_________________________________

                                                                                                                                          (íàèìåíîâàíèå îòäåëà)

                          _________________________________________________

_________________________________

                          îò _______________________________

                          _________________________________

_________________________________

                                                                                                                                            (ô.è.î., çàíèìàåìàÿ äîëæíîñòü)

 

         Óâåäîìëåíèå î ïîëó÷åíèè ïîäàðêà îò "__" ________ 20__ ã.

 

    Èçâåùàþ î ïîëó÷åíèè ___________________________________________________

                                                                                           (äàòà ïîëó÷åíèÿ)

ïîäàðêà(îâ) íà ____________________________________________________________

_________________________________________________________________________

                                                                 (íàèìåíîâàíèå ïðîòîêîëüíîãî ìåðîïðèÿòèÿ, ñëóæåáíîé

                                                              êîìàíäèðîâêè, äðóãîãî îôèöèàëüíîãî ìåðîïðèÿòèÿ, ìåñòî

                                                                                                 è äàòà ïðîâåäåíèÿ)

 

Íàèìåíîâàíèå ïîäàðêà

Õàðàêòåðèñòèêà ïîäàðêà, åãî îïèñàíèå

Êîëè÷åñòâî ïðåäìåòîâ

Ñòîèìîñòü â ðóáëÿõ <*>

1.

 

 

 

2.

 

 

 

Èòîãî

 

 

 

 

 

 

 

Ïðèëîæåíèå: ______________________________________________ íà _____ ëèñòàõ.

                                                                        (íàèìåíîâàíèå äîêóìåíòà)

 

Ëèöî, ïðåäñòàâèâøåå

óâåäîìëåíèå         _________  _________________________  "__" ____ 20__ ã.

                                   (ïîäïèñü)                (ðàñøèôðîâêà ïîäïèñè)

 

Ëèöî,     ïðèíÿâøåå

óâåäîìëåíèå         _________  _________________________  "__" ____ 20__ ã.

                                   (ïîäïèñü)                (ðàñøèôðîâêà ïîäïèñè)

 

Ðåãèñòðàöèîííûé íîìåð â æóðíàëå ðåãèñòðàöèè óâåäîìëåíèé ___________________

 

"__" _________ 20__ ã.

 

 

--------------------------------

<*> Çàïîëíÿåòñÿ ïðè íàëè÷èè äîêóìåíòîâ, ïîäòâåðæäàþùèõ ñòîèìîñòü ïîäàðêà.