ÄÎÂÅÐÅÍÍÎÑÒÜ (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.