元氏县人民法院 > 诉讼服务

正文

行政起诉状

2014-09-09 10:55:51 来源: 本站

原告         性别                 民族        出生年月日              

籍贯                 现住址                                

联系电话                            

 

被告                                                      

法定代表人           职务          

住址                                                        

联系电话                              

 

第三人         性别                  民族        出生年月日              

籍贯                 现住址                                

联系电话                            

 

案由:                    

 

诉讼请求:

  1.                                                                                                                                                

  2.                                                                                                                                                 

  3.                                                                                                                                                 

  4.                                                                                                                                                    

 

事实与理由:

                                                                                                                                                                                                                  

                                                                                                                                                                                                                     

                                                                                                                                                                                                                 

                                                                                                                                                                                                                 

                        

证据和证据来源:(证人的姓名和住址)

                                                                                                                                                                                                                   

                                                                                                                                                                                                                 

                                                                                                                                                                                                                  

 

    此致

元氏县人民法院

附:本起诉状副本              份

                                     

起诉人             

                                             年   月   日


附:2013032562706729.doc

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