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Proces verbal de predare primire auto a

mijlocului de transport!

Data: ________________ Ora: __________

PROCES-VERBAL DE PREDARE-PRIMIRE AUTOVEHICUL

Nr. nmatriculare autovehicul HN AZ 309

Locul predrii .................................. Data .........................

PREDATOR:

Nume/Prenume Ruslan Rusu, domiciliat in Nemeni, Jud. Hnceti, posesor al BI/CI cu


Seria. B, Nr. 01000102

PRIMITOR:

Nume/Prenume ............................................ domiciliat in .............................................


Str...........................................................Nr...... Jud..............................posesor al BI/CI cu
Seria.......... Nr.............................

AUTOVEHICUL:

Nr nmatriculare HN AZ 309; marca Opel; tipul Astra H;

Caroserie tip Universal;

Nr. km la bord.........................................km; Benzin-GPL in rezervor..................litri,

Stare de funcionare...............................................;

Defeciuni constatate:

.......................................................................................................................................................
.......................................................................................................................................................
......................................................................................................................
mpreun cu autovehiculul s-au predat/primit si urmtoarele documente i accesorii:

.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................

Primitorul a preluat autovehiculul n dotare cu cele amintite mai sus, n urma unui inventar,
fiind rspunztor de lipsa oricruia dintre cele amintite, precum i de defeciunile cauzate de
neutilizarea autovehiculului in mod corespunztor, conform specificaiilor cuprinse n fia
postului.

Observaii:

.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
....................

Am predat,

Nume/Prenume. Ruslan Rusu

Semntura................................................

Am preluat,

Nume/Prenume......................................

Semntura...............................................

Prezentul formular a fost ncheiat ntr-un numr de ................... exemplare, din


care ................. rmne la predtor i ........................ la primitor.

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