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SERVICIULPUBLICCOMUNITARREGIMPERMISEDECONDUCERE
bINMATRICULAREAVEHICULELOR

_______________________________________________________________________________


Subsemnatul(Subscrisa)___________________________________________________________,
C.N.P.(C.U.I.)__________________________________________________cudomiciliul(sediul)
n________________________________________,strada_______________________________,

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___________,
nr._______,bloc_______,scara_______,ap.______,jude/sector________________________,
(auto)vehiculului
solicit___________________________________________________________(auto)vehiculului
_______________________________________
____________________________
___________
marca_________________________________________________________________________
cunumruldeidentificare(serieasiu)________________________________________________.
________________________________________________.


Data:________________________ 

Semn
Semn
tura:_______________________
Semntura:__________________________________
((itampila,ncazulpersoanelorjuridice)
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tampila,
tampila, n cazul persoanelor


________________________________________________________________________________
__________________________________________________
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Datnfaamea,

Data:_______________________

Numele,prenumele,semnaturalucrtorSPCRPCIV
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DECLARAfIE

Subsemnatul____________________________________________________________________,
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C.N.P.________________________________________________________________cudomiciliul
______________
n________________________________________,strada_______________________________,
____________________________
nr._______,bloc_______,scara_______,ap.______,jude/sector________________________,
_______, bloc
cunoscndprevederileart.292codpenalprivindfalsulndeclaraii,declarpepropriarspundere
pierderea/furtul/deteriorarea:


plcii/plcilorcunumruldenmatriculare_______________________

certificatuldenmatricularecunr.________________________


Data:________________________ 

Semntura:__________________________________

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