ÌÎËÁÀ ÇÀ ÈÇÄÀÂÀÍÅ ÍÀ ÍÅÇÀÂÅÐÅÍ ÏÐÅÏÈÑ

 

                                                        ÄÎ

                                                        ÀÄÌÈÍÈÑÒÐÀÒÈÂÅÍ ÑÚÄ

                                                        Ð Ó Ñ Å

 

Ì  Π Ë  Á  À

                                  

                                   Îò………………………………………

                                                        ÅÃÍ…………………………………….

                                                        Àäðåñ………………………………….

                                                         êà÷åñòâîòî ñè íà…………………

                                                        ïî àäì. äåëî /êàíä/ ¹ …………………..

 

        

ÃÎÑÏÎÄÈÍ /ÃÎÑÏÎÆÎ/ ÑÚÄÈß,

 

Ìîëÿ, äà ìè áúäå èçäàäåí íåçàâåðåí ïðåïèñ îò ………………….

…………………………………………………………………………………… ïî àäì. äåëî /êàíä/ ¹ ……./20..….ã. ïî îïèñà íà …………………ñúä.

 

 

 

Ïðèëîæåíèå: …………………………………………………………………………

 

 

         Äàòà :……………                          Ïîäïèñ :

         ãð.

 

Ïîïúëâà ñå ïðè ïîëó÷àâàíå íà äîêóìåíòèòå

 

       Äíåñ, ……….., …………………………………………………………………………

             /Äàòà/                                         /èìå, ïðåçèìå, ôàìèëèÿ/

â êà÷åñòâîòî ñè íà ……………………………………………………………………………

 

ïîëó÷èõ ……………………………………………………………………………………….

/ïîñî÷âà ñå âèäà íà äîêóìåíòà è áð. ñòðàíèöè/

 

îò àäì.äåëî /êàíä/ ¹                     /                     ã.,                                                         ñúä.

 

 

            Äåëîâîäèòåë :                                                Ïîëó÷àòåë: