<p class="MsoNormal"> 黑龙江省双鸭山市双鸭山公证处<span></span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <b>公证申请表</b>（法人）<b></b> </p> <div align="center"> <table class="MsoTableGrid" border="1" cellspacing="0" cellpadding="0" align="center" style="border:none;width:90%;"> <tbody> <tr> <td width="85" 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;">单位名称<span></span></span> </p> </td> <td width="140" 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> <td width="85" colspan="2" 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;">机构代码<span></span></span> </p> </td> <td width="117" colspan="2" 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="69" colspan="2" 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;">营业执照号<span></span></span> </p> </td> <td width="130" colspan="2" 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="85" 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;">单位地址<span></span></span> </p> </td> <td width="140" 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> <td width="85" colspan="2" 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;">联系电话<span></span></span> </p> </td> <td width="132" 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> <td width="63" colspan="2" 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;">角色<span></span></span> </p> </td> <td width="121" 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="85" 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;">法定代表<span></span></span> </p> </td> <td width="75" colspan="2" 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="65" 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;">公民身份号码<span></span></span> </p> </td> <td width="85" colspan="2" 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="64" 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;">代理人<span></span></span> </p> </td> <td width="68" colspan="2" 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="63" colspan="2" 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;">公民身份号码<span></span></span> </p> </td> <td width="121" 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="625" colspan="12" 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> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <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="91" colspan="2" 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;">公证类别<span></span></span> </p> </td> <td width="534" colspan="10" 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="91" colspan="2" 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;">公证事项<span></span></span> </p> </td> <td width="534" colspan="10" 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="91" colspan="2" 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;">公证用途<span></span></span> </p> </td> <td width="209" 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> <td width="73" colspan="2" 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;">使用地<span></span></span> </p> </td> <td width="252" 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;"> </span> </p> </td> </tr> <tr> <td width="91" colspan="2" 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;">提供<span></span></span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;">证明<span></span></span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;">材料<span></span></span> </p> </td> <td width="534" colspan="10" 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="91" colspan="2" 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;">本申请<span></span></span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;">人保证<span></span></span> </p> </td> <td width="534" colspan="10" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="left"> <span style="font-size:12.0pt;font-family:宋体;">上列所填内容及所提交的全部文件和材料真实无讹，否则，愿意承担一切法律责任。<span></span></span> </p> </td> </tr> <tr> <td width="91" colspan="2" 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;">公证处<span></span></span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;">郑重警告<span></span></span> </p> </td> <td width="534" colspan="10" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="left"> <span style="font-size:12.0pt;font-family:宋体;">任何伪造、变造、盗用、冒用文件、印章、产权证书、票据或以他人名义进行欺诈以及进行合同诈骗等都将可能构成犯罪，受到刑事追究。<span></span></span> </p> </td> </tr> <tr> <td width="625" colspan="12" style="border:solid windowtext 1.0pt;"> <p class="MsoNormal" align="left"> <span style="font-size:12.0pt;font-family:宋体;">法定代表人（或代理人）签名：<span></span></span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;"> </span> </p> <p class="MsoNormal" align="center" style="text-align:center;"> <span style="font-size:12.0pt;font-family:宋体;">申请日期：<span></span></span> </p> </td> </tr> </tbody> </table> </div>