Äîäàòîê ¹11
êåð³âíîãî ñêëàäó òà ñêëàäó îïåðàòèâíîãî øòàáó( îïåðàòèâíî¿ ãðóïè ) __________________________________________
( íàéìåíóâàííÿ ï³äïðèºìñòâà, óñòàíîâè, îðãàí³çàö³¿)
ñõåìà îïîâ³ùåííÿ òà ³íôîðìóâàííÿ îñîáîâîãî ñêëàäó
ñòàíîì íà «___»__________________ 20___ ðîêó.
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¹ ç/ï |
Çàéìàíà ïîñàäà |
Ïð³çâèùå, ³ì’ÿ òà ïî áàòüêîâ³ |
Àäðåñà, íîìåð äîìàøíüîãî òåëåôîíó, ìîá³ëüíîãî òåëåôîíó. |
Íîìåð ñëóæáîâîãî àâòîìîá³ëÿ, àäðåñà âîä³ÿ äîìàøíüîãî òåëåôîíó, (ìîá³ëüíîãî) |
Ïðèì³òêà |
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_________________________________ ________________________ _____________________________
( ïîñàäà) (ï³äïèñ) (ϲÁ)
“_______” ______________________ 20____ð.