Anexa nr.

1
la Hotrrea Guvernului nr. 158
din 28 februarie 2013

Formularul mandatului avocatului

Recto
Seria MA nr. __________
Biroul asociat de avocai_____________________________________________
Cabinetul avocatului________________________________________________
Sediul_____________________________________________________________
Telefonul__________________________________________________________
Adresa electronic___________________________________________________
MANDAT
din_______________________20______
Avocatul______________________________, nr. licenei___________________
din___________________________, n conformitate cu:
1) Contractul de asisten juridic nr.___________ din___________________
2) Decizia coordonatorului Oficiului teritorial __________ al Consiliului Naional
pentru Asisten Juridic Garantat de Stat nr. ______ din__________________,
se mputernicete s acorde asisten juridic n cauza______________________
__________________________________________________________________
__________________________________________________________________
Semntura avocatului
tampila
Seria MA nr. _______

Biroul asociat de avocai_____________________________________________

Cabinetul avocatului________________________________________________
Sediul_____________________________________________________________
Telefonul__________________________________________________________
Adresa electronic__________________________________________________
MANDAT
din_______________________20______
Avocatul______________________________, nr. licenei___________________
din__________________________, n conformitate cu:
1) Contractul de asisten juridic nr.___________ din______________________
2) Decizia coordonatorului Oficiului teritorial __________ al Consiliului Naional
pentru Asisten Juridic Garantat de Stat nr. __________ din_______________,
se mputernicete s acorde asisten juridic n cauza_______________________
__________________________________________________________________
__________________________________________________________________
Semntura avocatului
tampila
 2

Verso

n conformitate cu art. 81 din Codul de procedur civil al Republicii

Moldova, mputernicirile avocatului snt:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

Numele i prenumele clientului

Semntura clientului*
* Dac se ntocmete o procur, avocatul va nota pe versoul mandatului textul Conform
procurii anexate i va semna versoul mandatului n locul clientului.

n conformitate cu art. 81 din Codul de procedur civil al Republicii

Moldova, mputernicirile avocatului snt:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Numele i prenumele clientului
Semntura clientului*
* Dac se ntocmete o procur, avocatul va nota pe versoul mandatului textul Conform
procurii anexate i va semna versoul mandatului n locul clientului.

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