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.