听 证 笔 录

 案件名称:                                           案号:                    

听证时间:                     分至      

听证地点:                                        听证方式:                   

听证申请人:                          法定代表人(负责人):          性别:    

工作单位:                          职务或职业:        身份证号:             

住址(住所):                           邮编:           电话:                

委托代理人:                     性别:      身份证号:                        

工作单位:                              职务:          电话:                 

委托代理人:                     性别:      身份证号:                         

工作单位:                              职务:          电话:                 

其他参加人:                                                                   

案件调查人:                      工作单位及职务:                             

案件调查人:                      工作单位及职务:                             

听证主持人:                 听证员:                   记录人:               

工作单位:                                                                    

听证笔录(正文):                                                                                                       

                                                                               

                                                                               

                                                                                

   尾页:在有关参加人对听证笔录审阅后,应注明“上述听证笔录内容已阅,记录属实。”                                               

听证申请人(签名或盖章):                               

委托代理人(签名或盖章):                                                                                                            

其他参加人(签名或盖章):                                                                    

案件调查人(签名或盖章):                                                                                   

听证主持人(签名或盖章):                        

听证员(签名或盖章):                                                                                

记录人(签名或盖章):                                                                           

 页共  

 

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