CERERE TIP

APROBAT

DIRECTOR GENERAL,

TEODOR NIȚĂ

DOMNULE DIRECTOR,

Subsemnatul/ a ____________________________________________________, domiciliat/ ă

în mun. ________________, jud. ________________, str.
_________________________________________________, nr. ____, bl. ____, sc. _____, ap.
____, identificat/ ă cu CI/ pașaport seria ____ nr. ___________, având telefon
_________________________ și adresa de e-mail
_____________________________________________, prin prezenta solicit:

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Nume solicitant: ___________________________________

Data: __________________

Semnătura: _________________________