NOTA EXPLICATIVA

Subsemnatul(a) ______________________ avand calitatea de __________ la __________

angajat
de la data de ___/___/____, domiciliat in __________ judetul/sector _________
bdul/str. _________________,
nr. ___, bloc ___, sc. ___, et. ___, ap. ___, telefon ____________, legitimat cu
BI/CI/Pasaport seria ____,
nr. ___________, eliberat de __________, la data de ___/___/____, CNP _____________
la intrebarile
puse de ____________________________, avand functia de ____________________ ,
dau urmatoarele explicatii:
1. Intrebare: _____________________________________________________
1. Raspuns: _____________________________________________________

2.Intrebare: _____________________________________________________
2. Raspuns: _____________________________________________________
3. Daca mai aveti ceva de adaugat? __________________________________
_________________________________________________________________

Semnatura salariat,

Data in fata noastra, azi ...............

Semnatura ................