djaphiro-nggiaoquan tenb^lll c?ng...
TRANSCRIPT
C@ the cac benh phai tra lai
Nhan xet
Ncri nhffn:
- Nhir tren;
Ngay ...........thang........... nam .
Chu nhi^ni quan y
@;,(?d@igdd'^
Tenb^lll
Djaphiro-nggiaoquan
C?ng Ghichu
@
Mau 4d. Bao cao sue kh6e chien si mm sau kham phuc tra va giam sat HIV, ma tuy
(Don vj cap tren true tiep)..
(Don vj bao cao)........
So;
CQNG H6A XA HQI CHU NGHIA VBET NAM
Bye lap - Tnr do - Hanh phuc
.............. (Biadanh), ngay thang nam
Bao cao sue kh6e chien si m6i
sau kham phuc tra va giam sat HIV, nia tuy
Nam ........
12
^-^DiaphiroTig T6ngcong
Soluong Tile
1.Soliro-ngnhan:
-Suekh6eloai1
...@@@.--Slickh6eloai2
-Suekh6eloai3
vasanglocHIV,matuy
1@-a)SoquanSusirekh6e
+Suekh6eloai1
+Sirekh6eloai2
+Suekh6eloai3
It)Sokh6ngausuekhoe
Trongdodo:
+Theluc
+N6ikhoa
+Tarnthankinh
+Ngoaikhoa
+Dalieu
+Mat
+Taimfiihong
+Ranghammat
+HIVduongtinh
+Matuyduongtinh
3.Co-caubenllchiensimW
a)SonguVimacbfnhnfi
-Benhtimmach
Nhan xet
Nffinhan:
- Nhu tren;
Chu nhiem quan y
(Ky, Song dau)
-Benhh6hap
-B^nhtieuhoa
-Benhn6ikhoakhac
b)Songuffimacbfnhngoai
@Coxuong
-Dantinhmachchan
-Dantinhmachthungtinh
-Chanbet,chaichan
-Bpihkhac
c)SongwffimScbenhngoaida
-Ghe
-Namda
-Benhkhac
d)S6nptlrimacbfnhT-M-H
-Benhvetai
-Benhvemui
-Benhvehong
a)S6ngffffimacbenhvemat
e)Songicdlmitebenhvering
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TANG VAT, PHLTONG TIfiN GOM(5)
Chung t6i l|ip bite ban ban giao ho so, tang vat, phuong tien ghi tr6n ai xit \f
theo quy djnh
a?; di?n ben nhfin da Idem tra lai va nh^n day du cac ho so, tang v|it, phuong
ti?n theo danh muc neu tren.
Bien ban ket thuc vao hoi............ gio.........ngay...... thang..........nam..................
Bien ban duoc lip thanh......ban; m8i ban g6m.,.......toi; c6 n$i dung va c6 gia trj
nhu nhau. Da giao cho........................................................-.......-----01 ban va m$t
ban liiu h6 so.
Sau khi dgc bi6n ban, nhflng nguoi c6 mat d6ng y ve n$i dung bien ban va cung ky
vao bien ban.
Y kite bo sung khac (neu c6) ('>:
fl^I DI$N BftN Ntt^N
(Ky, ghi r8 hf ten)
fl^I DIfN B&N GIAO
(Ky, ghi ro hp ten)
THfi TRIT6NG BON VI BAN NH^N
(Ky , ghi r5 hy ten v& Hong dm)
01 Ghi rS tin hang, quy each, chat luvng. Ktu ho sa, tang v#l, phamg tifn nhtlu, Ifp tMnh dank
mvc Snh Kirn. Danh mvcpMi c6 Say ail chS tf cua nhSng ngiaH c6 tin trong USn ban. Vtu hi sa,
tang vSI, phumg tifn <*@ nUm phong, phai ghi rS s6, kf Mfu (hpac chQ kf) 6 nilm phmg vao c6t ghi
chu.
"' NUing nguU c6 y Uin Uidc @@i nSt dung USn ban phai tv, gM f Idhl cua rnlnh. If do c6 y Uen
khdc.lsyvagUrSlwten.
STT Ttetangv&t,
ptawngtite
duocbangiao
tinh kh6iluong,
trongluong,
Chungloai,nhanhi^u,
xuatxii,tinhtrangtang
v^it,phuongtite
chu
.................................(1) C(>NG HOA XA HOI CHU NGHiA @V^T NAM
............................................... flgc Ijp - TV do - Hanh phic
S6:...................../BB-HC11
BIEN BAN lAMVEgC
Hom nay, h6i..................gi6'..............ngay.............fhang.............nam................
Tai".....................................................................................................................
Chung toi g6m:
l/..........................................................Chfc;vu:...........................Doinvi......................
DB lam vi^c v6i:
I/ 6ng (ba):........................................................Nam sinh...................Qu6c tjch:.........
Diachi:...........................................................................................................................
Nghenghite:..................................................................................................................
Giay CMND/HQ chieu/The can cu6c s6:....................Ngay cap...............Noi cap........
2/ 6ng (ba):........................................................Nam sinh...................Qu6c tjch:.........
Diachi:...........................................................................................................................
Nghenghite:..................................................................................................................
Giay CMND/H$ chieu/Thi can cu6c s6:....................Ngay cap...............Noi cap........
N$i dung lam viec:
"' Dons Irin ghi ten Off quan chu quan cap Irtn Irvc tl&p, Song duW ghi tin caquanlfp biln ban:
m Ghi aia aUm tifn hanh l@p bitn ban.
Bien banket thuc vao h6i....... gid......... ngav......... thing.......... nam..........
Bite ban duoc Hp thanh......ban; mSi ban gom.........to'; c6 noi dung va gia. trj
nhir nhau. B8 giao cho.........................................................@.......@ ..............01 ban.
Sau khi doc bite ban, nhung ngufti c6 m?t d6ng y ve n$i dung bite ban va ctmg ky
vao bite ban.
Y kite b6 sung khac (neu c6)(3):
NGIT6I THAM GIA LAM VI(:C NGU'6l UP BlAN BAN
(Ky, ghi ro hf ten) (Ky, ghi ro hy ten)
m Nhung nguSFi c6 y fain khdc ve n$i dung bien bdn phdi ty ghi y h'^i cua mtnh. lydocoy ki^n
kfvSc, ky vtt ghi r8 Ap ten.
.................................(1) CQNG HOA Xi HQI CHU NGHiA VIf,T NAM
............................................... fi$c lap - Ty do - Hanh phuc
S6:.........................7BB-HC12
BI&N BAN CHl^NG NH^N
HSm nay, h6i.................. gi&.............. ngay.............thang.............nain................
Tai........................................................................................................................
Chung t6i gom:
I/........................................................................Chucvu:...........................Don vj........
11.. .@@@.@..,@...@@@@...............@.@@............@@@.@. Chiicvu:.......................... Don vj........
Voi su'chung kien cua:
I/ 6ng (ba):........................................................NBm sinh...................Qu6c tjch:..........
Diachi:............................................................................................................................
Nghenghim:..................................................................................................................
Gliy CMND/H$ chieu/The can cufirc s6:....................Ngay cap...............Noi cap.........
116ng (ba):........................................................Nam sinh...................Qu6c tich:..........
Diachi:............................................................................................................^...............
Nghenghiep:...................................................................................................................
Giay CMND/H$ chieu/The can cir6c s6:....................Ngay cap...............Noi cap.........
Cluing nh@n rang(2):
(l) D6ng trSn ghi rS tSn ca quern ch& qu&n cdp tr&n tnfc tiep, dong du6i ghi rS t&n car quart l^p bi&n
b&n;
w Ghi @^ dung sy vipc can cfwng nh^n, niu phdt hi?n vi phifm nhimg thu^c truSmg hyp kh6ng x@r
phyl thi c6n ghi r5 thSng tin v@ t6 chixc, cd nh@n viphym;
Bite ban ketthuc vao hoi............ gio.........ngay......thang..........nam..................
Bien ban duoc 1ft) thanh......ban; moi ban g6m.........tor; c6 n$i dung vigia tn
nhiliihau.Dagiaocho.................-...........-----;--"-,--"---"---01,1'@- , ,
Sau khi doc bite ban, nhung nguoi c6 mBt dong y ve n$i dung bien ban va cung ky
vao bite ban.
Y kite bo sung khac (neu c6)(3):
NGVaiCTrffNGKDiN NGUOl UP BI&N BAN
(Ky, ghi ro ho ten) (Ky. ghi ro ho ten)
<" MSng nguM c6 y Uen Ode ve n6l dung bien ban phai tv gU y Iden cua minh, ly do c6 y lain
Uidc.kyvaghlrShoten.
.................................(1) CQNG HOA XA HQI CH6 NGHiA -VTf,T NAM
............................................... D$c lap - TV do - Hanh phuc
S6:........................../BB-HC13
BriSNBAN
Xac djnh trj gia hang boa, tang vat vi pham
H6m nay, h6i............gi&.........ngay...........thang.........nam.................................
Tai121.....................................................................................................................
Chung toi g6m:
21........................................................ Chiicvy....................................Don vi................
31........................................................ Chucvu.................................... Don VL. ..............
4/........................................................Chiicvu....................................Bonvj................
Voi su' chiing kien cua:
6ng (ba):........................................................Nam sinh...................Qu6c tjch:..........
D|achi:............................................................................................................................
Nghenghi^p:.......;............................................................................................................
Giay CMND/H? chieu/The can cir6c s6:....................Ngay cap...............Noi cap...........
Dai di?n t6 chu'c hoac ci nhan vi pham (neu c6):
6ng(ba):........................................................Namsinh...................Qu6ctich:..........
Djachi:............................................................................................................................
Nghenghite:....................................................................................................................
Giay CMND/H6 chieu/The can cuorc s6:....................Ngay cap...............Noi cap...........
Da tite hanh xac djnh tn gia hang hoa, tang vat vi pham hanh chinh (tai Bien
ban......................................,....s6......ngay..........thang...........nam.........cua...................)
dua trte cac can cu: sau day m:.......................................................................................
Hang hoa, tang vat vi pham duqc djnh gia g6m c6 (''):________________
So luong,
khoiluong,
trpng luong
STT Ten hang hoa,
tang v?t duoic
djnh gia
Donvj
tinh
Chung loai, nhan
hieu, xuat xir,
tinhtranghang
hoa, tang vat
Don Thanh| Ghi
tite chu
'' Dong tren ghi tin Co quan chu quan cap tren true tiep, dong duai ghi ten ccr quan lifp bien ban;
" Ghi ala aiem tien hanh sic ainh tri gia hUng hod, tang v#l @vipham:
" Ghi cac cSn at cu the He xdc ainh tri gid hang hod, fang vSI vipham;
w Ghi cu the timg loai hang hod, tang v6t vipham duyc ainh gia;
Qua trinh djnh gia hang hoa, tang v?t vi pham hanh chinh, da tuto thu theo dung
quy djnh cua phap lu^t.
Bite ban dugc l^p xong vao h6i......gi&...... cung ngay, mSi ban g6m.........t6'; c6
n6i dung va c6 gia trj nhu nhau. Sau khi Syc bite ban,: nhung nguoi c6 miit dong -f ve
w)i dung bien ban va cung ky vao bite ban.
Y kite b6 sung khac (neu c6)(5):..........................................................................
NGlrtnUPBI&NBAN NGir&ICHliTMGKriiN
(Ky, ghi ro ho ten) (Ky, ghi ro ho ten)
CANHANHO^C NGlTOITHAMGIAflINHGIA
DAI DItN TO CHfC VI PHAM (Ky, ghi r8 ho ten)
(neu c6)
(Ky, ghi r8 ho ten)
f" NhOng nguM c6 y Uen thac ve n6i dung bien ban phai tv ghi y Hen cua minh. If do c6 y Uen
khac.kyvaghirohpten;
.................................ll) CQNG HOA XA HQI CHO NGHiA VI(:T NAM
............................................... D$c l@p - TIT do - Hanh phfic
SA:........................../BB-HC14
BdiNBAN
Ve vitc ghi nhin tinh (rang tang vat, phiroTig tifa vi pham thay floi
so voi thofi diem ra quytt flmh tarn gift
Can cA Quyet djnh e):........s6........ngay.........thang..........nam..............................
do.........................^.................................................................................................ky<3).
Horn nay, h6i........... gio.......... ngay.....-...thang.......... nam............... tai.................
Chung toi g6m(4):
I/........................................................Chiicvu....................................Bon vi................
11........................................................ Chu-cvu....................................Ban vj................
3/........................................................ Chiicvu.................................... Bern vj................
4/........................................................Chucvu....................................Boa vj................
Tien hanh \m bien ban Ghi nh?n nhttag thay doi cua tang vyt, phuong tito vi
pham so voi thoi diem ra quyet djnh tarn giu cua tang v$t, phuong ti^n bj tjch thu cua:
6ng(bayr6chure:.................................................Namsinh...............Qu6ctich.............
Djachi:............................................................................................................................
Nghenghiep:.........................................................,..........................................................
Giay CMND/H$ chieu/The can cu6c s6:....................Ngay cap...............Noi cap...........
V6i su' chling kien cua(5):
6ng(ba)/T6churc:.................................................Nam sinh...............Qu6ctjch.............
Diachi:............................................................................................................................
Nghenghiep:....................................................................................................................
Giay CMND/H6 chieu/The can cu-Ac s6:....................Ngay cap...............Noi cap...........
Nguoi c6 trach nhi^m tarn giu(6):
6ng(ba)/T6ch>ic:.................................................Namsinh...............Qu6ctich.............
Djachi:............................................................................................................................
Nghenghifl):....................................................................................................................
Giay CMND/H$ chieu/The can cu6c s6:....................Ngay cap...............Noi cap...........
w D6ng tren ghi ten ca quan chu quan cap frSn true tiSp, dong du6i ghi ten off quan l&p bien ban;
m Ghi ten quyet dfnh la quyet afnh tarn giu hang hod, tang vdt, phucmg ti^n vi pham hanh chinh ve
hdiquan;
w Ghi ten, chuc vu cua ngiroi kf quyet afnh tarn giV hang hod, tang v6t, phucmg ti^n vipham hanh
chinh ve hdi quan
Hp ten va chuc vu ngucn Iftp bien ban;
(s) HQ va ten nguSri lam chung. Neu c6 dai di^n chinh quyen phai ghi r5 ho ten, chw vu;
(6) Hp va ten ngieSfi c6 trdch nhi?m tarn gitf;
Tinh (rang tang v^t, phuong ti^n c6 su thay doi so v6i thM diem ra quyet djnh
tarn giu(7):........................................................................................................................
Bite ban ketthuc vao h6i............ gi&.........ngay...... thang..........nam..................
Bite ban duoc lap manh......ban; moi ban g6m,........t&; c6 npi dung va gia tn
nhu" nhau. Da giao cho....................................................................................01 ban.
Sau khi doc bite ban, nhung ngufti c6 m^t d6ngiy ve nyi dung bite ban va cung
k} vao bite ban.
Y kite bo sung khac (neu c6)('":
NGirfnLAPBI&NBAN NGtfOl C6 TRACT NHI^M TAM GlC"
(Ky.ghirohoten) (Ky, ghi ro ho ten)
NGlrtn CHffNG KEfeN
(Ky, ghi ro ho ten)
<7) Ghi r5 nhSng thay aoi cua tang vdt. phucmg ti^n so vai thai aiem tarn giu';
w Nhung ngu^i c6 y kiw khdc v^ npi dung biSn ban phai tu ghi y tain cua minh. ly do c6 y ki^n
khac, ky va ghi r8 ho ten.
...(1) CONGHOAXAHOlCHflNGHiA VIETNAM
BQc lap - TV do - Hanh phuc
S6:........................../BB-HC15
BIEN BAN
Ve vi^c giai trinh tryc tiep trirfrc khi ra Quyet amh xu- phat vi pham hanh chinh
Can cu DiSu 61 Lu?t xu ly vi pham hanh chinh so 15/2012/QH13 ngay
20/6/2012;
Can cu' Bien ban vi pham hanh chinh s6....ngay.. ..fhang... .nam.. ...do.............. Ijip
h6i.....gicr.....ngay.....thang.....nam.......tai......,................................................................;
Can cli van ban yeu cau giai trinh true tiep
so.................. ngay.... thang........nam......cua 6ng (ba)/To chuc.......................................
Can en' van ban uy quyen cho nguoi dai di?n hop phap ve vi(c tham gia phien
giai trinh (neu c6) cua.....................................................................................................
Can cu' van ban th6ng bao cua(2>.......................................................................ve
vi^c t6 chiic phien giai trinh true tiep;
Horn nay, h6i......... gic@........ ngay............ thing.......... nam........... tai......................
Ching toi g6m:
Ngu6i tn chirc phite giai trinh:
I/....................................................................Chuc vu:.............................Don vj...........
2/....................................................................Chuc vu;.............................Don vj...........
Ben giai trinh:
6ng (ba)/T6 chuc(3):......................................................................................................
Ngay/thang/ nam sinh:.....................................................Qu6c tjch:..............................
Djachi:............................................................................................................................
Nghe nghite/lihh vuc boat d$ng:....................................................................................
Giay CMND/H@ chieu/The can cu6c s6:....................Ngay cap...............Noi cap...........
Quyet djnh fhanh lilp/ Giay chung nhan BKKD (hoic DKDN) so.................................
Ngay cap.............................................................Noi cap................................................
Ngu6i phite djch (n6u c6):
6ng (ba):.............................................................Nam sinh...............Qu6ctjch...............
Diachi:............................................................................................................................
Nghe nghi?p:....................................................................................................................
Giay CMND/H@ chieu/The can cu6c s6:....................Ngay cap...............Noi cap...........
Nfi dung phien giai trinh nhir sail:
1. Y kiln cua nguoi c6 tham quyen xii phat:
- Ve can cii phap ly:...................................'...........................................................
w D6ng tren ghi ten ca quan chu quan cap tren true tiep, dong ducri ghi ten ca quan lyp biSn ban;
w Van ban th6ng boo cho nguai vipham ve thai gian, aia aiem, t6 chucphi&n giai trinh true tiep.
w Ghi ten ca nhan hoQc t6 cnVc vipham, neu la 16 chuc thi ghi them ho, ten, chuc vu nguoi dai di^n
cho to chW;
- Ve cac tinh tiet, chung cu' lien quan den hanh vi vi pham..................................
- Ve cac hinh fhlic xu phat, bi^n phap khSc phfti h^u qua du kien ap dung doi
voi hanh vi vi pham:.........................................................................@............................
2. Y kien cua ca nhan/ To chuc vi pham, nguori dai dien hop phap:
Bite ban ket thuc h6i...........gi&........cung ngay; Suyc l^p thanh..... ban, mSi ban
g6m.........ti> c6 n6i dung vi gia tri nhu nhau, duoc doc cho moi nguoi cung nghe (da
dua cho moi nguoi tyr dqc), cong nhan la dung, ciing ky ten vao tung to va da giao cho
nguoi vi pham/dai di^n t6 chuc vi pham 01 ban.
Sau khi doc bien ban, nhiing nguOi c6 n4t d6ng f ve n6i dung bite ban va cung
k^ vao bite ban.
Y kite bo sung khac (neu c6):...........................-...........-.------------
NGlTfn GIAI TMNH DAI Drf;N B&N T6 CHti"C GIAI TRiNH
(HO^C NGlTcn DAI DItN HOP PHAP) (Ky, ghi re ho ten)
(Ky, ghi ro hp ten)
NGU"OILAPBlfiNBAN
(Ky.ghirShoten)
CQNG HOA XA HOI CHfl NGHiA VI^T NAM
D$c lap - Ty do - Hanh phic
So:................... ......./BB-HC16
BliiNBAN
Xac minh tinh tiet cua vu vifc vi pham hanh chinh
Horn nay, hoi............gi&.........ngay...........thang.........nam..................................
Tai@................................................................................-.....-@.@.@@@.
Chung t6i g6m:
3/............................ .@@@@@...Chiicvu@@ ...........................Don vi................
4/.............................@..@@................ Chiicvu@................................. Don vj................
V6i su'chung kien cua;
I/ 6ng (ba):..........@@@@...@@.............Nam sinh...................Qu6c tjch:..........
Diachi:.......................-..................................................................................................
Nghengm^:..........----..............................................................................................
GiayCMND/Ho chieu/The can cu6c s6:....................Ngay [email protected] cap...........
11 6ng (ba):........................................................Nam sinh...................Qu6c tjch:.@@@
Diachi:@...................................................................................................,..................
Nghenghite:-.................................................................................................................
Giay CMND/H$ chieu/The can cuAc s6:....................Ngay cap...............Noi cap...........
Da tien hanh xac mmh tinh net vu vice vi pham doi voi truing hop cua:
6ng (ba)/T6 chuc(3):....................................'.............'......................................................
Namsinh..................-.............................Qu6ctich:.........;......@@...............:..............
Diachi@.......................................................................................................................
Nghenghiep:.............................................................................,......................................
Giay CMND/H$ chieu/The can cuoc/Quyet djnh thanh Ijtp/ Giay chung nhan DKKD
(hoac DKDN) s6:..............................Ngay cap:.....................Noi cap..............................
N$i dung xac minh*4':
w Doing tren ghi ten cv quan chu quan cap tren true tiep, dung dual ghi ten ca quan lap bien ban;
m Ghi dia aifm Hen hanh xdc mink
w Ghi ten va cac th6ng tin lien quan Sen t6 chuv, ca nhan thuv hi^n xdc minh, nghe nghi^p, qu6c
tich, so chung minh Ihu- hoac h6 chieu, Qufit Sfnh lhanh Ifp, Giay chung nhfn dang tf lanh doanh
hoSc aang ky doanh nghi^p.;
141 Ghi n6i dung xdc minh theo fuy ainh tai Oman I Bleu 59 Luft xu ly vl pham hanh chinh so
15/2012/QH13.
Vi?c xac minh ket thuc vao hoi [email protected]@
Bite ban dupe l|ip thanh 02 bin; m6i ban g6m...,.....t&; c6 noi dung va c6 gia trj
nhunhau. Da giao cho.............................................. @@@.@@...@ .........01 ban.
Sau khi Syc, bite ban, nhung ngudi c6 m@t d6ng if ve noi dung bite ban va cung
ky vao bite ban.
Y kite bo sung khac (neu c6)(5)@@@@....-.....@@..............-...@@...........
NGlTOILAPBriSNBAN NGlrtn CHC TRi THVC HI^N XAc MINH
(Ky, ghi ro ho ten) (Ky, ghi ro ho ten)
DAI DBEN CAC CO QUAN C6 LlAN QUAN (n& co)
pl NhCng nguM c6 y Hen Wdc ve n6i dung bitn bdn phai IV, ghi y kien cua mmh, ly do c6 y kien
Hide, ty va ghi ro ho ten.
.................................(" CQNG HOA XA HI)I CHt NGHIA @VIfI NAM
............................................... BQc l?p - Tff do - Hanh phfic
SB: ..@@...@./BB-HC17
BIEN BAN
Ve vifC ca nhan/to chuc vi pham hanh chinh khong nhan
quyet djnh xft phat vi pham hanh chinh121
H6m nay, ngay @ thang... nam............... tai(3)....................................................
Chung toi g6m:(4).....................@@@........@@@.@@......@@@...@@.-.
I/..........@ ..@.@....@[email protected] vu@@...........................Don vi................
31........................................................Chuc vu............@@@@...........Don vj..@.@.
da den giao Quyet djnh xu phat vi pham hanh chmh so ............. ngay ... thang ... nam
...........@ do Ong/ba: @@.@@@.@., chuc vu (5): .................@..... k^ cho 6ng
(ba)/T6 chlic vi pham hanh chinh c6 ten trong Quyet dmh xu' phat vi pham hanh chmh
so................ ngay... thang ... nam.... de thi hanh nhung 6ng (ba)/To chuc nay c6 tinh
khong nhan Quyet djnh.
Vi v$y, tienhanhljip bien ban nay v6i sychiing kien cua16' :...............@.............
Va c6 xac nhto cua chmh quyen dja phuong la(7):.........................................................
It.................... .@@@@......................Chuc vu@@@.@[email protected] vi................
Bite ban gom ......... trang, duffc lap thanh ........... ban c6 npi dung, gia tri nhu
nhau; duoc cong nh^n la dung va duoc luu trong h6 sor va giao cho chinh quyen dja
phuong 01 ban./.
NGU'Al CHUNG KdiN NGVOI L^P BitN BAN
(Ky, ghi r8 ho ten) (Ky, ghi ro ho ten, chuc vy, San vj)
DAI DI(;N CHfNH QUYtN
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(Xdc nhyn, ky va ghi ro ho ten, chuc vif)
111 Dong tren ghi tin caquanchu quan cap tren tnfc nip, dang duU ghi ten caquanlfpbuin ban:
-I Ap dung Mi vH truang hop giao qvyet dinh xuphal trvc Hep theo qvy ainh tat Bleu 70 Luft xu ly
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<" Ghi dia chl no! tfp bien ban.
m Ghi rS hy ten, call bfc, cUtc vu, San vi cua nguvl giao Quyet afnh xuphat vipham hanh chinh.
"' Ghi rC ho ten, cap bdc, chic vu cua nguU c6 tham quyen ban hanh Quyel dinh xH phot vi pham
hanh chinh.
m Neu nguai chung kien cung la nguoi cua chinh quyen dia phwmg thi ghi ro ho ten, chuc vu cua
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r" Ghi ro tin xa, prolong, thi Iran noi ciS nhan vipham cu tru/16 chuc vipham c6 tru so.
ho.
PI,