art. 85 unic declaratie somer 85unic
Post on 13-Jul-2016
214 Views
Preview:
DESCRIPTION
TRANSCRIPT
Nr.............................../....................................Decl. 5.
DECLARATIE,
Subsenmatul (a) ______________________________________, posesor al ____, seria _____, nr. __________, eliberat (a) la data de __________, de politia _________, domiciliat (a) in localitatea ________________________, str. _______________________, bl. ____, sc. ____, ap. ___, judetul ___________, cunoscand prevederile art. 292 cod penal, privind declaratii false, declar pe propria raspundere ca membrii familiei monoparentaleNume............................................................../CNP....................................................Nume............................................................../CNP....................................................Nume............................................................../CNP....................................................Nume............................................................../CNP....................................................al carui unic intretinator sunt, locuiesc impreuna cu subsemnatul.
DATA, SEMNATURA,
F85.5,Ed.1,Rev.1
top related