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scalex100 \ul0\nosupersub\cf1\f2\fs24 Nr. \u8230?\u8230?\u8230?\u8230?\u8230? Da
ta \u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\par\pard\li14
18\sb276\sl-276\slmult0\fi0 \up0 \expndtw-3\charscalex100 AVIZ\par\pard\ql \li46
90\sb0\sl-276\slmult0 \par\pard\ql\li4690\sb273\sl-276\slmult0 \up0 \expndtw-3\c
harscalex100 DOMNULE PRE\u350?EDINTE \par\pard\ql \li1418\sb0\sl-276\slmult0 \pa
r\pard\ql\li1418\sb268\sl-276\slmult0 \up0 \expndtw-3\charscalex100 Subsemnatul(
a) ... \par\pard\ql \li1418\sb144\sl-276\slmult0 \up0 \expndtw-2\charscalex100 N
umele anterior \ul0\nosupersub\cf2\f3\fs24 (dac\u259? este cazul) \ul0\nosupersu
b\cf1\f2\fs24 ... \par\pard\ql \li1418\sb124\sl-276\slmult0 \up0 \expndtw-3\char
scalex100 Legitimat(\u259?) cu actul de identitate \ul0\nosupersub\cf2\f3\fs24 (
serie \u351?i num\u259?r) \ul0\nosupersub\cf1\f2\fs24 ... \par\pard\qj \li1418\r
i3710\sb26\sl-420\slmult0 \up0 \expndtw-3\charscalex100 Eliberat la data \u8230?
\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8
230?\u8230? Cet\u259?\u355?enia ... \up0 \expndtw-3\charscalex100 Data \u351?i l
ocul na\u351?terii ... \par\pard\ql \li1418\sb119\sl-276\slmult0 \up0 \expndtw-2
\charscalex100 Prenumele p\u259?rin\u355?ilor ... \par\pard\ql \li1418\ri3596\sb
6\sl-420\slmult0 \up0 \expndtw-3\charscalex100 Domiciliat(\u259?) n localitatea
... \line \up0 \expndtw-3\charscalex100 Adresa ... \par\pard\ql \li1418\ri4503\
sb17\sl-400\slmult0 \up0 \expndtw-2\charscalex100 Nr. telefon ... \line \up0 \ex
pndtw-2\charscalex100 e-mail ... \par\pard\qj \li1418\sb0\sl-410\slmult0 \par\pa
rd\qj\li1418\ri936\sb22\sl-410\slmult0 \up0 \expndtw-1\charscalex100 Conform O.
U.G. nr. 24/2008 aprobat\u259? cu modific\u259?ri \u351?i complet\u259?ri
prin Legea \up0 \expndtw0\charscalex100 nr. 293/2008, v\u259? solicit prin
prezenta cerere accesul la dosarul ntocmit de \up0 \expndtw0\charscalex10
0 Securitate pe numele meu. \par\pard\ql \li1418\sb121\sl-276\slmult0 \up0 \expn
dtw-3\charscalex100 Anexez acestei cereri fotocopia actului meu de identitate va
labil. \par\pard\ql \li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb268\sl-276\
slmult0 \up0 \expndtw-3\charscalex100 OBSERVA\u354?II: \par\pard\ql \li1418\sb0\
sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl
-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-2
76\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276
\slmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\s
lmult0 \par\pard\ql\li1418\sb0\sl-276\slmult0 \par\pard\ql\li1418\sb0\sl-276\slm
ult0 \par\pard\ql\li1418\sb8\sl-276\slmult0 \up0 \expndtw-8\charscalex100 DATA \
u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u82
30?
SEMN\u258?TURA \u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u
8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230?\u8230? \par\pard\qj \li1418\sb0\
sl-255\slmult0 \par\pard\qj\li1418\sb0\sl-255\slmult0 \par\pard\qj\li1418\sb0\sl
-255\slmult0 \par\pard\qj\li1418\ri824\sb17\sl-255\slmult0\fi0 \up0 \expndtw0\ch
arscalex100 \ul0\nosupersub\cf4\f5\fs22 Prin semnarea prezentei cereri, n conform
itate cu prevederile Legii nr. 677/2001 privind \up0 \expndtw-3\charscalex100 pr
otec\u355?ia datelor cu caracter personal, declar pe proprie r\u259?spun
dere c\u259? nu voi folosi \up0 \expndtw-1\charscalex100 informa\u355?iile d

espre alte persoane, men\u355?ionate n documentele emise de Securitate \u351?i ca


re \up0 \expndtw0\charscalex100 fac obiectul dreptului meu de acces, pentr
u a aduce atingere imaginii, onoarei \u351?i \up0 \expndtw0\charscalex100
demnit\u259?\u355?ii acestora.
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