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发表日期:2015-09-07

      鹰潭市环境保护局

调 查 询 问 笔 录

                                                                                         

 

时间:  2015    4    16 18 30 分至          地点:               

询问人及执法证号:                                         记录人:            

被询问人姓名及职务                  电话:            与本案关系:           

工作单位:                             地址:                                  

法定代表人姓名及职务:                    电话:            邮编:             

营业执照注册号:                         组织机构代码:                        

其他参加人姓名及工作单位(地址)                                              

                                                                               

问:我们是鹰潭市环境监察支队的执法人员,这是我们的执法证件,请过目确认。今天我们依法进行检查并了解有关情况,你应当配合调查,如实回答询问和提供材料,不得拒绝、阻碍、隐瞒或者提供虚假情况。如果你认为我们与本案有利害关系,可能影响公正办案,可申请我们回避,并说明理由。清楚了吗?答:  

                                                                 

                                                                              

                                                                                         

                                                                                            

                                                                                                                   

                                                                                            

                                                                                            

                                                                                            

                                                                                           

                                                                                            

                                                                                            

                                                                                                                                               

                                                                                                            

被询问人对笔录的审阅确认意见:                                         

被询问人签名:                                                                                                    

询问人签名:                                                                        

记录人签名:                                                                       

参加人签名:                                                    

                                                                                 

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被询问人对笔录的审阅确认意见:                                         

被询问人签名:                                                                                                    

询问人签名:                                                                       

记录人签名:                                                                       

参加人签名:                                                    

                                                                                  

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