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节能监察文书举报记录

来源:厦门市节能监察中心 发布时间:2008年12月04日 阅读(1270) 分享

附件:举报记录(点击下载)

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时间:                       

地点:                                                                                       

接待人:                           记录人:                                                   

举报人姓名:           性别:      出生年月:                                                

身份证号码:                住址:                                                          

联系电话:                 是否要求保密:                                                    

举报内容:                                                                                  

                                                                                            

                                                                                            

                                                                                           

                                                                                           

                                                                                            

                                                                                            

                                                                                           

                                                                                             

                                                                                           

                                                                                            

                                                                                           

                                                               

附:相关证据材料  份。

注:1、可添加续页;2、经举报人核对无误后,接待人、记录人、举报人逐页签字或者盖章,并签注时间。