.</Explicatus>
            <Stk id="Par7_Stk1">
              <Exitus>
                <Linea>
                  <Char>For løbende leverancer, for hvilke elinstallationen registreres eller slettes fra registrering efter § 2, kan toldvæsenet give tilladelse til forholdsmæssig opgørelse af den del af leverancen, der kan afgiftsberigtiges efter den særlige elvarmesats.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
          <Paragraf id="Par8" localId="8">
            <Explicatus>§ 8.</Explicatus>
            <Stk id="Par8_Stk1">
              <Exitus>
                <Linea>
                  <Char>Elforsyningsselskabet skal på fakturaer efter toldvæsenets anvisninger oplyse hvor stor en del af leverancen der er afgiftsberigtiget efter henholdsvis den særlige elvarmesats og satsen for anden elektricitet.</Char>
                </Linea>
              </Exitus>
            </Stk>
            <Stk id="Par8_Stk2">
              <Explicatus>Stk. 2.</Explicatus>
              <Exitus>
                <Linea>
                  <Char>Elforsyningsselskabet skal efter toldvæsenets anvisninger tydeligt gøre elvarmeforbrugeren opmærksom på bestemmelsen i § 4, herunder at forbrugeren kan ifalde strafansvar ved overtrædelse efter § 10.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
          <Paragraf id="Par9" localId="9">
            <Explicatus>§ 9.</Explicatus>
            <Stk id="Par9_Stk1">
              <Exitus>
                <Linea>
                  <Char>Ved godtgørelse af elafgift til momsregistrerede virksomheder med elinstallationer, der er registreret efter § 2, beregnes tilbagebetalingsbeløbet efter den særlige elvarmesats.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
          <Paragraf id="Par10" localId="10">
            <Explicatus>§ 10.</Explicatus>
            <Stk id="Par10_Stk1">
              <Exitus>
                <Linea>
                  <Char>Med bøde straffes den, der forsætligt eller groft uagtsomt:</Char>
                </Linea>
              </Exitus>
              <Exitus>
                <Index id="Par10_Stk1_X1">
                  <Indentatio formaInd="Litra" id="Par10_Stk1_Lita">
                    <Explicatus>a)</Explicatus>
                    <Exitus>
                      <Linea>
                        <Char>afgiver urigtige eller vildledende oplysninger eller fortier oplysninger til brug for beregningen af afgiften.</Char>
                      </Linea>
                    </Exitus>
                  </Indentatio>
                  <Indentatio formaInd="Litra" id="Par10_Stk1_Litb">
                    <Explicatus>b)</Explicatus>
                    <Exitus>
                      <Linea>
                        <Char>overtræder § 2, stk. 1, § 8, stk. 1 eller 2.</Char>
                      </Linea>
                    </Exitus>
                  </Indentatio>
                  <Indentatio formaInd="Litra" id="Par10_Stk1_Litc">
                    <Explicatus>c)</Explicatus>
                    <Exitus>
                      <Linea>
                        <Char>undlader at give meddelelse efter § 4.</Char>
                      </Linea>
                    </Exitus>
                  </Indentatio>
                </Index>
              </Exitus>
            </Stk>
            <Stk id="Par10_Stk2">
              <Explicatus>Stk. 2.</Explicatus>
              <Exitus>
                <Linea>
                  <Char>Bestemmelserne i lovens § 15, stk. 4, og § 16 finder anvendelse.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
          <Paragraf id="Par11" localId="11">
            <Explicatus>§ 11.</Explicatus>
            <Stk id="Par11_Stk1">
              <Exitus>
                <Linea>
                  <Char>Bekendtgørelsen træder i kraft dagen efter bekendtgørelsen i Lovtidende.</Char>
                </Linea>
              </Exitus>
            </Stk>
          </Paragraf>
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    <Explicatus>Bilag 1</Explicatus>
    <BilagIndhold>
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          <Linea>
            <Char>(Elforsyningsselskabets navn og adresse)</Char>
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                  <Linea>
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                    <Char>.</Char>
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                    <Char>.</Char>
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            <Char>Registrering af elvarmeinstallationer i helårsboliger</Char>
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              <Explicatus>1.</Explicatus>
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              <Explicatus>2.</Explicatus>
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                    <Char>Herved anmodes om, at nedennævnte bolig bliver registreret hos mit elselskab og i Bygnings- og Boligregistret som elopvarmet helårsbolig, dvs. helårsboligen har en af de under punkt 4 nævnte elvarmeinstallationer som hovedvarmekilde.</Char>
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                    <Char>Installationen vedrører boligen med følgende adresse.</Char>
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                    <Char>Det er vigtigt, at De angiver den fuldstændige adresse.</Char>
                  </Linea>
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            <Tr>
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              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
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              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
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              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
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              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
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              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
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              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
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                    <Char>postnr.</Char>
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              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
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                    <Char>Vejnavn husnr.</Char>
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                    <Char>etage side/dørnr.</Char>
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              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
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            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
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              <Td valign="top" width="290" colspan="5" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
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                    <Char>Elinstallationens nr. </Char>
                    <Char formaChar="Bold">___________________</Char>
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              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
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                    <Char>Installationen omfatter </Char>
                    <Char formaChar="Bold">__________</Char>
                    <Char> boligenhed(er).</Char>
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              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="652" colspan="13" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
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                    <Char>(Omfatter installationen flere boligenheder, bedes De vedlægge en liste over adresserne).</Char>
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                </Exitus>
              </Td>
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>4.</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="217" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Boligens elvarmeinstallation er:</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="145" colspan="4" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst" formaEx="Center">
                  <Linea>
                    <Char>Sæt kryds</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst" formaEx="Center">
                  <Linea>
                    <Char>Sæt kryds</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="217" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Elradiator – paneler eller lign.</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="66" style="border-top: none; border-left: none; border-bottom: none; border-right: 1pt solid #000000; " />
              <Td valign="top" width="19" colspan="2" style="border-top: 1pt solid #000000; border-left: 1pt solid #000000; border-bottom: 1pt solid #000000; border-right: 1pt solid #000000; " />
              <Td valign="top" width="60" style="border-top: none; border-left: 1pt solid #000000; border-bottom: none; border-right: none; " />
              <Td valign="top" width="145" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Elvarmekedel</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="22" style="border-top: none; border-left: none; border-bottom: none; border-right: 1pt solid #000000; " />
              <Td valign="top" width="19" style="border-top: 1pt solid #000000; border-left: 1pt solid #000000; border-bottom: 1pt solid #000000; border-right: 1pt solid #000000; " />
              <Td valign="top" width="31" style="border-top: none; border-left: 1pt solid #000000; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr height="4">
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="217" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="66" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="19" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="60" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="217" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Elvarmepumpe</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="66" style="border-top: none; border-left: none; border-bottom: none; border-right: 1pt solid #000000; " />
              <Td valign="top" width="19" colspan="2" style="border-top: 1pt solid #000000; border-left: 1pt solid #000000; border-bottom: 1pt solid #000000; border-right: 1pt solid #000000; " />
              <Td valign="top" width="60" style="border-top: none; border-left: 1pt solid #000000; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Andet</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="22" style="border-top: none; border-left: none; border-bottom: none; border-right: 1pt solid #000000; " />
              <Td valign="top" width="19" style="border-top: 1pt solid #000000; border-left: 1pt solid #000000; border-bottom: 1pt solid #000000; border-right: 1pt solid #000000; " />
              <Td valign="top" width="31" style="border-top: none; border-left: 1pt solid #000000; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="580" colspan="12" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>(anfør hvilket) </Char>
                    <Char formaChar="Bold">___________________________________________________</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>5.</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="652" colspan="13" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Jeg erklærer, at de oplysninger, jeg har givet ovenfor, er rigtige.</Char>
                  </Linea>
                </Exitus>
              </Td>
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="145" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="362" colspan="9" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="145" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst" formaEx="Center">
                  <Linea>
                    <Char>dato</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="362" colspan="9" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst" formaEx="Center">
                  <Linea>
                    <Char>underskrift</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="652" colspan="13" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst">
                  <Linea>
                    <Char>(Den, der forsætligt eller groft uagtsomt afgiver urigtige eller vildledende oplysninger eller fortier oplysninger til brug ved beregningen af elafgiften, kan straffes med bøde).</Char>
                  </Linea>
                </Exitus>
              </Td>
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>6.</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="652" colspan="13" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Hvis De ejer boligen sendes skemaet til Deres elselskab.</Char>
                  </Linea>
                  <Linea>
                    <Char>Er de lejer af boligen skal ejer eller administrator bekræfte oplysningerne før skemaet sendes til elselskabet.</Char>
                  </Linea>
                </Exitus>
              </Td>
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>7.</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="652" colspan="13" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Udfyldes af udlejer/administrator:</Char>
                  </Linea>
                </Exitus>
              </Td>
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="652" colspan="13" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Det bekræftes, at de oplysninger, der er givet om boligen, jeg har udlejet, er rigtige.</Char>
                  </Linea>
                </Exitus>
              </Td>
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="145" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="362" colspan="9" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="145" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst" formaEx="Center">
                  <Linea>
                    <Char>dato</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="362" colspan="9" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst" formaEx="Center">
                  <Linea>
                    <Char>underskrift</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>8.</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="652" colspan="13" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Udfyldes af selskabet: Seneste årsforbrug </Char>
                    <Char formaChar="Bold">_________________</Char>
                    <Char> kWh.</Char>
                  </Linea>
                </Exitus>
              </Td>
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="652" colspan="13" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="TabelTekst">
                  <Linea>
                    <Char>Tidligere registreret som elopvarmet ja/nej.</Char>
                  </Linea>
                  <Linea>
                    <Char>Dato for modtagelse af anmodningen </Char>
                    <Char formaChar="Bold">________________</Char>
                  </Linea>
                </Exitus>
              </Td>
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="145" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="362" colspan="9" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="145" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst" formaEx="Center">
                  <Linea>
                    <Char>dato</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="362" colspan="9" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst" formaEx="Center">
                  <Linea>
                    <Char>underskrift</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus>
                  <Linea>
                    <Char>9.</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="652" colspan="13" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus>
                  <Linea>
                    <Char>Udfyldes af kommunen: Boligen er registreret/opfylder betingelserne for at blive registreret i BBR som elopvarmet helårsbolig ja /nej</Char>
                  </Linea>
                </Exitus>
              </Td>
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="145" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="362" colspan="9" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="145" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst" formaEx="Center">
                  <Linea>
                    <Char>dato</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="362" colspan="9" style="border-top: none; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus formaForma="SmallTabelTekst" formaEx="Center">
                  <Linea>
                    <Char>underskrift</Char>
                  </Linea>
                </Exitus>
              </Td>
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="652" colspan="13" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; ">
                <Exitus>
                  <Linea>
                    <Char>Begrundelse hvis nej:</Char>
                  </Linea>
                </Exitus>
              </Td>
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
              <Td valign="top" width="72" style="border-top: none; border-left: none; border-bottom: 1pt solid #000000; border-right: none; " />
            </Tr>
            <Tr>
              <Td valign="top" width="28" style="border-top: none; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="2" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" colspan="3" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
              <Td valign="top" width="72" style="border-top: 1pt solid #000000; border-left: none; border-bottom: none; border-right: none; " />
            </Tr>
          </Table>
        </Exitus>
      </TekstGruppe>
    </BilagIndhold>
  </Bilag>
</Dokument>