Председателю Выгоничского районного суда

                                                                      Е.В. Сайфутдиновой

                                                                     от ________________________________________________

                                                                                                                                 (фамилия, имя, отчество)

                                                                     __________________________________________________

                                                                                                (наименование занимаемой должности)

                                                                     __________________________________________________

                                                                     (наименование государственного органа, предприятия, организации)

                                                                     Год рождения ______________________________________

                                                                     Образование _______________________________________

                                                                     __________________________________________________

                                                                     Проживаю (индекс)_________________________________

                                                                     __________________________________________________

                                                                     __________________________________________________

                                                                     Телефон: __________________________________________

                                                                                                          (рабочий, домашний)

Заявление

Прошу  принять на должность 

«____» _______________ 20__ г.   ______________                _________________________________

               (дата)                                                 (подпись)                                                  (расшифровка подписи)