ÄÎÂÅÐÅÍÍÎÑÒÚ (ÑÏÅÖÈÀËÜÍÀß)

ÎÒ ÈÌÅÍÈ ÞÐÈÄÈ×ÅÑÊÎÃÎ ËÈÖÀ ÍÀ ÇÀÊËÞ×ÅÍÈÅ ÄÎÃÎÂÎÐÀ

 

ã. ___________________              ____________________________________

                                                          (÷èñëî, ìåñÿö, ãîä (ïðîïèñüþ))

 

Íàñòîÿùåé äîâåðåííîñòüþ ___________________________________________

                                              (íàèìåíîâàíèå è ìåñòîíàõîæäåíèå îðãàíèçàöèè)

â ëèöå _________________, äåéñòâóþùåãî íà îñíîâàíèè ___________________,

           (ô.,è.,î., äîëæíîñòü)                                                 (óñòàâà, ïîëîæåíèÿ è ïð.)

óïîëíîìî÷èâàåò _______________________________________________________

(ô.,è.,î.)

ïàñïîðò ñåðèè ____________ ¹ ___________, âûäàí “___” _________ 199 ___ ã.

                                                                                    (êîãäà âûäàí)

_____________________________________________________________________

(êåì âûäàí)

çàêëþ÷àòü äîãîâîðû ____________________________________________________

                                (óêàçàòü âèä äîãîâîðîâ)

íà óñëîâèÿõ __________________________________________________________

                (óêàçàòü óñëîâèÿ äîãîâîðà, ëèáî ôðàçó “ïî åãî óñìîòðåíèþ”)

è âûïîëíèòü âñå íåîáõîäèìûå äåéñòâèÿ, ñâÿçàííûå ñ âûïîëíåíèåì íàñòîÿùåãî ïîðó÷åíèÿ.

Íàñòîÿùàÿ äîâåðåííîñòü âûäàíà ñðîêîì íà ____________________________.

                                                          (ñ ïðàâîì ïåðåäîâåðèÿ, áåç ïðàâà ïåðåäîâåðèÿ)

 

Ïîäïèñü ___________________

 

Ì.Ï.