CHESTIONAR

(asistenţa juridică de urgenţă)

1. Numărul solicitării:__________________________________________________________________

2. Data solicitării:_____________________________________________________________________

3. Ora solicitării:______________________________________________________________________

4. Numele solicitantului:________________________________________________________________

5. Funcţia solicitantului:________________________________________________________________

6. Date de contact ale solicitantului:_______________________________________________________

____________________________________________________________________________________

7. Numele beneficiarului:_______________________________________________________________

8. Data naşterii a beneficiarului:__________________________________________________________

9. Date de contact ale beneficiarului:______________________________________________________

10. Motivul

reţinerii:__________________________________________________________________

11. Data şi ora

reţinerii:________________________________________________________________

12. Locul

reţinerii:____________________________________________________________________

13. Timpul, locul şi acţiunea procesuală

preconizată:_________________________________________

___________________________________________________________________________________.

Executor:____________________