DECLARATIEDETRASEU

Privind deplasarea de la domiciliu la locul de munca si invers Subsemnatul(a) _________________________________

care ma legitimez cu____ seria______nr.____________________CNP______________________________ 
grupa sanguina_______ data nasterii_______________in loc.__________________  judetul_________________si
domiciliul actual in
str._________________________ nr.___ap._____localitatea__________________________jud________________
__ studii ___________________angajat la societatea ________________________________________________ avind
marca_______________calificarea_________________________in functia de _________________________
declar pe proprie raspundere ca deplasarea de ladomiciliul actual la locul de munca o efectuez pe urmatorul
traseu: ___________________________________________________________________  ___________
___________________________________________________________  _________________________
_____________________________________________  _______________________________________
______________________ folosind urmatoarele mijloace de transport : _______________ ____________ ___   ___
__ _ _____________________________________________________________ timpul total al deplasarii
fiind in medie de ______ore si _______ minute. Deasemenea la deplasarea de la locul de munca la domiciliu folosesc
urmatorul traseu:________________________________________________
______________ _________________________________________________________________________
_____________________________________________________________________________________
_____________________________________   folosind urmatoarele mijloace de transport ________ __________
____ ________________________________________________ timpul total al deplasarii fiind in medie de
_____ore si _____minute.data:

Semnatura ____________________

DECLARATIEDETRASEU

Privind deplasarea de la domiciliu la locul de munca si invers Subsemnatul(a) _________________________________

care ma legitimez cu____ seria______nr.____________________CNP______________________________ 
grupa sanguina_______ data nasterii_______________in loc.__________________  judetul_________________si
domiciliul actual in
str._________________________ nr.___ap._____localitatea__________________________jud________________
__ studii ___________________angajat la societatea ________________________________________________ avind
marca_______________calificarea_________________________in functia de _________________________
declar pe proprie raspundere ca deplasarea de ladomiciliul actual la locul de munca o efectuez pe urmatorul
traseu: ___________________________________________________________________  ___________
___________________________________________________________  _________________________
_____________________________________________  _______________________________________
______________________ folosind urmatoarele mijloace de transport : _______________ ____________ ___   ___
__ _ _____________________________________________________________ timpul total al deplasarii
fiind in medie de ______ore si _______ minute. Deasemenea la deplasarea de la locul de munca la domiciliu folosesc
urmatorul traseu:________________________________________________
______________ _________________________________________________________________________
_____________________________________________________________________________________
_____________________________________   folosind urmatoarele mijloace de transport ________ __________
____ ________________________________________________ timpul total al deplasarii fiind in medie de
_____ore si _____minute.data:
Semnatura ____________________