Xxxxxxxxxxxx xxxxxxxxxxx xxxxxxxxxx xx formátu *xxx (xxxxxxxx xxxxxxx) při xxxxxxxxx otevření xxxx xxxxxxx.
Xxxxxx/Xxxxxxx úřad *)......................................................................................................
Xxxxx ......................................................................................................
Xx. ....................................................................
X .................................. xxx ..................................
Xxxxxx pan (Xxxxxx paní) *)
xxxxxxxxxxx ........................................................................................................................................
Xxxxxx pan (Xxxxxx xxxx) *)
xxxxxxx ........................................................................................................................................
Příkaz
Obecní/Městský xxxx *)&xxxx;.................................. xxxxx ..................................
xxxx orgán podle § ........ xxxx. ...... písm. ...... xxxxxx x. / Xx.
xxxxx a xxxxxx xxxxxxxxx (§10 x §11 xxxxxxxxx xxxx)
xx xxxx ........................................................................................................................................
xxxxxxx xx xxxxx xxxxx §150 xxxxxxxxx xxxx, xx xxxxxxx návrhu xxxxxxxxxxxx (xxxxxxxxxxxxx) *)
xxxx (xxxx) *)&xxxx;........................................................................................................................................
xx xxx ..................................
x xxxxxxxxx xxxxxxx (xxxxxxxxx) *)
xxxx (xxxx) *)........................................................................................................................................
xxxxxx xxxxxxxxx ........................................................................................................................................
xxxxx xx xxxxx.
Xxxxxxx:
Xxxxxxxxxx xxxxxxx lze xxxxxxxx vlastnoručně podepsaným xxxxxxxxxxx účastníka, xx x xxxxxxxx xxxxxxxxxx xxxxxxxx. Xxxxxxxxxx xxxxxxxxxx xx příkaz xxxxx xxxxxxxxxxx x xxxxxxxxxxxx xxxxxxxxxxx.
Xxxxxxxxxx xxxxxxx:
X xxxxxxxx xxxxxxxxxx xxxxxxxxx
....................................................................
xxxxxx odpůrce
úřední xxxxxxx - otisk
....................................................................
jméno, xxxxxxxx x xxxxxx xxxxxxxxx xxxxxx xxxxx