<?xml version="1.0" encoding="UTF-8"?>
<pog5:POG5 xmlns:ds="http://www.w3.org/2000/09/xmldsig#"
           xmlns:pog5="http://www.e-clo.pl/ZEFIR2/eZefir2/xsd/v4_0/POG_5.xsd"
           xmlns:pog5a="http://www.e-clo.pl/ZEFIR2/eZefir2/xsd/v4_0/POG_5A.xsd"
           xmlns:pog5c="http://www.e-clo.pl/ZEFIR2/eZefir2/xsd/v4_0/POG_5C.xsd"
           xmlns:pog5d="http://www.e-clo.pl/ZEFIR2/eZefir2/xsd/v4_0/POG_5D.xsd"
           xmlns:tp4="http://www.e-clo.pl/ZEFIR2/eZefir2/xsd/v4_0/Types.xsd"
           xmlns:tr="http://www.e-clo.pl/ZEFIR2/eZefir2/xsd/v4_0/Trader.xsd"
           xmlns:xs="http://www.w3.org/2001/XMLSchema"
           version="4_0">
   <pog5:Header period="2023-12"
                taxOffice="1209"
                identifier="1111111111"
                submissionAim="Deklaracja"
                selfRef="11111111110202312POG520240109T084314">
      <pog5:Trader typeOfTaxpayer="N">
         <tr:Corporate>
            <tr:TaxpayerData fullName="Firma" REGON="000000000"/>
            <tr:Residence country="PL"
                          province="12"
                          district="61"
                          commune="1261011"
                          street="Ulica"
                          houseNumber="1"
                          localNumber="2"
                          city="Kraków"
                          postalCode="31-111"
                          provinceName="MAŁOPOLSKIE"
                          districtName="Kraków"
                          communeName="Kraków"/>
         </tr:Corporate>
      </pog5:Trader>
      <pog5:AmountPayable amountPog5a="375"
                          amountPog5c="240"
                          amountPog5d="170"
                          totalExciseDuties="785"
                          excessContributSettlementOfPrevDecl="0"
                          amountOfPaymentsDaily="0"
                          toPay="785"
                          excessContributSettlement="0"/>
      <pog5:Attachment totalExciseDuty="785">
         <pog5a:POG5A version="4_0">
            <pog5a:Header totalAmountOfTax="375"
                          identifier="1111111111"
                          formNo="1"
                          period="2023-12"
                          fullName="Firma"
                          Regon="000000000">
               <pog5a:Concession formNumber="1"
                                 numberOfConcession="1"
                                 licensingAuthority="Org1"
                                 licenseIssueDate="2024-01-01"
                                 totalOfTax="375">
                  <pog5a:CalculationOfTaxOnGame typeOfGame="21"
                                                tax="1500"
                                                taxRatePercentage="0.25"
                                                amountOfTax="375"/>
               </pog5a:Concession>
            </pog5a:Header>
         </pog5a:POG5A>
         <pog5c:POG5C version="4_0">
            <pog5c:Header identifier="1111111111"
                          period="2023-12"
                          formNo="1"
                          taxPaid="0"
                          totalAmountOfTax="240"
                          Regon="000000000"
                          fullName="Firma">
               <pog5c:Monopoly data="Dane" creationDate="2024-01-02"/>
               <pog5c:CalculationOfTaxOnGame typeOfGame="36"
                                             tax="1600"
                                             taxRatePercentage="0.1500"
                                             amountOfTax="240"/>
            </pog5c:Header>
         </pog5c:POG5C>
         <pog5d:POG5D version="4_0">
            <pog5d:Header identifier="1111111111"
                          period="2023-12"
                          totalAmountOfTax="170"
                          regon="000000000"
                          fullName="Firma"
                          formNo="1">
               <pog5d:Concession formNumber="1"
                                 numberOfConcession="2"
                                 licensingAuthority="Org2"
                                 licenseIssueDate="2024-01-04"
                                 totalOfTax="170">
                  <pog5d:CalculationOfTaxOnGame typeOfGame="48"
                                                tax="1700"
                                                taxRatePercentage="0.1"
                                                amountOfTax="170"/>
               </pog5d:Concession>
            </pog5d:Header>
         </pog5d:POG5D>
      </pog5:Attachment>
      <pog5:Statement affirmation="Oświadczam, że są mi znane przepisy Kodeksu karnego skarbowego o odpowiedzialności za podanie danych niezgodnych z rzeczywistością."
                      declarationDate="2024-01-09">
         <tp4:representative repFirstName="Piotr"
                             repSurname="Kolano"
                             phone="124567788"
                             email="op@op.pl"/>
      </pog5:Statement>
   </pog5:Header>
</pog5:POG5>