Professional Documents
Culture Documents
CERERE
Subsemnatul(a)____________________________________________________,
cu
domiciliul n Bucureti,
str._________________________________________ nr. ______ bl. ________ sc. ____ ap.
______
sector
6,
locuind
fapt
______________________,
____________________________________________
nr._______,
str.
bl._______,
____
_____,
emis()
de
C.E.P.A.H.
sector
6/C.S.E.P.A.H.,
valabilitate
AP.
Casierie
de ___________________________________, n calitate
de___________________,
cu
domiciliul
n_________________,
str.
_______________________________, nr.____, bl. _____, sc. ___, et. ___, ap. ___, sector___,
legitimat cu B.I./C.I./C.P. seria __, nr.________, eliberat de ________, la data de ___/___/____.
Semntura _______________
Verificat ndeplinirea prevederilor legale n privina acordrii/ncetrii
prestaiilor sociale i facilitilor, conform gradului de handicap,
Inspector/referent___________________________
___