Human Rights Monitoring Institute

Contribute 2 percent of your income tax for the consolidation of human rights in Lithuania.

Account No. LT957044060003048165, Human Rights Monitoring Institute.

Below you will find the application form for the transfer of up to 2 percent of your income tax to Lithuanian entities which are entitled to receive support pursuant to the Law on Charity and Support of the Republic of Lithuania.

Data must be entered accurately in the required fields without transgressing the lines of the specific fields.

The applications must be filled out in capital letters only.

Please leave the lines that are not to be filled empty (do not enter any symbols, for example, slashes, crosses, zeros, etc. there)
Field 1 – specify your ID number.
Field  2 – specify your name and family name.
Field  3 – specify your home address (city, street, numbers of the building and the flat).
Field  4 – specify your telephone number.
Field  5 – specify your e-mail address (if any).
Field  6 – specify your reporting period, i.e. the calendar year for which you paid the income tax out of which the contributed percentage is to be transferred.
Field  7 – specify the date of filling in the application (year, month and day).

Application form FR0512.doc.

Once filled out, this form (FR0512) may be submitted to the territorial branch of the State Tax Inspectorate in the following ways:

1) Send it by post to the following address:
Vilniaus AVMI
Šermukšnių g. 4
LT-0116, Vilnius

2) Deliver it personally to
State Tax Inspectorate of Vilnius Region
Verkių g. 37 (the form is to be left in a specially designed box there)

3) Deliver it personally (or send by e-mail) together with the Income Tax Declaration for the year 2004. You may find the electronic form of the declaration here: http://deklaravimas.vmi.lt/PublicPages.aspx.