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SERVICIULPUBLICCOMUNITARREGIMPERMISEDECONDUCERE
bINMATRICULAREAVEHICULELOR

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Subsemnatul(Subscrisa)___________________________________________________________,
C.N.P.(C.U.I.)__________________________________________________cudomiciliul(sediul)
n________________________________________,strada_______________________________,
___________,
nr._______,bloc_______,scara_______,ap.______,jude/sector________________________,

IT
(auto)vehiculului
solicit___________________________________________________________(auto)vehiculului
_______________________________________
_______________________________________
marca_________________________________________________________________________

U
cunumruldeidentificare(serieasiu)________________________________________________.
________________________________________________.

G V.
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A
Data:________________________  Semntura:_______________________
Semn
Semntura:__________________________________

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tampila,
((itampila,ncazulpersoanelorjuridice)
tampila, n cazul persoanelor

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bu .C

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ri .P


Datnfaamea,
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Data:_______________________
di D

Numele,prenumele,semnaturalucrtorSPCRPCIV
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DECLARAfIE
Subsemnatul____________________________________________________________________,
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C.N.P.________________________________________________________________cudomiciliul
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e

n________________________________________,strada_______________________________,
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nr._______,bloc_______,scara_______,ap.______,jude/sector________________________,
_______, bloc
cunoscndprevederileart.292codpenalprivindfalsulndeclaraii,declarpepropriarspundere
pierderea/furtul/deteriorarea:
 plcii/plcilorcunumruldenmatriculare_______________________
 certificatuldenmatricularecunr.________________________

Data:________________________  Semntura:__________________________________

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