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Главная ПОСЕЛЕНИЯ Альметьевское сельское поселение Обращения граждан ЗАЯВЛЕНИЕ О РАСТОРЖЕНИИ БРАКА

ЗАЯВЛЕНИЕ О РАСТОРЖЕНИИ БРАКА

<table border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td colspan="10" width="249" valign="top">
<p>Запись акта о расторжении брака</p>
</td>
</tr>
<tr>
<td width="21" valign="top">
<p>№</p>
</td>
<td colspan="4" width="66" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="5" width="163">
<p>&nbsp;</p>
</td>
</tr>
<tr>
<td colspan="2" width="30" valign="bottom">
<p>от "</p>
</td>
<td width="28" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="11" valign="bottom">
<p>"</p>
</td>
<td colspan="2" width="83" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="7" valign="bottom">
<p>&nbsp;</p>
</td>
<td width="38" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="19" valign="bottom">
<p>&nbsp;г.</p>
</td>
<td width="32">
<p>&nbsp;</p>
</td>
</tr>
<tr height="0">
<td width="21">&nbsp;</td>
<td width="9">&nbsp;</td>
<td width="28">&nbsp;</td>
<td width="11">&nbsp;</td>
<td width="17">&nbsp;</td>
<td width="66">&nbsp;</td>
<td width="7">&nbsp;</td>
<td width="38">&nbsp;</td>
<td width="19">&nbsp;</td>
<td width="32">&nbsp;</td>
</tr>
</tbody>
</table>
<p>В отдел ЗАГСа&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>от&nbsp;</p>
<p align="center"><em>фамилия, имя, отчество</em></p>
<p>&nbsp;</p>
<p align="center"><em>фамилия, имя, отчество</em></p>
<p align="center"><strong>ЗАЯВЛЕНИЕ О РАСТОРЖЕНИИ БРАКА</strong></p>
<p align="center"><strong>(на основании решения суда о расторжении брака)</strong></p>
<p>Просим (прошу) произвести государственную регистрацию расторжения брака в порядке, предусмотренном статьей 35 Федерального закона "Об актах гражданского состояния", на основании решения суда о расторжении брака&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p align="center"><em>наименование суда</em></p>
<table border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td width="30" valign="bottom">
<p>от "</p>
</td>
<td width="28" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="11" valign="bottom">
<p>"</p>
</td>
<td width="83" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="7" valign="bottom">
<p>&nbsp;</p>
</td>
<td width="38" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="19" valign="bottom">
<p>&nbsp;г.</p>
</td>
</tr>
</tbody>
</table>
<p>Сообщаем (сообщаю) следующие сведения о расторгающих брак.</p>
<table border="1" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="18" width="180">
<p align="center">он</p>
</td>
<td colspan="16" width="181">
<p align="center">она</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">1.</p>
</td>
<td width="246" valign="top">
<p>Фамилия, имя, отчество</p>
<p>&nbsp;</p>
</td>
<td colspan="18" width="180" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="16" width="181" valign="top">
<p>&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">2.</p>
</td>
<td width="246" valign="top">
<p>Дата рождения</p>
</td>
<td colspan="3" width="15" valign="top">
<p align="right">"</p>
</td>
<td colspan="2" width="25" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="2" width="13" valign="bottom">
<p>"</p>
</td>
<td colspan="4" width="68" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="2" width="8" valign="bottom">
<p>&nbsp;</p>
</td>
<td colspan="2" width="34" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="3" width="17" valign="bottom">
<p align="center">г.</p>
</td>
<td colspan="2" width="15" valign="bottom">
<p align="right">"</p>
</td>
<td width="25" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="2" width="13" valign="bottom">
<p>"</p>
</td>
<td colspan="5" width="68" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="8" valign="bottom">
<p>&nbsp;</p>
</td>
<td colspan="2" width="34" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="3" width="18" valign="bottom">
<p align="center">г.</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="18" width="180" valign="top">
<p align="center">&nbsp;</p>
</td>
<td colspan="16" width="181" valign="bottom">
<p align="center">&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">3.</p>
</td>
<td width="246" valign="top">
<p>Место рождения</p>
<p>&nbsp;</p>
</td>
<td colspan="18" width="180" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="16" width="181" valign="top">
<p>&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">4.</p>
</td>
<td width="246" valign="top">
<p>Гражданство</p>
<p>&nbsp;</p>
</td>
<td colspan="18" width="180" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="16" width="181" valign="top">
<p>&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">5.</p>
</td>
<td width="246" valign="top">
<p>Национальность<em><br />(графа заполняется по желанию каждого из лиц, расторгающих брак)</em></p>
</td>
<td colspan="18" width="180" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="16" width="181" valign="top">
<p>&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">6.</p>
</td>
<td width="246" valign="top">
<p>Место жительства</p>
<p>&nbsp;</p>
</td>
<td colspan="18" width="180" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="16" width="181" valign="top">
<p>&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">7.</p>
</td>
<td width="246" valign="top">
<p>&nbsp;Документ, удостоверяющий личность</p>
</td>
<td width="8" valign="top">
<p align="right">&nbsp;</p>
</td>
<td colspan="16" width="165" valign="bottom">
<p>&nbsp;</p>
</td>
<td width="8" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="8" valign="bottom">
<p align="right">&nbsp;</p>
</td>
<td colspan="14" width="166" valign="bottom">
<p>&nbsp;</p>
</td>
<td width="7" valign="bottom">
<p align="center">&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="top">
<p>&nbsp;</p>
</td>
<td width="8" valign="top">
<p align="right">&nbsp;</p>
</td>
<td colspan="16" width="165" valign="top">
<p align="center"><em>наименование документа</em></p>
</td>
<td width="8" valign="top">
<p align="center"><em>&nbsp;</em></p>
</td>
<td width="8" valign="top">
<p align="center"><em>&nbsp;</em></p>
</td>
<td colspan="14" width="166" valign="top">
<p align="center"><em>наименование документа</em></p>
</td>
<td width="7" valign="bottom">
<p align="center">&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="6" width="48" valign="top">
<p align="center">серия</p>
</td>
<td colspan="2" width="42" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="2" width="23" valign="bottom">
<p align="center">№</p>
</td>
<td colspan="7" width="59" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="8" valign="top">
<p align="center"><em>&nbsp;</em></p>
</td>
<td colspan="4" width="48" valign="bottom">
<p align="center">серия</p>
</td>
<td colspan="2" width="42" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="3" width="23" valign="bottom">
<p align="center">№</p>
</td>
<td colspan="6" width="60" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="7" valign="bottom">
<p align="center">&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="top">
<p>&nbsp;</p>
</td>
<td width="8" valign="top">
<p align="right">&nbsp;</p>
</td>
<td colspan="16" width="165" valign="bottom">
<p>&nbsp;</p>
</td>
<td width="8" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="8" valign="bottom">
<p align="right">&nbsp;</p>
</td>
<td colspan="14" width="166" valign="bottom">
<p>&nbsp;</p>
</td>
<td width="7" valign="bottom">
<p align="center">&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="top">
<p>&nbsp;</p>
</td>
<td width="8" valign="top">
<p align="right">&nbsp;</p>
</td>
<td colspan="16" width="165" valign="top">
<p align="center"><em>наименование органа,<br />выдавшего документ</em></p>
</td>
<td width="8" valign="top">
<p align="center"><em>&nbsp;</em></p>
</td>
<td width="8" valign="top">
<p align="center"><em>&nbsp;</em></p>
</td>
<td colspan="14" width="166" valign="top">
<p align="center"><em>наименование органа,<br />выдавшего документ</em></p>
</td>
<td width="7" valign="bottom">
<p align="center">&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="3" width="15" valign="top">
<p align="right">"</p>
</td>
<td colspan="2" width="25" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="2" width="13" valign="bottom">
<p>"</p>
</td>
<td colspan="4" width="68" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="2" width="8" valign="bottom">
<p>&nbsp;</p>
</td>
<td colspan="2" width="34" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="3" width="17" valign="bottom">
<p align="center">г.</p>
</td>
<td colspan="2" width="15" valign="bottom">
<p align="right">"</p>
</td>
<td width="25" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="2" width="13" valign="bottom">
<p>"</p>
</td>
<td colspan="5" width="68" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="8" valign="bottom">
<p>&nbsp;</p>
</td>
<td colspan="2" width="34" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="3" width="18" valign="bottom">
<p align="center">г.</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="18" width="180" valign="top">
<p align="center">&nbsp;</p>
</td>
<td colspan="16" width="181" valign="top">
<p align="center">&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top"><br />
<p align="center">8.</p>
</td>
<td width="246" valign="top">
<p>Реквизиты записи акта о заключении</p>
</td>
<td colspan="34" width="361" valign="top">
<p>запись акта о заключении брака</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="top">
<p>брака</p>
</td>
<td colspan="4" width="26" valign="bottom">
<p align="center">№</p>
</td>
<td colspan="5" width="64" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="3" width="33" valign="bottom">
<p align="center">от "</p>
</td>
<td colspan="2" width="33" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="2" width="15" valign="bottom">
<p>"</p>
</td>
<td colspan="9" width="108" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="8" valign="bottom">
<p>&nbsp;</p>
</td>
<td colspan="4" width="52" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="4" width="22" valign="bottom">
<p>&nbsp;г.</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="2" width="9" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="30" width="344" valign="bottom">
<p>&nbsp;</p>
</td>
<td colspan="2" width="8" valign="bottom">
<p>&nbsp;</p>
</td>
</tr>
<tr>
<td width="40" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="246" valign="top">
<p>&nbsp;</p>
</td>
<td colspan="2" width="9" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="30" width="344" valign="top">
<p align="center"><em>наименование органа ЗАГСа</em></p>
</td>
<td colspan="2" width="8" valign="bottom">
<p>&nbsp;</p>
</td>
</tr>
<tr height="0">
<td width="40">&nbsp;</td>
<td width="246">&nbsp;</td>
<td width="8">&nbsp;</td>
<td width="2">&nbsp;</td>
<td width="6">&nbsp;</td>
<td width="11">&nbsp;</td>
<td width="13">&nbsp;</td>
<td width="8">&nbsp;</td>
<td width="5">&nbsp;</td>
<td width="37">&nbsp;</td>
<td width="1">&nbsp;</td>
<td width="22">&nbsp;</td>
<td width="8">&nbsp;</td>
<td width="3">&nbsp;</td>
<td width="5">&nbsp;</td>
<td width="28">&nbsp;</td>
<td width="6">&nbsp;</td>
<td width="9">&nbsp;</td>
<td width="1">&nbsp;</td>
<td width="8">&nbsp;</td>
<td width="8">&nbsp;</td>
<td width="8">&nbsp;</td>
<td width="25">&nbsp;</td>
<td width="8">&nbsp;</td>
<td width="5">&nbsp;</td>
<td width="37">&nbsp;</td>
<td width="9">&nbsp;</td>
<td width="8">&nbsp;</td>
<td width="7">&nbsp;</td>
<td width="8">&nbsp;</td>
<td width="8">&nbsp;</td>
<td width="30">&nbsp;</td>
<td width="4">&nbsp;</td>
<td width="10">&nbsp;</td>
<td width="0">&nbsp;</td>
<td width="7">&nbsp;</td>
</tr>
</tbody>
</table>
<p align="left">Просим (прошу) присвоить фамилии *: ему &nbsp;</p>
<p align="left">&nbsp;</p>
<p>ей &nbsp;&nbsp;&nbsp;&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>Копию решения суда о расторжении брака прилагаем (прилагаю).</p>
<table border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td colspan="3" width="51">
<p>&nbsp;</p>
</td>
<td colspan="6" width="272" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="64" valign="top">
<p align="center">&nbsp;</p>
</td>
<td width="268" valign="top">
<p align="center">&nbsp;</p>
</td>
</tr>
<tr>
<td colspan="3" width="51">
<p>&nbsp;</p>
</td>
<td colspan="6" width="272" valign="top">
<p align="center"><em>он</em></p>
</td>
<td width="64" valign="top">
<p align="center"><em>&nbsp;</em></p>
</td>
<td width="268" valign="top">
<p align="center"><em>она</em></p>
</td>
</tr>
<tr>
<td colspan="3" width="51">
<p>&nbsp;</p>
</td>
<td colspan="8" width="605" valign="top">
<p align="center"><em>подписи лиц, расторгающих брак</em></p>
</td>
</tr>
<tr>
<td width="11" valign="bottom">
<p>"</p>
</td>
<td width="28" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td colspan="2" width="13" valign="bottom">
<p>"</p>
</td>
<td width="117" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="7" valign="bottom">
<p>&nbsp;</p>
</td>
<td width="55" valign="bottom">
<p align="center">&nbsp;</p>
</td>
<td width="19" valign="bottom">
<p>&nbsp;г.</p>
</td>
<td colspan="3" width="404">
<p>&nbsp;</p>
</td>
</tr>
<tr height="0">
<td width="11">&nbsp;</td>
<td width="28">&nbsp;</td>
<td width="11">&nbsp;</td>
<td width="2">&nbsp;</td>
<td width="117">&nbsp;</td>
<td width="7">&nbsp;</td>
<td width="55">&nbsp;</td>
<td width="19">&nbsp;</td>
<td width="71">&nbsp;</td>
<td width="64">&nbsp;</td>
<td width="269">&nbsp;</td>
</tr>
</tbody>
</table>
<p>* Заполняется в отношении заявителя.</p>

  Яндекс.Метрика Рейтинг@Mail.ru
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