Sunteți pe pagina 1din 1

Ctre,


SERVICIULPUBLICCOMUNITARREGIMPERMISEDECONDUCERE
bINMATRICULAREAVEHICULELOR

_______________________________________________________________________________


Subsemnatul(Subscrisa)___________________________________________________________,
C.N.P.(C.U.I.)__________________________________________________cudomiciliul(sediul)
n________________________________________,strada_______________________________,

di D
st .R
ri .P
bu .C
ie .I
.
G V.
R
A
T
U
IT

___________,
nr._______,bloc_______,scara_______,ap.______,jude/sector________________________,
(auto)vehiculului
solicit___________________________________________________________(auto)vehiculului
_______________________________________
____________________________
___________
marca_________________________________________________________________________
cunumruldeidentificare(serieasiu)________________________________________________.
________________________________________________.


Data:________________________ 

Semn
Semn
tura:_______________________
Semntura:__________________________________
((itampila,ncazulpersoanelorjuridice)
i
tampila,
tampila, n cazul persoanelor


________________________________________________________________________________
__________________________________________________
____________________________________
______________


Datnfaamea,

Data:_______________________

Numele,prenumele,semnaturalucrtorSPCRPCIV
_________________________________________
__________________________

DECLARAfIE

Subsemnatul____________________________________________________________________,
_________________

S
e

C.N.P.________________________________________________________________cudomiciliul
______________
n________________________________________,strada_______________________________,
____________________________
nr._______,bloc_______,scara_______,ap.______,jude/sector________________________,
_______, bloc
cunoscndprevederileart.292codpenalprivindfalsulndeclaraii,declarpepropriarspundere
pierderea/furtul/deteriorarea:


plcii/plcilorcunumruldenmatriculare_______________________

certificatuldenmatricularecunr.________________________


Data:________________________ 

Semntura:__________________________________