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ȼɧɢɦɚɧɢɟ! Ɉɩɥɚɬɚ ɞɚɧɧɨɝɨ ɫɱɟɬɚ ɨɡɧɚɱɚɟɬ ɫɨɝɥɚɫɢɟ ɫ ɭɫɥɨɜɢɹɦɢ ɩɨɫɬɚɜɤɢ ɬɨɜɚɪɚ. ɍɜɟɞɨɦɥɟɧɢɟ ɨɛ ɨɩɥɚɬɟ ɨɛɹɡɚɬɟɥɶɧɨ, ɜ ɩɪɨɬɢɜɧɨɦ ɫɥɭɱɚɟ ɧɟ ɝɚɪɚɧɬɢɪɭɟɬɫɹ ɧɚɥɢɱɢɟ ɬɨɜɚɪɚ ɧɚ ɫɤɥɚɞɟ. Ɍɨɜɚɪ ɨɬɩɭɫɤɚɟɬɫɹ ɩɨ ɮɚɤɬɭ ɩɪɢɯɨɞɚ ɞɟɧɟɝ ɧɚ ɪ/ɫ ɉɨɫɬɚɜɳɢɤɚ, ɫɚɦɨɜɵɜɨɡɨɦ, ɩɪɢ
ȻɚɧɤɩɨɥɭɱɚɬɟɥɹɈȺɈ «ɗɧɫɤɢɣ ɛɚɧɤ» ɮɢɥɢɚɥ ɜȺɄȻɋȻ ɊɎ |
ȻɂɄ |
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Ʉɉɉ 575302101 |
ɋɱ. ʋ |
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ɉɨɥɭɱɚɬɟɥɶɈɈɈ «Ȼɟɫɬ» |
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ɋɱɟɬ ɧɚ ɨɩɥɚɬɭ ʋ 01 ɨɬ 03.12.2008 ɝ.
ɉɨɫɬɚɜɳɢɤ: Ɉɛɳɟɫɬɜɨ ɫ ɨɝɪɚɧɢɱɟɧɧɨɣ ɨɬɜɟɬɫɜɟɧɧɨɫɬɶɸ «Ȼɟɫɬ»
Ƚɪɭɡɨɨɬɩɪɚɜɢɬɟɥɶ: Ɉɛɳɟɫɬɜɨ ɫ ɨɝɪɚɧɢɱɟɧɧɨɣ ɨɬɜɟɬɫɜɟɧɧɨɫɬɶɸ «Ȼɟɫɬ»
ɉɨɤɭɩɚɬɟɥɶ: Ɉɛɳɟɫɬɜɨ ɫ ɨɝɪɚɧɢɱɟɧɧɨɣ ɨɬɜɟɬɫɜɟɧɧɨɫɬɶɸ «Ȼɟɫɬ»
Ƚɪɭɡɨɩɨɥɭɱɚɬɟɥɶ: Ɉɬɤɪɵɬɨɟ ɚɤɰɢɨɧɟɪɧɨɟ ɨɛɳɟɫɬɜɨ «Ɏɨɪɭɦ»
ʋ |
Ⱥɪɬɢɤɭɥ |
Ɍɨɜɚɪɵ (ɪɚɛɨɬɵ, ɭɫɥɭɝɢ) |
Ʉɨɥ-ɜɨ |
ȿɞ. |
ɐɟɧɚ |
ɋɭɦɦɚ |
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ɂɬɨɝɨ:
ȼɬɨɦɱɢɫɥɟɇȾɋ:
ɂɬɨɝɨɤɨɩɥɚɬɟ:
ȼɫɟɝɨ ɧɚɢɦɟɧɨɜɚɧɢɣ ___________, ɧɚ ɫɭɦɦɭ ________________________ ɪɭɛ. _____ ɤɨɩ.
Ⱦɢɪɟɤɬɨɪ |
_______________ |
____________________ |
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ɉɨɞɩɢɫɶ |
ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ |
Ƚɥɚɜɧɵɣ ɛɭɯɝɚɥɬɟɪ |
_______________ |
____________________ |
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ɉɨɞɩɢɫɶ |
ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ |
Ɉɬɜɟɬɫɬɜɟɧɧɵɣ |
_______________ |
____________________ |
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ɉɨɞɩɢɫɶ |
ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ |
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ɉɨɤɭɩɚɬɟɥɶ: |
ɋɑȿɌ ɇȺ ɈɉɅȺɌɍ ʋ ___ ɨɬ _____________ |
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ɍɫɥɨɜɢɹ ɩɨɫɬɚɜɤɢ |
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ɨɛɪɚɡɟɰ ɡɚɩɨɥɧɟɧɢɹ ɩɥɚɬɟɠɧɨɝɨ ɩɨɪɭɱɟɧɢɹ |
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ȻɂɄ |
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Ȼɚɧɤ ɩɨɥɭɱɚɬɟɥɹ |
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ɋɱ. ʋ |
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Ʉɉɉ |
ɋɱ. ʋ |
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ȼɢɞ ɨɩ. |
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ɋɪɨɤ |
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ɩɥɚɬ. |
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ɉɨɥɭɱɚɬɟɥɶ |
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ɇɚɡ. |
ɩɥ. |
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Ɉɱɟɪ. |
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ɩɥɚɬ. |
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Ʉɨɞ |
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Ɋɟɡ. ɩɨɥɟ |
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Ɂɚ _______________ ɩɨ ɫɱɟɬɭ ʋ ___ ɨɬ __________________ ɛɟɡ ɧɚɥɨɝɚ (ɇȾɋ)
ɇɚɡɧɚɱɟɧɢɟ ɩɥɚɬɟɠɚ
_________________________________________________________________________________
_________________________________________________________________________________
ʋ |
ɇɚɢɦɟɧɨɜɚɧɢɟ ɬɨɜɚɪɚ (ɨɩɢɫɚɧɢɟ ɜɵɩɨɥɧɟɧɧɵɯ ɪɚɛɨɬ, |
ȿɞ. |
Ʉɨɥɢ- |
ɐɟɧɚ (ɬɚɪɢɮ) |
ɋɬɨɢɦɨɫɬɶɬɨɜɚɪɨɜ |
ɡɚɟɞɢɧɢɰɭɢɡɦɟɪɟ- |
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ɨɤɚɡɚɧɧɵɯ ɭɫɥɭɝ) |
ɢɡɦ. |
ɱɟɫɬɜɨ |
ɧɢɹ, ɪɭɛ.ɤɨɩ. |
(ɪɚɛɨɬ, ɭɫɥɭɝ), ɪɭɛ.ɤɨɩ. |
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ȼɫɟɝɨ ɤ ɨɩɥɚɬɟ:
Ȼɟɡ ɧɚɥɨɝɚ (ɇȾɋ)
ȼɵɩɢɫɚɥ (ɩɪɟɞɩɪɢɧɢɦɚɬɟɥɶ): Ȼɭɯɝɚɥɬɟɪ (ɩɪɟɞɩɪɢɧɢɦɚɬɟɥɶ):
Ɋɭɤɨɜɨɞɢɬɟɥɶ (ɩɪɟɞɩɪɢɧɢɦɚɬɟɥɶ): Ɇ. ɉ.
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ɉɪɢɥɨɠɟɧɢɟ 1 ɤ ɉɨɫɬɚɧɨɜɥɟɧɢɸ ɉɪɚɜɢɬɟɥɶɫɬɜɚ ɊɎ ɨɬ 1 1 . 0 5 . 2 0 0 6 ʋ 2 8 3
ɋɑȿɌ-ɎȺɄɌɍɊȺ ʋ __________ ɨɬ
«____»______________________________________________________________________________________________________(1)
ɉɪɨɞɚɜɟɰ _____________________________________________________________________________________________________________________________________(2) Ⱥɞɪɟɫ ________________________________________________________________________________________________________________________________________(2ɚ) ɂɇɇ/Ʉɉɉ ɩɪɨɞɚɜɰɚ___________________________________________________________________________________________________________________________ (2ɛ) Ƚɪɭɡɨɨɬɩɪɚɜɢɬɟɥɶ ɢ ɟɝɨ ɚɞɪɟɫ____________________________________________________________________________________________________________________ (3) Ƚɪɭɡɨɩɨɥɭɱɚɬɟɥɶ ɢ ɟɝɨ ɚɞɪɟɫ____________________________________________________________________________________________________________________ (4) Ʉ ɩɥɚɬɟɠɧɨ-ɪɚɫɱɟɬɧɨɦɭ ɞɨɤɭɦɟɧɬɭ ʋ __________________ ɨɬ________________________________________________________________________________________ (5) ɉɨɤɭɩɚɬɟɥɶ ____________________________________________________________________________________________________________________________________ (6) Ⱥɞɪɟɫ ________________________________________________________________________________________________________________________________________ (6ɚ) ɂɇɇ/Ʉɉɉ ɩɨɤɭɩɚɬɟɥɹ _________________________________________________________________________________________________________________________ (6ɛ)
ɇɚɢɦɟɧɨɜɚɧɢɟ ɬɨɜɚɪɚ (ɨɩɢɫɚɧɢɟ ɜɵɩɨɥɧɟɧɧɵɯ |
ȿɞɢɧɢɰɚ ɢɡ- |
Ʉɨɥɢɱɟɫɬɜɨ |
ɐɟɧɚ (ɬɚɪɢɮ) |
ɋɬɨɢɦɨɫɬɶ ɬɨɜɚ- |
ȼ ɬɨɦ |
ɇɚɥɨɝɨɜɚɹ |
ɋɭɦɦɚ |
ɋɬɨɢɦɨɫɬɶ ɬɨɜɚɪɨɜ |
ɋɬɪɚɧɚ |
ɇɨɦɟɪ ɬɚɦɨ- |
ɪɚɛɨɬ, ɨɤɚɡɚɧɧɵɯ ɭɫɥɭɝ, ɢɦɭɳɟɫɬɜɟɧɧɨɝɨ ɩɪɚɜɚ) |
ɦɟɪɟɧɢɹ |
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ɡɚ ɟɞɢɧɢɰɭ |
ɪɨɜ (ɪɚɛɨɬ, ɭɫ- |
ɱɢɫɥɟ |
ɫɬɚɜɤɚ |
ɧɚɥɨɝɚ |
(ɪɚɛɨɬ, ɭɫɥɭɝ), ɢɦɭɳɟ- |
ɩɪɨɢɫɯɨ- |
ɠɟɧɧɨɣ ɞɟɤɥɚ- |
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ɢɡɦɟɪɟɧɢɹ |
ɥɭɝ), ɢɦɭɳɟɫɬ- |
ɚɤɰɢɡ |
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ɫɬɜɟɧɧɵɯ ɩɪɚɜ, ɫ ɭɱɟ- |
ɠɞɟɧɢɹ |
ɪɚɰɢɢ |
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ɜɟɧɧɵɯ ɩɪɚɜ, |
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ɬɨɦ ɧɚɥɨɝɚ |
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ɜɫɟɝɨ ɛɟɡ ɧɚɥɨɝɚ |
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ȼɫɟɝɨ ɤ ɨɩɥɚɬɟ
Ɋɭɤɨɜɨɞɢɬɟɥɶ ɨɪɝɚɧɢɡɚɰɢɢ _____________________________________________ |
Ƚɥɚɜɧɵɣ ɛɭɯɝɚɥɬɟɪ |
_________________________________________________ |
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(ɩɨɞɩɢɫɶ) |
(Ɏ., ɂ., Ɉ.) |
(ɩɨɞɩɢɫɶ) |
(Ɏ., ɂ., Ɉ.) |
ɂɧɞɢɜɢɞɭɚɥɶɧɵɣ ɩɪɟɞɩɪɢɧɢɦɚɬɟɥɶ ____________ ___________________________ ___________________________________________________________________________
(ɩɨɞɩɢɫɶ) (Ɏ., ɂ., Ɉ.) (ɪɟɤɜɢɡɢɬɵ ɫɜɢɞɟɬɟɥɶɫɬɜɚ ɨ ɝɨɫɭɞɚɪɫɬɜɟɧɧɨɣ ɪɟɝɢɫɬɪɚɰɢɢ ɢɧɞɢɜɢɞɭɚɥɶɧɨɝɨ ɩɪɟɞɩɪɢɧɢɦɚɬɟɥɹ) ɉɪɢɦɟɱɚɧɢɟ. ɉɟɪɜɵɣ ɷɤɡɟɦɩɥɹɪ - ɩɨɤɭɩɚɬɟɥɸ, ɜɬɨɪɨɣ ɷɤɡɟɦɩɥɹɪ - ɩɪɨɞɚɜɰɭ
ɍɧɢɮɢɰɢɪɨɜɚɧɧɚɹ ɮɨɪɦɚ ʋ Ɍɨɪɝ-12 ɍɬɜɟɪɠɞɟɧɚ ɩɨɫɬɚɧɨɜɥɟɧɢɟɦ Ƚɨɫɤɨɦɫɬɚɬɚ Ɋɨɫɫɢɢ ɨɬ 25.12.1998. ʋ 132
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Ɏɨɪɦɚ ɩɨ ɈɄɍȾ |
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Ʉɨɞ |
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ɩɨ ɈɄɉɈ |
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ɨɪɝɚɧɢɡɚɰɢɹ, ɚɞɪɟɫ |
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ɫɬɪɭɤɬɭɪɧɨɟ ɩɨɞɪɚɡɞɟɥɟɧɢɟ |
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ȼɢɞ ɞɟɹɬɟɥɶɧɨɫɬɢ ɩɨ ɈɄȾɉ |
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Ƚɪɭɡɨɨɬɩɪɚɜɢɬɟɥɶ |
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ɩɨ ɈɄɉɈ |
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ɉɨɫɬɚɜɳɢɤ |
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ɧɚɢɦɟɧɨɜɚɧɢɟ ɨɪɝɚɧɢɡɚɰɢɢ, ɚɞɪɟɫ, ɧɨɦɟɪ ɬɟɥɟɮɨɧɚ, ɛɚɧɤɨɜɫɤɢɟ ɪɟɤɜɢɡɢɬɵ |
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ɩɨ ɈɄɉɈ |
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ɉɥɚɬɟɥɶɳɢɤ |
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ɧɚɢɦɟɧɨɜɚɧɢɟ ɨɪɝɚɧɢɡɚɰɢɢ, ɚɞɪɟɫ, ɧɨɦɟɪ ɬɟɥɟɮɨɧɚ, ɛɚɧɤɨɜɫɤɢɟ ɪɟɤɜɢɡɢɬɵ |
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ɩɨ ɈɄɉɈ |
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Ɉɫɧɨɜɚɧɢɟ |
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ɧɚɢɦɟɧɨɜɚɧɢɟ ɨɪɝɚɧɢɡɚɰɢɢ, ɚɞɪɟɫ, ɧɨɦɟɪ ɬɟɥɟɮɨɧɚ, ɛɚɧɤɨɜɫɤɢɟ ɪɟɤɜɢɡɢɬɵ |
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ɧɨɦɟɪ |
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ɞɨɝɨɜɨɪ, ɡɚɤɚɡ-ɧɚɪɹɞ |
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ɞɚɬɚ |
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Ɍɪɚɧɫɩɨɪɬɧɚɹ ɧɚɤɥɚɞɧɚɹ |
ɧɨɦɟɪ |
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ɞɚɬɚ |
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ȼɢɞ |
ɨɩɟɪɚɰɢɢ |
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ɇɨɦɟɪ |
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Ⱦɚɬɚ |
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ɞɨɤɭɦɟɧɬɚ |
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ɫɨɫɬɚɜɥɟɧɢɹ |
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ɌɈȼȺɊɇȺə ɇȺɄɅȺȾɇȺə |
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ɇɨɦɟɪ |
Ɍɨɜɚɪ |
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ȿɞɢɧɢɰɚ ɢɡɦɟɪɟ- |
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Ʉɨɥɢɱɟɫɬɜɨ |
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Ʉɨɥɢ- |
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ɋɭɦɦɚ ɛɟɡ |
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ɇȾɋ |
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ɋɭɦɦɚ ɫ |
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ɧɢɹ |
ȼɢɞ |
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Ɇɚɫɫɚ, |
ɱɟɫɬɜɨ, |
ɐɟɧɚ, |
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ɩɨ ɩɨ- |
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ɭɱɟɬɚ ɇȾɋ, |
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ɭɱɟɬɨɦ ɇȾɋ, |
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(ɦɚɫɫɚ |
ɪɭɛ., ɤɨɩ. |
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ɪɹɞɤɭ |
ɧɚɢɦɟɧɨɜɚɧɢɟ, ɯɚɪɚɤɬɟɪɢɫɬɢɤɚ, |
ɤɨɞ |
ɧɚɢɦɟ- |
ɤɨɞ ɩɨ |
ɭɩɚɤɨɜɤɢ |
ɜ ɨɞɧɨɦ |
ɦɟɫɬ, |
ɛɪɭɬɬɨ |
ɪɭɛ., ɤɨɩ. |
ɫɬɚɜɤɚ, |
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ɫɭɦɦɚ, |
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ɪɭɛ., ɤɨɩ. |
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ɫɨɪɬ, ɚɪɬɢɤɭɥ ɬɨɜɚɪɚ |
|
ɧɨɜɚɧɢɟ |
ɈɄȿɂ |
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ɦɟɫɬɟ |
ɲɬɭɤ |
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ɧɟɬɬɨ) |
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% |
ɪɭɛ., ɤɨɩ. |
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ɂɬɨɝɨ |
ɏ |
ɏ |
ȼɫɟɝɨ ɩɨ ɧɚɤɥɚɞɧɨɣ |
ɏ |
ɏ |
24
Ɍɨɜɚɪɧɚɹ ɧɚɤɥɚɞɧɚɹ ɢɦɟɟɬ ɩɪɢɥɨɠɟɧɢɟ ɧɚ
_________________________________________________________________________________________________________________ ɥɢɫɬɚɯ
ɢ ɫɨɞɟɪɠɢɬ
________________________________________________________________________________________________________________________
ɩɨɪɹɞɤɨɜɵɯ ɧɨɦɟɪɨɜ ɡɚɩɢɫɟɣ
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ɩɪɨɩɢɫɶɸ |
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Ɇɚɫɫɚ ɝɪɭɡɚ( ɧɟɬɬɨ) |
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ɩɪɨɩɢɫɶɸ |
ȼɫɟɝɨ ɦɟɫɬ |
Ɇɚɫɫɚ ɝɪɭɡɚ (ɛɪɭɬɬɨ) |
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ɩɪɨɩɢɫɶɸ |
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ɩɪɨɩɢɫɶɸ |
ɉɪɢɥɨɠɟɧɢɟ, (ɩɚɫɩɨɪɬɚ, ɫɟɪɬɢɮɢɤɚɬɵ ɢ ɬ. ɩ.) ɧɚ ________________ ɥɢɫɬɚɯ |
ɉɨ ɞɨɜɟɪɟɧɧɨɫɬɢ ʋ __________ ɨɬ «____» ________________ 200 __ ɝ. |
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ɩɪɨɩɢɫɶɸ |
ɜɵɞɚɧɧɨɣ ____________________________________________________ |
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ȼɫɟɝɨ ɨɬɩɭɳɟɧɨ ɧɚ ɫɭɦɦɭ _______________________________________________ |
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ɤɟɦ, ɤɨɦɭ (ɨɪɝɚɧɢɡɚɰɢɹ, ɞɨɥɠɧɨɫɬɶ, ɮɚɦɢɥɢɹ, ɢ., ɨ.) |
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ɩɪɨɩɢɫɶɸ |
_____________________________________________________________ |
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____________________________________________________________ ɪɭɛ. ____ ɤɨɩ. |
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Ɉɬɩɭɫɤ ɪɚɡɪɟɲɢɥ _________________ ___________ _____________________________ |
_ |
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ɞɨɥɠɧɨɫɬɶ |
ɩɨɞɩɢɫɶ |
ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ |
Ƚɪɭɡ ɩɪɢɧɹɥ _________________ __________________ |
_____________________________ |
|||
_________________ ______________ _____________________________ |
ɞɨɥɠɧɨɫɬɶ |
ɩɨɞɩɢɫɶ |
ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ |
||||
ɞɨɥɠɧɨɫɬɶ |
ɩɨɞɩɢɫɶ |
ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ |
Ƚɪɭɡ ɩɨɥɭɱɢɥ ɝɪɭɡɨɩɨɥɭɱɚɬɟɥɶ ____________ _____________ |
________________ |
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Ɇ.ɉ. |
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ɞɨɥɠɧɨɫɬɶ |
ɩɨɞɩɢɫɶ |
ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ |
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Ɇ.ɉ. |
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25
ɁȺȾȺɇɂȿ 2. Ɂɚɩɨɥɧɟɧɢɟ ɞɨɤɭɦɟɧɬɨɜ ɩɨ ɯɨɡɹɣɫɬɜɟɧɧɨɣ ɨɩɟɪɚɰɢɢ
ɉɟɪɟɞɚɧɨ ɜ ɦɨɧɬɚɠ ɨɛɨɪɭɞɨɜɚɧɢɟ ɞɥɹ ɫɬɪɨɹɳɟɝɨɫɹ ɰɟɯɚ
ɍɧɢɮɢɰɢɪɨɜɚɧɧɚɹ ɮɨɪɦɚ ʋ Ɍɨɪɝ-13
ɍɬɜɟɪɠɞɟɧɚ ɩɨɫɬɚɧɨɜɥɟɧɢɟɦ Ƚɨɫɤɨɦɫɬɚɬɚ Ɋɨɫɫɢɢ ɨɬ 25.12.1998. ʋ 132
Ʉɨɞ
Ɏɨɪɦɚ ɩɨ ɈɄɍȾ |
0330213 |
ɩɨ ɈɄɉɈ
ɨɪɝɚɧɢɡɚɰɢɹ
ȼɢɞ ɞɟɹɬɟɥɶɧɨɫɬɢ ɩɨ ɈɄȾɉ ȼɢɞ ɨɩɟɪɚɰɢɢ
ɇȺɄɅȺȾɇȺə
ɇȺ ȼɇɍɌɊȿɇɇȿȿ ɉȿɊȿɆȿɓȿɇɂȿ, ɉȿɊȿȾȺɑɍ ɌɈȼȺɊɈȼ, ɌȺɊɕ
ɇɨɦɟɪ |
Ⱦɚɬɚ |
ɞɨɤɭɦɟɧɬɚ |
ɫɨɫɬɚɜɥɟɧɢɹ |
|
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Ɉɬɩɪɚɜɢɬɟɥɶ |
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ɉɨɥɭɱɚɬɟɥɶ |
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Ʉɨɪɪɟɫɩɨɧɞɢɪɭɸɳɢɣ ɫɱɟɬ |
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ɫɬɪɭɤɬɭɪɧɨɟ ɩɨɞɪɚɡ- |
ɜɢɞ ɞɟɹɬɟɥɶɧɨɫɬɢ |
ɫɬɪɭɤɬɭɪɧɨɟ ɩɨɞɪɚɡ- |
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ɜɢɞ ɞɟɹɬɟɥɶɧɨɫɬɢ |
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ɫɱɟɬ, ɫɭɛɫɱɟɬ |
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ɤɨɞ ɚɧɚɥɢɬɢɱɟɫɤɨɝɨ ɭɱɟɬɚ |
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ɞɟɥɟɧɢɟ |
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ɞɟɥɟɧɢɟ |
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Ɍɨɜɚɪ, ɬɚɪɚ |
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ɋɨɪɬ |
ȿɞɢɧɢɰɚ ɢɡɦɟɪɟɧɢɹ |
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Ɉɬɩɭɳɟɧɨ |
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ɉɨ ɭɱɟɬɧɵɦ ɰɟɧɚɦ |
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ɧɚɢɦɟɧɨɜɚɧɢɟ, ɯɚɪɚɤɬɟɪɢɫɬɢɤɚ |
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ɧɚɢɦɟɧɨ- |
|
ɤɨɞ ɩɨ |
ɤɨɥɢɱɟɫɬɜɨ |
ɦɚɫɫɚ |
ɰɟɧɚ, |
ɫɭɦɦɚ, |
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ɤɨɞ |
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ɜ ɨɞɧɨɦ |
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ɦɟɫɬ, |
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ɜɚɧɢɟ |
|
ɈɄȿɂ |
|
ɛɪɭɬɬɨ |
ɧɟɬɬɨ |
ɪɭɛ., ɤɨɩ. |
ɪɭɛ., ɤɨɩ. |
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ɦɟɫɬɟ |
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ɲɬɭɤ |
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1 |
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2 |
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3 |
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11 |
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ɂɬɨɝɨ |
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ɏ |
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Ɍɨɜɚɪ, ɬɚɪɚ |
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ȿɞɢɧɢɰɚ ɢɡɦɟɪɟɧɢɹ |
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Ɉɬɩɭɳɟɧɨ |
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ɉɨ ɭɱɟɬɧɵɦ ɰɟɧɚɦ |
|||
ɧɚɢɦɟɧɨɜɚɧɢɟ, ɯɚɪɚɤɬɟɪɢɫɬɢɤɚ |
|
ɋɨɪɬ |
ɧɚɢɦɟɧɨ- |
ɤɨɞ ɩɨ |
ɤɨɥɢɱɟɫɬɜɨ |
ɦɚɫɫɚ |
ɰɟɧɚ, |
ɫɭɦɦɚ, |
||
ɤɨɞ |
ɜ ɨɞɧɨɦ |
ɦɟɫɬ, |
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ɜɚɧɢɟ |
ɈɄȿɂ |
ɛɪɭɬɬɨ |
ɧɟɬɬɨ |
ɪɭɛ., ɤɨɩ. |
ɪɭɛ., ɤɨɩ. |
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ɦɟɫɬɟ |
ɲɬɭɤ |
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1 |
2 |
3 |
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10 |
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ɂɬɨɝɨ |
ɏ |
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ȼɫɟɝɨ ɩɨ ɧɚɤɥɚɞɧɨɣ |
ɏ |
Ɉɬɩɭɫɬɢɥ _______________ __________________ |
___________________________ ɬɨɜɚɪ ɢ ɬɚɪɭ ɩɨ ɤɨɥɢɱɟɫɬɜɭ |
|
ɞɨɥɠɧɨɫɬɶ |
ɩɨɞɩɢɫɶ |
ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ |
ɢ ɧɚɞɥɟɠɚɳɟɦɭ ɤɚɱɟɫɬɜɭ ɧɚ ɫɭɦɦɭ ___________________________________________________________________________
ɩɪɨɩɢɫɶɸ
____________________________________________________________________ ɪɭɛ._________ ɤɨɩ.
ɉɨɥɭɱɢɥ _________________ __________________ ______________________________
ɞɨɥɠɧɨɫɬɶ |
ɩɨɞɩɢɫɶ |
ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ |
27
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ɍɧɢɮɢɰɢɪɨɜɚɧɧɚɹ ɮɨɪɦɚ ʋ Ɉɋ-15 |
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ɍɬɜɟɪɠɞɟɧɚ ɩɨɫɬɚɧɨɜɥɟɧɢɟɦ Ƚɨɫɤɨɦɫɬɚɬɚ Ɋɨɫɫɢɢ ɨɬ 21.01.2003. ʋ 7 |
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Ɉɪɝɚɧɢɡɚɰɢɹ-ɡɚɤɚɡɱɢɤ |
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Ʉɨɞ |
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Ɏɨɪɦɚ ɩɨ ɈɄɍȾ |
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ɇɚɢɦɟɧɨɜɚɧɢɟ |
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ɩɨ ɈɄɉɈ |
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ɇɚɢɦɟɧɨɜɚɧɢɟ ɫɬɪɭɤɬɭɪɧɨɝɨ ɩɨɞɪɚɡɞɟɥɟɧɢɹ ɡɚɤɚɡɱɢɤɚ |
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ɧɨɦɟɪ |
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Ⱦɨɝɨɜɨɪ |
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ɞɚɬɚ |
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ȺɄɌ |
ɇɨɦɟɪ ɞɨɤɭɦɟɧɬɚ |
Ⱦɚɬɚ ɫɨɫɬɚɜɥɟɧɢɹ |
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ɫɞɚɱɢ ɜ ɦɨɧɬɚɠ |
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Ⱦɚɬɚ |
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ɨ ɩɪɢɟɦɤɟ-ɩɟɪɟɞɚɱɟ ɨɛɨɪɭɞɨɜɚɧɢɹ ɜ ɦɨɧɬɚɠ |
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ɫɞɚɱɢ ɜ ɷɤɫɩɥɭɚɬɚɰɢɸ |
ɩɨ ɞɨɝɨɜɨɪɭ |
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ɮɚɤɬɢɱɟɫɤɚɹ |
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Ɇɟɫɬɨ ɫɨɫɬɚɜɥɟɧɢɹ ɚɤɬɚ ____________________________________________________________________ ɩɨ ɈɄɉɈ _______
Ɉɪɝɚɧɢɡɚɰɢɹ-ɢɡɝɨɬɨɜɢɬɟɥɶ __________________________________________________________________ ɩɨ ɈɄɉɈ _______
Ɉɪɝɚɧɢɡɚɰɢɹ-ɩɨɫɬɚɜɳɢɤ ____________________________________________________________________ ɩɨ ɈɄɉɈ _______
Ɇɨɧɬɚɠɧɚɹ ɨɪɝɚɧɢɡɚɰɢɹ ____________________________________________________________________ ɩɨ ɈɄɉɈ _______
ɉɟɪɟɱɢɫɥɟɧɧɨɟ ɧɢɠɟ ɨɛɨɪɭɞɨɜɚɧɢɟ ɩɟɪɟɞɚɧɨ ɞɥɹ ɦɨɧɬɚɠɚ ɜ _____________________________________________________
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Ɉɛɨɪɭɞɨɜɚɧɢɟ |
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ɉɨɫɬɭɩɥɟɧɢɟ ɧɚ |
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ɋɬɨɢɦɨɫɬɶ, ɪɭɛ. |
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ɫɤɥɚɞ ɡɚɤɚɡɱɢɤɚ |
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Ʉɨɥɢɱɟɫɬɜɨ, |
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ɧɨɦɟɪ |
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ɧɨɦɟɪ |
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ɉɪɢɦɟɱɚɧɢɟ |
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ɧɚɢɦɟɧɨɜɚɧɢɟ |
ɡɚɜɨɞɫɤɨɣ |
ɩɚɫɩɨɪɬɚ |
ɩɨɡɢɰɢɢ ɩɨ |
ɬɢɩ, |
ɞɚɬɚ |
ɚɤɬɚ |
ɲɬ. |
ɟɞɢɧɢɰɵ |
ɜɫɟɝɨ |
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(ɧɨɦɟɧɤɥɚ |
(ɦɚɪɤɢ |
ɬɟɯɧɨɥɨɝɢɱɟ |
ɦɚɪɤɚ |
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ɬɭɪɧɵɣ) |
ɪɨɜɤɢ) |
ɫɤɨɣ ɫɯɟɦɟ |
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ɩɪɢɟɦɤɢ |
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Ɉɛɨɪɨɬɧɚɹ ɫɬɨɪɨɧɚ ɮɨɪɦɵ ʋ Ɉɋ-15 |
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ɉɪɢ ɩɪɢɟɦɤɟ ɨɛɨɪɭɞɨɜɚɧɢɹ ɜ ɦɨɧɬɚɠ ɭɫɬɚɧɨɜɥɟɧɨ: |
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ɫɨɨɬɜɟɬɫɬɜɭɟɬ |
ɨɛɨɪɭɞɨɜɚɧɢɟ |
-------------------------------ɩɪɨɟɤɬɧɨɣ ɫɩɟɰɢɚɥɢɡɚɰɢɢ ɢɥɢ ɱɟɪɬɟɠɭ (ɟɫɥɢ ɧɟ ɫɨɨɬɜɟɬɫɬɜɭɟɬ, ɭɤɚɡɚɬɶ ɜ ɱɟɦ ɧɟɫɨɨɬɜɟɬɫɬɜɢɟ) |
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ɧɟ ɫɨɨɬɜɟɬɫɬɜɭɟɬ |
_______________________________________________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________________________________________________
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ɤɨɦɩɥɟɤɬɧɨ |
Ɉɛɨɪɭɞɨɜɚɧɢɟ ɩɟɪɟɞɚɧɨ |
-------------------------- (ɭɤɚɡɚɬɶ ɫɨɫɬɚɜ ɤɨɦɩɥɟɤɬɚ ɢ ɬɟɯɧɢɱɟɫɤɨɣ ɞɨɤɭɦɟɧɬɚɰɢɢ, ɩɨ ɤɨɬɨɪɨɣ ɩɪɨɢɡɜɟɞɟɧɚ |
ɧɟɤɨɦɩɥɟɤɬɧɨ
ɩɪɢɟɦɤɚ, ɢ ɤɚɤɚɹ ɤɨɦɩɥɟɤɬɧɨɫɬɶ) ________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________
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ɧɟ ɨɛɧɚɪɭɠɟɧɵ |
Ⱦɟɮɟɤɬɵ ɩɪɢ ɧɚɪɭɠɧɨɦ ɨɫɦɨɬɪɟ ɨɛɨɪɭɞɨɜɚɧɢɹ |
--------------------- (ɟɫɥɢ ɨɛɧɚɪɭɠɟɧɵ, ɩɨɞɪɨɛɧɨ ɢɯ ɩɟɪɟɱɢɫɥɢɬɶ) _____________________ |
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ɨɛɧɚɪɭɠɟɧɵ |
________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________
ɉɪɢɦɟɱɚɧɢɟ. Ⱦɟɮɟɤɬɵ, ɨɛɧɚɪɭɠɟɧɧɵɟ ɩɪɢ ɦɨɧɬɚɠɟ, ɧɚɥɚɞɤɟ ɢ ɢɫɩɵɬɚɧɢɢ ɨɛɨɪɭɞɨɜɚɧɢɹ, ɨɮɨɪɦɥɹɸɬɫɹ ɚɤɬɨɦ ɨ ɜɵɹɜɥɟɧɧɵɯ ɞɟɮɟɤɬɚɯ ɨɛɨɪɭɞɨɜɚɧɢɹ (ɮɨɪɦɚ ʋ Ɉɋ-16)
Ɂɚɤɥɸɱɟɧɢɟ ɨ ɩɪɢɝɨɞɧɨɫɬɢ ɤ ɦɨɧɬɚɠɭ: ________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________________________________________________
ɋɞɚɥ |
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ɉɪɢɧɹɥ |
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ɉɪɟɞɫɬɚɜɢɬɟɥɶ ɨɪɝɚɧɢɡɚɰɢɢ-ɡɚɤɚɡɱɢɤɚ |
ɉɪɟɞɫɬɚɜɢɬɟɥɶ ɨɪɝɚɧɢɡɚɰɢɢ-ɡɚɤɚɡɱɢɤɚ |
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________________ |
_________ |
____________ |
__________________ _______ |
____________ |
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(ɞɨɥɠɧɨɫɬɶ) |
(ɩɨɞɩɢɫɶ) |
(ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ) (ɞɨɥɠɧɨɫɬɶ) |
(ɩɨɞɩɢɫɶ) |
(ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ) |
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ɦ.ɩ. |
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ɦ.ɩ. |
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ɍɤɚɡɚɧɧɨɟ ɨɛɨɪɭɞɨɜɚɧɢɟ ɩɪɢɧɹɬɨ ɧɚ ɨɬɜɟɬɫɬɜɟɧɧɨɟ ɯɪɚɧɟɧɢɟ |
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Ɇɚɬɟɪɢɚɥɶɧɨ ɨɬɜɟɬɫɬɜɟɧɧɨɟ ɥɢɰɨ ___________________ |
_________ |
______________________ |
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(ɞɨɥɠɧɨɫɬɶ) |
(ɩɨɞɩɢɫɶ) |
(ɪɚɫɲɢɮɪɨɜɤɚ ɩɨɞɩɢɫɢ) |
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"____" ___________ 20___ɝ. |
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ɁȺȾȺɇɂȿ3. Ɂɚɩɨɥɧɟɧɢɟ ɞɨɤɭɦɟɧɬɨɜ ɩɨ ɯɨɡɹɣɫɬɜɟɧɧɨɣ ɨɩɟɪɚɰɢɢ
Ⱥɤɰɟɩɬɨɜɚɧ ɫɱɟɬ ɩɨɞɪɹɞɧɨɣ ɨɪɝɚɧɢɡɚɰɢɢ ɡɚ ɜɵɩɨɥɧɟɧɧɵɟ ɫɬɪɨɢɬɟɥɶɧɨɦɨɧɬɚɠɧɵɟ ɪɚɛɨɬɵ ɩɨ ɜɨɡɜɟɞɟɧɢɸ ɡɞɚɧɢɹ ɰɟɯɚ (ɜɤɥɸɱɚɹ ɧɚɥɨɝ
ɧɚ ɞɨɛɚɜɥɟɧɧɭɸ ɫɬɨɢɦɨɫɬɶ)
ȾɈȽɈȼɈɊ ɉɈȾɊəȾȺ (ɧɚ ɜɵɩɨɥɧɟɧɢɟ ɩɨɞɪɹɞɧɵɯ ɪɚɛɨɬ)
ɝ.__________ "___"___________20__ɝ.
__________________________________________________ ɜ ɞɚɥɶɧɟɣɲɟɦ Ɂɚɤɚɡɱɢɤ,
(ɧɚɢɦɟɧɨɜɚɧɢɟ ɩɪɟɞɩɪɢɹɬɢɹ),
ɜ ɥɢɰɟ ________________________________________ ɞɟɣɫɬɜɭɸɳɟɝɨ ɧɚ ɨɫɧɨɜɚɧɢɢ
(ɞɨɥɠɧɨɫɬɶ, Ɏ.ɂ.Ɉ.)
________________________________________________________ ɫ ɨɞɧɨɣ ɫɬɨɪɨɧɵ,
(ɭɫɬɚɜɚ, ɞɨɜɟɪɟɧɧɨɫɬɢ),
ɢ _______________________________________________ ɜ ɞɚɥɶɧɟɣɲɟɦ ɉɨɞɪɹɞɱɢɤ,
(ɧɚɢɦɟɧɨɜɚɧɢɟ ɩɪɟɞɩɪɢɹɬɢɹ)
ɜ ɥɢɰɟ _________________________________________ ɞɟɣɫɬɜɭɸɳɟɝɨ ɧɚ ɨɫɧɨɜɚɧɢɢ
(ɞɨɥɠɧɨɫɬɶ, Ɏ.ɂ.Ɉ.)
_______________________________________________________ ɫ ɞɪɭɝɨɣ ɫɬɨɪɨɧɵ,
(ɭɫɬɚɜɚ, ɞɨɜɟɪɟɧɧɨɫɬɢ),
ɡɚɤɥɸɱɢɥɢ ɧɚɫɬɨɹɳɢɣ ɞɨɝɨɜɨɪ ɨ ɧɢɠɟɫɥɟɞɭɸɳɟɦ:
I.ɉɪɟɞɦɟɬ ɞɨɝɨɜɨɪɚ
1.1.Ɂɚɤɚɡɱɢɤ ɩɨɪɭɱɚɟɬ, ɚ ɉɨɞɪɹɞɱɢɤ ɩɪɢɧɢɦɚɟɬ ɧɚ ɫɟɛɹ ɨɛɹɡɚɬɟɥɶɫɬɜɨ ɜɵɩɨɥ-
ɧɢɬɶ ɫɥɟɞɭɸɳɢɟ ɜɢɞɵ ɪɚɛɨɬ: _________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Ɋɚɛɨɬɵ ɜɵɩɨɥɧɹɸɬɫɹ ɢɡ ɦɚɬɟɪɢɚɥɨɜ ______________________________________
_________________________________________________________ (Ɂɚɤɚɡɱɢɤɚ ɢɥɢ ɉɨɞɪɹɞɱɢɤɚ).
1.2.ɋɬɨɢɦɨɫɬɶ ɪɚɛɨɬ ɨɩɪɟɞɟɥɹɟɬɫɹ ɫɨɝɥɚɫɧɨ ɫɦɟɬɟ (ɉɪɢɥɨɠɟɧɢɟ 1).
II.Ɉɛɹɡɚɬɟɥɶɫɬɜɚ ɫɬɨɪɨɧ
2.1. Ɂɚɤɚɡɱɢɤ ɨɛɹɡɭɟɬɫɹ:
-ɨɛɟɫɩɟɱɢɬɶ ɉɨɞɪɹɞɱɢɤɚ ɫɥɟɞɭɸɳɢɦɢ ɦɚɬɟɪɢɚɥɚɦɢ: _______________________
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________,
-ɨɛɟɫɩɟɱɢɬɶ ɉɨɞɪɹɞɱɢɤɭ ɧɟɨɛɯɨɞɢɦɵɟ ɭɫɥɨɜɢɹ ɞɥɹ ɜɵɩɨɥɧɟɧɢɹ ɪɚɛɨɬ, ɜɤɥɸ-
ɱɚɸɳɢɟ ɜ ɫɟɛɹ: _____________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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