<p class="MsoNormal" align="center" style="margin-left:0cm;text-align:center;"> <br /> </p> <p class="MsoNormal" align="center" style="margin-left:0cm;text-align:center;"> <b><span style="font-size:16px;">法律援助来访</span><span style="font-size:16px;">/</span><span style="font-size:16px;">电话</span><span style="font-size:16px;">/</span><span style="font-size:16px;">信函</span><span style="font-size:16px;">/</span><span style="font-size:16px;">网络咨询登记表</span><span></span></b> </p> <p class="MsoNormal" style="text-align:center;margin-left:-7.05pt;text-indent:5.25pt;"> 咨询日期：<span> </span>年<span> </span>月<span> </span>日<b> </b><b> </b><b> </b>援咨字[ ]第<span> </span>号<span></span> </p> <table class="MsoNormalTable" border="1" cellspacing="0" cellpadding="0" style="border:none;width:80%;" align="center"> <tbody> <tr> <td width="560" colspan="26" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" style="text-align:center;margin-left:21.1pt;text-indent:-21.1pt;"> <b><span style="font-size:14.0pt;font-family:宋体;">咨询人基本情况<span></span></span></b> </p> </td> </tr> <tr> <td width="47" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;">姓名<span></span></span> </p> </td> <td width="76" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> </td> <td width="66" colspan="3" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;">性别<span></span></span> </p> </td> <td width="76" colspan="4" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> </td> <td width="95" colspan="5" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;">出生日期<span></span></span> </p> </td> <td width="76" colspan="4" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> </td> <td width="57" colspan="5" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;">民族<span></span></span> </p> </td> <td width="69" colspan="3" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> </td> </tr> <tr> <td width="123" colspan="2" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span><span style="font-size:12.0pt;font-family:宋体;">身份证号<span></span></span> </p> </td> <td width="24" style="border:solid windowtext 1.0pt;" colspan="24"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> </td> </tr> <tr> <td width="123" colspan="2" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span><span style="font-size:12.0pt;font-family:宋体;">住所地<span></span></span> </p> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;">（经常居住地）<span></span></span> </p> </td> <td width="437" colspan="24" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> </td> </tr> <tr> <td width="123" colspan="2" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span><span style="font-size:12.0pt;font-family:宋体;">联系电话<span></span></span> </p> </td> <td width="142" colspan="7" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> </td> <td width="173" colspan="11" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span><span style="font-size:12.0pt;font-family:宋体;">共同咨询人数<span></span></span> </p> </td> <td width="122" colspan="6" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> </td> </tr> <tr> <td width="123" colspan="2" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <b><span style="font-size:14.0pt;font-family:宋体;">咨询方式<span></span></span></b> </p> </td> <td width="437" colspan="24" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;">A来访<span> B</span>电话<span> C</span>信函<span> D</span>网络 <strong>您的选择：</strong></span> </p> </td> </tr> <tr> <td width="560" colspan="26" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <b><span style="font-size:14.0pt;font-family:宋体;">咨询事项类别<span></span></span></b> </p> </td> </tr> <tr> <td width="560" colspan="26" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;">A刑事<span></span></span> </p> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;">B民事 （B1劳动<span> </span>B2侵权<span> B3</span>婚姻家庭<span> B4</span>其他<u><span> </span></u>）<span></span></span> </p> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;">C行政<span></span></span> </p> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;">D其他<b><u><span></span></u></b></span> </p> <p class="MsoNormal"> <span><span style="font-size:16px;line-height:24px;"><strong>您的选择：</strong></span></span> </p> </td> </tr> <tr> <td width="560" colspan="26" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <b><span style="font-size:14.0pt;font-family:宋体;">咨询内容<span></span></span></b> </p> </td> </tr> <tr> <td width="560" colspan="26" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> </td> </tr> <tr> <td width="560" colspan="26" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <b><span style="font-size:14.0pt;font-family:宋体;">答复意见</span></b><u><span style="font-size:14.0pt;font-family:宋体;"></span></u> </p> </td> </tr> <tr> <td width="560" colspan="26" valign="top" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" style="text-indent:182.0pt;"> <span style="font-size:14.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal" style="text-indent:182.0pt;"> <span style="font-size:14.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal" style="margin-left:21.0pt;text-indent:135.0pt;"> <span style="font-size:12.0pt;font-family:宋体;"> </span><span style="font-size:12.0pt;font-family:宋体;">接待人员（签字）：</span><b><span style="font-size:16.0pt;font-family:宋体;"></span></b> </p> </td> </tr> <tr> <td width="560" colspan="26" valign="top" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal"> <b><span style="font-size:14.0pt;font-family:宋体;">备注：</span></b><b><span style="font-size:16.0pt;font-family:宋体;"></span></b> </p> </td> </tr> </tbody> </table> <p> <br /> </p>