元氏县人民政府
 
发布时间:2020-12-19    来源:司法局
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   检查(勘验)笔录

                                                                                                 

时间:                     分至      

地点:                                             

被检查(勘验)人名称:                        法定代表人(负责人):      

被检查(勘验)人姓名:            性别:    身份证号码:                  

工作单位:                             职务或职业:           电话:          

    址:                                           邮编:                       

其他见证人:           职务:           单位或住址:                                 

检查(勘验)人及执法证编号:                                记录人:                                    

工作单位:                                                                           

告知事项:                                                                    

现场情况:                                                                              

                                                                                                              

                                                                                                                                                                                                                                                                                                                                                                                                     

                                                                                                                                                                  

                                                                                  

                                                                           (以下是检查笔录尾页)                                                                          

被检查(勘验)人或现场负责人注明:笔录上述内容,情况属实。”                              

被检查(勘验)人或现场负责人签字:                                               

见证人签字:                                                             

检查(勘验)人签字:                            记录人签字:                

                                                                                 页共 

检查(勘验)照片

 


 

拍照地点:

拍照时间:

执法人员(执法证号):

照片反映内容:

见证人签字:

当事人签字:

 


 

拍照地点:

拍照时间:

执法人员(执法证号):

照片反映内容:

见证人签字:

当事人签字: