Právní předpis byl sestaven k datu 31.12.2011.
Zobrazené znění právního předpisu je účinné od 01.01.2006 do 31.12.2011.
Vyhláška o stanovení vzorů v oblasti personální bezpečnosti a bezpečnostní způsobilosti a o seznamech písemností přikládaných k žádosti o vydání osvědčení fyzické osoby a k žádosti o doklad o bezpečnostní způsobilosti fyzické osoby a o způsobu podání těchto žádostí (vyhláška o personální bezpečnosti)
527/2005 Sb.
Vzory v oblasti personální bezpečnosti a bezpečnostní způsobilosti §1
Vzory v oblasti personální bezpečnosti §2
Vzory v oblasti bezpečnostní způsobilosti §3
Seznam písemností přikládaných k žádosti o vydání osvědčení fyzické osoby a žádosti o doklad o bezpečnostní způsobilosti fyzické osoby §4
Způsob podání žádostí §5
Účinnost §6
Příloha č. 1 - Prohlášení fyzické osoby o způsobilosti k právním úkonům
Příloha č. 2 - Prohlášení k osobnostní způsobilosti
Příloha č. 3 - Oznámení o splnění podmínek pro přístup k utajované informaci stupně utajení Vyhrazené
Příloha č. 4 - Poučení
Příloha č. 5 - Žádost o vydání osvědčení fyzické osoby
Příloha č. 6 - Dotazník fyzické osoby
Příloha č. 7 - Osvědčení fyzické osoby
Příloha č. 8 - Žádost o vydání osvědčení fyzické osoby pro cizí moc
Příloha č. 9 - Žádost o uznání bezpečnostního oprávnění fyzické osoby
Příloha č. 10 - Poučení
Příloha č. 11 - Žádost o vydání dokladu o bezpečnostní způsobilosti fyzické osoby
Příloha č. 12 - Dotazník
Příloha č. 13 - Doklad o bezpečnostní způsobilosti fyzické osoby
527
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x xxxxxxxxx xxxxx v xxxxxxx xxxxxxxxxx xxxxxxxxxxx x xxxxxxxxxxxx xxxxxxxxxxxx x o xxxxxxxxx xxxxxxxxxx přikládaných x xxxxxxx x xxxxxx xxxxxxxxx fyzické xxxxx x k xxxxxxx x xxxxxx x xxxxxxxxxxxx xxxxxxxxxxxx xxxxxxx xxxxx x x xxxxxxx podání xxxxxx xxxxxxx (xxxxxxxx o xxxxxxxxxx xxxxxxxxxxx)
§1
Xxxxx x oblasti personální xxxxxxxxxxx x xxxxxxxxxxxx xxxxxxxxxxxx
(1) Vzor xxxxxxxxxx fyzické xxxxx x způsobilosti k xxxxxxx xxxxxx je xxxxxx x příloze č. 1 xxxx xxxxxxxx.
(2) Xxxx prohlášení x xxxxxxxxxx způsobilosti xx xxxxxx x příloze č. 2 xxxx xxxxxxxx.
§2
Xxxxx x oblasti xxxxxxxxxx xxxxxxxxxxx
(1) Vzor xxxxxxxx x splnění xxxxxxxx xxx xxxxxxx xxxxxxx xxxxx x xxxxxxxxx xxxxxxxxx xxxxxx xxxxxxx Xxxxxxxxx je xxxxxx v příloze č. 3 xxxx xxxxxxxx.
(2) Xxxx poučení xx xxxxxxxx v příloze č. 4 xxxx xxxxxxxx.
(3) Xxxx žádosti o xxxxxx osvědčení xxxxxxx xxxxx xx uveden x příloze č. 5 xxxx xxxxxxxx.
(4) Xxxx xxxxxxxxx xxxxxxx xxxxx xx xxxxxx x příloze č. 6 této xxxxxxxx. Xxxx xxxxxxxxx fyzické xxxxx stanoví x xxxxxx xxxxx xxxxxxxxx xxxxxxx xxxxx vyplňovaných x xxxxxxx xxxxxxx xxxxx §94 odst. 4 xxxxxx.
(5) Xxxx xxxxxxxxx xxxxxxx xxxxx je uveden x příloze č. 7 této xxxxxxxx.
(6) Xxxx xxxxxxx x xxxxxx xxxxxxxxx xxxxxxx xxxxx xxx xxxx xxx xx xxxxxx x příloze č. 8 této xxxxxxxx.
(7) Xxxx xxxxxxx x xxxxxx xxxxxxxxxxxxxx xxxxxxxxx xxxxxxx xxxxx xx xxxxxx v příloze č. 9 xxxx xxxxxxxx.
(8) Xxxx xxxxxxx xxxxx §58 xxxx. 5 xxxxxx xx xxxxxx v příloze č. 10 xxxx vyhlášky.
§3
Xxxxx x oblasti xxxxxxxxxxxx xxxxxxxxxxxx
(1) Xxxx xxxxxxx x doklad x bezpečnostní xxxxxxxxxxxx xxxxxxx xxxxx xx xxxxxx x příloze č. 11 xxxx xxxxxxxx.
(2) Xxxx dotazníku je xxxxxx v příloze č. 12 xxxx vyhlášky. Xxxx xxxxxxxxx stanoví x xxxxxx xxxxx xxxxxxxxx xxxxxxxxxxxx x xxxxxxx xxxxxxx podle §99 xxxx. 4 xxxxxx.
(3) Vzor xxxxxxx x xxxxxxxxxxxx způsobilosti xxxxxxx osoby je xxxxxx v příloze č. 13 xxxx vyhlášky.
§4
Seznam xxxxxxxxxx xxxxxxxxxxxx x xxxxxxx x xxxxxx xxxxxxxxx fyzické xxxxx x xxxxxxx x xxxxxx x xxxxxxxxxxxx xxxxxxxxxxxx fyzické osoby
Xxxxxxx osoba k xxxxxxx o xxxxxx xxxxxxxxx xxxxxxx osoby xxxx xxxxxxx o xxxxxx o xxxxxxxxxxxx xxxxxxxxxxxx fyzické xxxxx xxxxx §94 xxxx. 2 písm. x) xxxx §99 xxxx. 2 písm. x) xxxxxx xxxxxxx
x) xxxxx xxxx xxxxxxx xxxx, xxxxxxxxx xxxxx xxxxxxx doklady,
x) xxxxxx x xxxxxxxxx xxxxxxxxx xxxxxxxx,
x) xxxxxxxxx x xxxxxx x zahraničí včetně xxxx xxxxxx xxxxxx,
x) rozhodnutí xxxxxx xxxxxxx x xxxxxxxx xxxxxx x xxxxxxxxx xxxxxx,
x) xxxxxxxxx xxxxxxxxxxxxxx o xxxxxxxx x xxxxxxxx xxxxxx xxxx, x případě xxxxxx xxxxx xxxxxx xxxxxx xxxxxxxx nebo xxxx xxxxxx xxxxxxxxxxx xxxxx příjem, x xx 5 let xxxxxx x xxxxxxx xxxxx žádosti x xxxxxx xxxxxxxxx xxxx xx xxxxxx, xxxxx xxxxxxxx xx posledního xxxxxxxxxx xxxxxx dokladů x xxxxxxxxxxxxx xxxxxx,
x) doklady x xxxxxxx xxxxxxx xxxx xxxxxxxxxxxx xxxxxxxxxxx žadatele,
x) xxxxxxx xxxxxxxxxxxxx xxxxxx mezi zápisem xx veřejném xxxxxxx xxxxx nebo xxxxxx xxxxxxxx xxxxxx a xxxxxxxxxxx a
x) xxxxxxxxxx xxxxxxxxxxx orgánu x xxxxxxxx výkonu xxxxxxxxxx.
§5
Xxxxxx xxxxxx xxxxxxx
(1) Xxxxxxxx vzory xxxxxxx x přílohách č. 1, 2, 6 a 12 xxxx xxxxxxxx xx xxxxxxxx v xxxxxxxxxxxx x xxxxxxxx xxxxxx, x elektronické xxxxxx xx podávají xx xxxxxxxxxx xxxxxx xxx.
(2) Xxxxxxxxxxxx šablona xxxxx xxxxxxxxx v přílohách č. 1 xx 6 x 8 xx 12 xxxx vyhlášky xx zveřejňuje xxxxxxxx xxxxxxxxxxx xxxxxxx xxxxxxx xx internetové adrese Xxxxxxxxx xxxxxxxxxxxxxx úřadu.
(3) Listinná xxxxxx xxxxxxxxxx xxxxx xxxxx xxxxxxxx 1 musí xxxxxxxxx xxxxxx elektronické xxxxxx, x xxxxxxxx xxxxxxx.
§6
Xxxxxxxx
Xxxx xxxxxxxx nabývá xxxxxxxxx xxxx 1. xxxxx 2006.
Xxxxxxx:
Mgr. Mareš x. x.
Xxxxxxx č. 1 x xxxxxxxx x. 527/2005 Sb.
PROHLÁŠENÍ XXXXXXX XXXXX X XXXXXXXXXXXX X PRÁVNÍM XXXXXX
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Xxxxxx xxxxx trvalého pobytu
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1. Xxxxxxxxxx, že jsem - xxxxxx* plně xxxxxxxxx/x x xxxxxxx xxxxxx.
2. Prohlašuji, xx xxxx x xxxxxxxxx xxx/x - xxxxx/x* xxxxxx/x způsobilosti x xxxxxxx úkonům x xx má xxxxxxxxxxx x právním xxxxxx xxx/x - xxxxx/x* xxxxxxx.
3. V xxxxxxx, xx xxxx xx x xxxx 1 xxxxxxxx/x xxxxxxx xxxx x xxxx 2 xxxxxx, xxxxxx:
x) Xxxxx xxxxx, xxxxx xxxxxxxxx xxxxxxxxxx vydal:
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b) Xxxxx xxxxxxx rozhodnutí xxxxx:
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x) Xxxxxx xxxxxx, po xxxxx xxxx byl/a xxxxxx/x způsobilosti x xxxxxxx úkonům xxxx xx xxxxx byla Xxxx xxxxxxxxxxx x xxxxxxx úkonům xxxxxxx:
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* Xxxxxxxx xx xxxxxxxx
Příloha x. 2 x xxxxxxxx x. 527/2005 Xx.
XXXXXXXXXX X XXXXXXXXXX ZPŮSOBILOSTI
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Jméno x xxxxxxxx
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1. Xxxxxxxxxx, xx xxxx - xxxxxx* xxxxx/x xxxxxxxxxxx x xxxx - xxxxxx* x xxxx xxxxxxxxxx. Xxxxxxxxxx, xx xxxx x minulosti xxx/x - xxxxx/x* xxxxx/x xxxxxxxxxxx x xxx/x - nebyl/a* xxxx x xxxx xxxxxxxxxx.
2. X xxxxxxxxxxx xxxxxxxx - xxxxxxxxxx* xxxxxxxxx obtíže.
3. X xxxxxxx, xx xxxx xx x xxxxxx 1 nebo 2 xxxxxxxx/xx xxxxxx, uveďte:
a) Xxxxx xxxxxxxxx (xxxxxx xxxxxx xxxxx)
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x) Xxxxxx, xxxxx Xxx xxxxx x xxxxxxxxx psychiatra xxxx xxxxxxxxxx
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x) Xxxxxx xxxxx - xxxxxxxxxx - xxxxxxx hospitalizace
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d) Xxxxxxxx
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x) Xxxxx xxxxxxxxx xxxxxxxx, xxxxx x xxxxxxxx xxxxxxxxxx nebo xxxxxxxxxx
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x) Xxxxxxxxxx xxxxxxx Xxxx xxxxxxxxx obtíže x popište okolnosti xxxxxxx (intenzita, xxxxxxx, xxxx xxxxxx, léčba).
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Dne
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Podpis
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* Xxxxxxxx xx xxxxxxxx
Příloha x. 3 x xxxxxxxx x. 527/2005 Sb.
Xxxxxxxx subjektu
(xxxxx xx xxxxx a xxxxx orgánu státu, xxxxxxxxx xxxxx xxxx xxxxxxxxxxx xxxxxxx xxxxx)
______________________________________________________________________________________
OZNÁMENÍ
o xxxxxxx podmínek xxx xxxxxxx x xxxxxxxxx xxxxxxxxx stupně xxxxxxx Xxxxxxxxx
Xxxxx x xxxxxxxx:
Xxxxx xxxxxxxx:
Xxxxx narození:
Xxxxx xxxxxxxx:
Xxxxxx xxxxxxxxx:
V ..................................... xxx ..........................
Xxxxxxx xxxxxxxx uvedených xxxxx §6 odst. 2 xxxxxx č. 412/2005 Xx., o xxxxxxx xxxxxxxxxxx informací x x xxxxxxxxxxxx xxxxxxxxxxxx xxxxxx x xxxxxxxx vydal:
Xxxxx a xxxxxxxx:
Xxxxxx:
Xxxxx xxxxxxx:
Xxxxxxx x. 4 k xxxxxxxx x. 527/2005 Xx.
Xxxxxxxx xxxxxxxx
(xxxxx xx název x xxxxx orgánu xxxxx, xxxxxxxxx xxxxx nebo xxxxxxxxxxx xxxxxxx xxxxx)
___________________________________________________________________________________
Xxxxxxx
xxxxx §9 odst. 1 x §11 odst. 2 zákona x. 412/2005 Xx., x xxxxxxx utajovaných xxxxxxxxx x o xxxxxxxxxxxx xxxxxxxxxxxx
Xxxx xxxxxxx xxxxx xxxx xxxxxxxxx x jejími xxxxx x xxxxxxxxxxx v xxxxxxx xxxxxxx xxxxxxxxxxx xxxxxxxxx. Byla seznámena x xxxxxxx zákona x. 412/2005 Xx., x ochraně xxxxxxxxxxx xxxxxxxxx x x xxxxxxxxxxxx způsobilosti (xxxx xxx "xxxxx") a x xxxxxxx xxxxxxxxxxx xxxxxxxx xxxxxxxx. Byla xxxxxxxxx x povinnostmi, xxxxx xxxx stanoveny x §65 a §66 odst. 1 xxxxxx, xxxxxxx x xxxxxxxxxx
a) dodržovat xxxxxxxxx xxxxxxxxxx xxx xxxxxxx xxxxxxxxxxx informací,
x) zachovávat xxxxxxxxxxx x xxxxxxxxx xxxxxxxxx, x xxx xx xxxx xxxx xxxxxxx, xxxxx xxxx xxxx xxxxxxxxxx xxxxxxxxxx xxxxxxx xxxxxxxxx,
x) neumožnit xxxxxxx x xxxxxxxxx xxxxxxxxx neoprávněné xxxxx.
Xxxx xxxx xxxxxxxxx xx xxxxx xxxxxxxx xxxxxxxx povinností stanovených xxxxxxx, xxxxxxx s xxxxxxxxxx xxxxxxxxx xxxxxxx xxxx xxxxxxx xxxxxx xx xxxxxxxx správního xxxxxxx.
Xxxx xxxxxxx xxxxx xxxx - xxxxxx* seznámena x xxxxxxxx XXXX
byla - xxxxxx* xxxxxxxxx x xxxxxxxx EU
xxxx - xxxxxx* xxxxxxxxx x předpisy XXX
X ............................ xxx ...........................
Xxxxxxx xxxxxxx Xxxxxxx xxxxx
Xxxxx x xxxxxxxx: Xxxxx x xxxxxxxx:
Xxxxxx: Xxxxx narození:
Xxxxx xxxxxxx: Xxxxx xxxxxxxxx:
Podpis:
* Nehodící se xxxxxxxx
Xxxxxxx x. 5 k xxxxxxxx x. 527/2005 Xx.
Xxxxxx o xxxxxx xxxxxxxxx xxxxxxx xxxxx
Xxxxx o xxxxxx xxxxxxxxx fyzické xxxxx xxx:
Xxxxx x xxxxxxxx:
Xxxxx xxxxxxxx:
Xxxxx narození:
Xxx xxxxxx utajení:
Xxxxxxxxxx nutnosti xxxxxxxx x xxxxxxxxx xxxxxxxxx:
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Xxxxxx xxxxxxx xxxxx
Xxxxxxxxx xxxxxxxxxx xxxxxxxx xxxxxxxx x xxxxxxxxx xxxxxxxxx
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Odpovědná xxxxx
Xxxxxxxx xxxxxxxx:
Xxxxx x příjmení:
Xxxxx xxxxxxxx:
Xxxxxx:
Xxxxx xxxxxxx:
nebo
Ten, xxx xxxx xxxxxxxxxx xxxxxxxxx xxxxxxxxxx:
Označení xxxxxxxx:
Xxxxx x xxxxxxxx:
Xxxxx xxxxxxxx:
Xxxxxx:
Otisk xxxxxxx:
X .............................. xxx ...................
Xxxxxxx x. 6 x xxxxxxxx x. 527/2005 Xx.
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X xxxxxxx xxxxx x xxxxx xxxxxxx xxxxxxxx xxxxx zákona č. 412/2005 Sb., x ochraně xxxxxxxxxxx xxxxxxxxx x o xxxxxxxxxxxx způsobilosti, x xxxxxxxx položek Xxxxxxxx xxxxxxxxxxxxx údaje, Xxxxxx xxxxxxxx xxxxxx x Xxxxxx xxx xxxxx xxxxxxxxxx, vyplňujte pouze xxxxx.
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Xxxxxxxx xxxxxxxxxxxxx xxxxx
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Akademický xxxxx xxxx xxxxxx
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Xxxxxxxxxx xxxxx za xxxxxxxxx
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Xxxxx xxxxxxxx (obvod)
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Stát narození
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číselník
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Státní xxxxxxxxx xxxxxxxx
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Adresa xxxxxxxx xxxxxx
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Xxxxxxxxxx, xx xxxx xxxxx xxxxx/x xxxxx x xxxxxxxx Xxxxx x xxxxxx
Xxxxxx jiného xxxxx, xxx xx xxxxxxxxx xxxx xxxx xx xxxxxxxx(x) déle než 30 xxx v xxxxxxxxxx deseti xxxxxx
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Xxxxxx xxx xxxxx doručování
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Xxxxxx xxxxxxxxxx/xxxxxxxx xxxxxx
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Xxxxxxxxxx, xx xxxx údaje xxxxx/x xxxxx x xxxxxxxx Xxxxx x xxxxxx
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Názvy xxxxxxxxxxx xxxxxxxxxxxxxx x xxxxxxxx xxxx xxxxxx x xxxxxxxx pracovněprávního xxxxxx xxxx služebního xxxxxx
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| &xxxx; | &xxxx; | &xxxx; | &xxxx; | |||
| &xxxx;
Xxxxxxxx další xxxxxxxxx
|
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| &xxxx; | &xxxx; | |||||
Xxxxxxxxxx, xx xxxx údaje xxxxx/x xxxxx x xxxxxxxx Xxxxx x xxxxxx
Xxxxxxxx x orgánech xxxxxxxxxxx osob x xxxxxxxxxx 5 xxxxxx
(xxxxxxxxxx xxxxx, dozorčí xxxx xxxx.)
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Xxx
|
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|
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| &xxxx;
Xxxxxxxx xxxxx xxxxxxxxx
|
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| &xxxx; | &xxxx; | |||||
Xxxxxxxxxxx x xxxxxxx, xx xxxxxxxxx x xxxxxx xxxxxxxxxx společnostem x xxxxxxxxxx 5 xxxxxx
| &xxxx;
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|
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|
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Xxxxxxxxx xxxxxx
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Xxxxx finančně xx Xxx závislé
|
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|
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|
Ne
|
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|
Jméno
|
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|
Příjmení
|
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Rodné číslo
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Datum xxxxxxxx
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|
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| &xxxx; | ||||||
Xxxxxxxxxx, xx xxxx údaje xxxxx/x xxxxx a xxxxxxxx Xxxxx a xxxxxx
Xxxxxx majetkových poměrů (x xxxxxxx xxxxxx xxxxxxxx podrobně xxxxxxxx)
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|
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Xxxxxxxx xxxxxxxx
|
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|
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Xxxxxxxxxx xxxxxxxx (podle §3 xxxxxx x. 256/2004 Xx., ve znění xxxxxxxxxx xxxxxxxx)
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|
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Xxxxxxxx xxxxx xxxxxxxxx
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Xxxxx xxxxxx po xxxxxxx xxxxxxxx xxxxxxxxxx xx 5 xxxxxxxxxx xxx
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Xxxxxx
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Xxxx xxxxxx než xxxx xxxx xxxx
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Xxxxxxxxxx, xx jsem xxxxx xxxxx/x xxxxx x xxxxxxxx Xxxxx a xxxxxx
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Xxxxxx nabytí
|
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|
Výše
|
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|
Měna
|
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Movitý xxxxxxx
(xxxxx xxxxx, xxxxxxx xxxxxxx x xxxxxxx xxxxxxx xxxxx xxxxxxxxx 100.000 Xx, xxxx. xxxxxx, xxxxxx xxxxxxxxx, xxxxxxxxxxxxx, xxxxxxxx, elektronika aj.)
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Počet xxxx
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(x xxxxxxx xxxxxxxxxxx xxxx XX uveďte xxxxxx)
|
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Xxxxx xxxxxxxxxxx (xxxx. xxxxx, xxxxxxxxx objekt, xxxx, xxx, xxx...)
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|
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Výše
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Měna
|
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Dlužník
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Případné xxxxx xxxxxxxxx
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| &xxxx; | &xxxx; | ||||
Xxxxxxxxxx, xx xxxx xxxxx xxxxx/x xxxxx a xxxxxxxx Xxxxx x xxxxxx
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Xxxxxxxx xxxxx xxxxxxxxx
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Xxxxxxx xxxxxx
(Xxxxxx xxxxxxx xxxxxxx stíhání, která xxxxx Xxx xxxx xxxxxx, x xx xxx xxxxxx xx xxxxxxxx řízení či xxxxxxxx xxxxxxxxx xxxxxx x osvědčení xx x xxxxxxxxxxx xxxxxx.)
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Xxxxxxx xxxxxxxx trestného činu
|
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|
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|
Datum xxxxxxxx trestního stíhání
|
Datum xxxxxxxx xxxxxxxxx stíhání
|
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|
Trestní xxxxxxx xxxx (xxxxxxx xxxxxx, xxxxx xxxxxxx)
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Xxxxxx xxxxxxxx
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Xxxxxxxx vyjádření
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Nařízené xxxxxx xxxxxxxxxx
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Xxxxxxxx xxxxxxxxx
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| &xxxx; | &xxxx; | ||||
Xxxxxxxxxx, xx jsem údaje xxxxx/x úplně a xxxxxxxx Xxxxx x xxxxxx
Xxxxx x místa xxxx xx xxxxxxxx xxxxxxx školní xxxxxxxx
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Důvod xxxxxx
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| &xxxx; | &xxxx; | |||||
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Xxxxx xxxxxxxx, xxxxx na xxxxx xxxxxx
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|
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|
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| &xxxx; | &xxxx; | &xxxx; | &xxxx; | |||
Xxxxxx, xxxxxxxx xxxxxxxxxxxx xxxxxxxx xx xxxxxxxx xxxxxxxxxxx xxxxxxxxxxx xxxxx Evropské xxxx xxxx Xxxxxxxxxx Xxxxxxxxxxxxxxxx xxxxxxx, se xxxxxxxx xxxxxx Xxxxx republiky xxxxxxxx v zahraničí x x xxxxxx xxxxxxxx příslušníky xxxxxxxx x Xxxxx xxxxxxxxx
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Xxxxxxxxxxx, xxxxxxxx a xxxxx xx bývalé x současné xxxxxxxxxxxx xxxxxx cizí moci xxxx na xxxx xxxxxx x xxxxxxx xxxxxxxxxxxxx x na xxxxxx xxxxxxx x §14 odst. 3 xxxx. x) xxxxxx x. 412/2005 Xx.
(xx. xxxxxx xxxxxx Státní xxxxxxxxxxx x rozvědným xxxx xxxxxxxxxxxxxxx zaměřením, xxxxxx Xxxxxxxx xxxxxxxxxxxxxx, xxxxxxxxxxxx xxxxxx Generálního xxxxx Xxxxxxxxxxxxxx xxxxxx xxxxxx xxxx odboru xxxxxxx ochrany Xxxxx xxxxxxxx xxxxxxx.)
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|
V xxxxxxx že ano
|
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Prohlašuji, xx jsem xxxxx xxxxx/x úplně x xxxxxxxx Datum a xxxxxx
Xxxxxxx xxxxxx xxxx xxxxxxxxxxxx látky, xxxxxxx x xxxxxx xxxxxxxxxxx xxxxxx xxxxxxxxxx látek x xxxxxxx xxxxxxxx
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|
V případě xx xxx xxxxxxxxxxxx
|
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| &xxxx; | &xxxx; | |||
Xxxxxxxxxxx xxxxxxxx
Xxxxxxx xxxxxxxx xxx (x xxxxxxx kladné xxxxxxxx podrobně xxxxxxxx)
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|
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X xxxxxxx xx xxx
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Xxxxx xxxxxxxxxx na xxxxxxxx nebo xxxxxxxxxxxxxx xxxxxxx, xxxxxxxx x xxxxx xxxxxxxxxxxxx xxxxxxxx
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|
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|
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|
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Xxxxxxxx xxxxxxxxx
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X xxxxxxx xx xxx
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| &xxxx; | &xxxx; | |||
Xxxxxxxxx xxxxxxxxxxxx xxxxxx
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Xxx
|
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|
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|
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| &xxxx; | &xxxx; | |||
X xxxxxxx, xx Xxx xxxxxxxxxxxx
xxxx Xxxxxxx, Tajné, Xxxxxx xxxxx, Xxxxxxxxxxxx xxxxxxxxxxx.
| &xxxx;
Xxxxxxxx xxxxxx
|
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Xxxxxx
|
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Xxxxxxxx
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Xxxxx xxxxx, xxxxx řízení xxxxxxxx
|
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| &xxxx; | &xxxx; | ||||||
Xxxxxxxx xxxxxxxxx
Xxxxxxx xxxxxx formou. Xxxxxxxxxxxx Xxx následující xxxxxxx: xxxxxx, xxxxx x příprava xx xxxxxxxxxx, xxxxxxxxxx xxxxxxxxxxxxx, xxxxxxxxxx x xxxxxxx xxxxx, xxxxxxxxxx, způsob xxxxxxx xxxxxxx xxxx, xxxxxxx x xxxxxxx xxxxxx. V xxxxxxx, xx xxxx xxxxxxxxx xxxxxxxx xxxxxxxxx, xxxxxx xxxxx životopisu xx xxxxxx xx xxxxxx xxxxxxxxx žádosti.
Prohlašuji, xx xxxx xxxxx xxxxx/x xxxxx a pravdivě Xxxxx x xxxxxx
Xxxxxx(xx) x xxxxx xxxxxx 18 xxx xxxxxx x xxxxxxxxxx s xxxxxxxx osobou
|
Jméno
|
opakovatelně
|
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|
Příjmení
|
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|
Rodné xxxxxxxx
|
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Xxxxx xxxxxxx xxxxxxxx
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|
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| &xxxx; | &xxxx; | &xxxx; | &xxxx; | |
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Xxxxxxxxxx xxxxx xxxx xxxxxx
|
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Xxxxxxxxxx titul xx xxxxxxxxx
|
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| &xxxx; | &xxxx; | &xxxx; | &xxxx; | |
| &xxxx;
Xxxxx narození
|
Rodné xxxxx
|
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| &xxxx; | &xxxx; | &xxxx; | &xxxx; | |
| &xxxx;
Xxxxx narození
|
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|
Okres xxxxxxxx (xxxxx)
|
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| &xxxx; | &xxxx; | |||
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Xxxx narození
|
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|
Státní xxxxxxxxx xxxxxxxx
|
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Xxxxxx xxxxxxxxx xxxxxxxxx
|
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Xxxxx x Vaší xxxxx
|
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Xxxxxxxx xxxxxxxx (popřípadě xxxxxxxxxx xxxxxxx)
|
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| &xxxx; | &xxxx; | |||
| &xxxx;
Xxxxxxxxx od
|
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Příslušnost xxxxxxx(xx) x osob xxxxxxxx 18 xxx xxxxxxxx v xxxxxxxxxx x fyzickou xxxxxx x xxxxxxx, xx xxxxxxxxx a obecně xxxxxxxxxx společnostem xx xxxxxxxxxx 5 xxx
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|
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|
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|
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|
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| &xxxx; | &xxxx; | &xxxx; | &xxxx; | ||||
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Xxxxxx
|
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| &xxxx; | &xxxx; | ||||||
Xxxxxxxxxx, xx xxxx xxxxx xxxxx/x xxxxx x pravdivě Xxxxx x podpis
Nezletilé xxxx
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| &xxxx;
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|
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|
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Xxxxx xxxxxxxx
|
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| &xxxx; | &xxxx; | ||
| &xxxx;
Xxxxx xxxxxxx příjmení
|
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|
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|
Datum xxxxxxxx
|
&xxxx; | &xxxx;
Xxxxx xxxxx
|
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| &xxxx; | &xxxx; | &xxxx; | &xxxx; |
| &xxxx;
Xxxxx narození
|
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|
Okres xxxxxxxx (xxxxx)
|
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| &xxxx; | &xxxx; | ||
| &xxxx;
Xxxx xxxxxxxx
|
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| &xxxx; | &xxxx; | ||
| &xxxx;
Xxxxxx občanství xxxxxxxx
|
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|
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| &xxxx; | &xxxx; | ||
| &xxxx;
Xxxxxx xxxxxxxxx xxxxxxxxx
|
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| &xxxx; | &xxxx; | ||
Xxxxxx xxxxxxxx xxxxxx xxxxxxxxxxx xxxxxx
| &xxxx;
Xxxxx
|
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| &xxxx; | &xxxx; | &xxxx; | &xxxx; | |
| &xxxx;
Xxxxx popisné (xxxx xxxxxxxxx)
|
&xxxx; | &xxxx;
Xxxxx orientační
|
||
|
Obec
|
||||
|
Okres, obvod
|
||||
|
PSČ
|
||||
|
Stát
|
číselník
|
|||
Prohlašuji, xx xxxx xxxxx xxxxx/x xxxxx a xxxxxxxx Datum x xxxxxx
Příloha č. 7 x vyhlášce x. 527/2005 Xx.
Xxxxxxxx xxxxxxxx
(xxxxx xx xxxxx subjektu, xxxxx xxxxxxxxx xxxxx)
________________________________________________________________________________________
X X X X X X X X X
xxxxxxx xxxxx
Xxxxxxxxxxx xx Security Xxxxxxxxx/Xxxxxxxxxx x'xxxxxxxxxxxx personnelle
ČÍSLO:
Number/Numéro
Jméno x xxxxxxxx
Xxxx xxx Xxxxxxx
Xxx xx xxxxxx
Xxxxx příjmení
Maiden Xxxx
Xxx de naissance
Datum xxxxxxxx Xxxxx xxxxx
Xxxx xx Xxxxx Xxxxxxxx No.
Date de xxxxxxxxx Xxxxxx d'identification personnelle
Místo xxxxxxxx
Xxxxx of Xxxxx
Xxxx xx naissance
Státní xxxxxxxxx
Xxxxxxxxxxx
Xxxxxxxxxxx
Xxxxxx xxxxxxx
Xxxxxxxxxxxxxx Level
Niveau xx xxxxxxxxxxxxxx
Xxxxx vydání Platnost od Platnost xx
Xxxx of Xxxxx Xxxxx xxxx Xxxx of Xxxxxx
Xxxx xx xxxxxxxxxx Xxxxxxxx à xxxxxx xx Xxxx x'xxxxxxxxxx
Xxxxxx xxxxxxxxxxx xxxxxxxx Xxxxx xxxxxxxx xxxxxxx
Xxxxxxxxx of xxx Xxxxxxxxx Representative Official Stamp/Cachet xxxxxxxx
Xxxxxxxxx xx représentant xxxxxxxx
Xxxxxxx x. 8 x vyhlášce x. 527/2005 Xx.
Xxxxxx x xxxxxx xxxxxxxxx xxxxxxx xxxxx xxx xxxx xxx
Xxxxx x xxxxxx xxxxxxxxx fyzické xxxxx xxx cizí xxx xxx:
Xxxxx x xxxxxxxx x xxxxxxxxxx xxxxx:
Xxxxx xxxxxxxx:
Místo narození:
Stupeň xxxxxxx, xxx xxxxx je xxxxxxxxx xxxxxxx xxxxx xxx xxxx xxx xxxxxxxxxx:
Xxxxx xxxxxxxx, xxxxxxxx xxxxxxxxx xxxxxxx xxxxx x xxxxxx xxxxxxx, xxx xxxxx je xxxxxx:
Xxxxxxxxxx xxxxxxxx xxxxxxxx fyzické xxxxx x xxxxxxxxx xxxxxxxxx xxxx moci:
Xxxxxx pro xxxxxxxxxx:
V ........................ xxx ........................
.......................................................
Xxxxxx fyzické xxxxx
Xxxxxxx x. 9 x vyhlášce x. 527/2005 Xx.
Xxxxxx x xxxxxx xxxxxxxxxxxxxx oprávnění fyzické xxxxx
Xxxxx x xxxxxx xxxxxxxxxxxxxx xxxxxxxxx xxxxxxx xxxxx xxx:
Xxxxx, xxxxxxxx x akademický xxxxx:
Datum x xxxxx xxxxxxxx:
Xxxxxx trvalého xxxxxx:
Xxxx:
Xxxxxx xxxxxxxxx:
Xxxxx, proč má xxx xxxxxx xxxxxxxxxxxxxx xxxxxxxxx xxxxxxxxx:
Xxxx, xx kterou xx xxx uznání xxxxxxxxx:
Adresa xxx xxxxxxxxxx:
X .............................. dne .........................
.......................................................
Xxxxxx xxxxxxx osoby
Xxxxxxx x. 10 x vyhlášce x. 527/2005 Xx.
Xxxxxxxx xxxxxxxx
(xxxxx xx název x xxxxx xxxxxxxx, x xxxxxxx je řízení xxxxxx)
______________________________________________________________________________________
X x x č x x x
xxxxx §58 xxxx. 5 xxxxxx x. 412/2005 Sb., o xxxxxxx xxxxxxxxxxx xxxxxxxxx x x bezpečnostní xxxxxxxxxxxx
Xxxx xxxxxxx xxxxx xxxx xxxxxxxxx x xxxxxx xxxxx x xxxxxxxxxxx x oblasti xxxxxxx xxxxxxxxxxx xxxxxxxxx. Xxxx xxxxxxxxx x obsahem xxxxxx č. 412/2005 Xx., o ochraně xxxxxxxxxxx xxxxxxxxx x x xxxxxxxxxxxx xxxxxxxxxxxx (xxxx xxx "xxxxx") x x obsahem xxxxxxxxxxx právních předpisů. Xxxx xxxxxxxxx s xxxxxxxxxxx, které jsou xxxxxxxxx x §65 x §66 odst. 1 xxxxxx, zejména x xxxxxxxxxx
a) xxxxxxxxx xxxxxxxxx xxxxxxxxxx xxx xxxxxxx xxxxxxxxxxx xxxxxxxxx,
x) xxxxxxxxxx xxxxxxxxxxx o xxxxxxxxx xxxxxxxxx, x xxx xx nebo xxxx xxxxxxx, xxxxx xxxx xxxx xxxxxxxxxx oprávněným xxxxxxx xxxxxxxxx,
x) xxxxxxxxx přístup x xxxxxxxxx informaci neoprávněné xxxxx.
Xxxx xxxx xxxxxxxxx se xxxxx xxxxxxxx xxxxxxxx xxxxxxxxxx xxxxxxxxxxx xxxxxxx, zejména x následkem xxxxxxxxx xxxxxxx nebo xxxxxxx xxxxxx xx xxxxxxxx xxxxxxxxx deliktu. Xxxx xxxxxx xxxxxxx x xxx, xx xxxxx x ní xxxx Xxxxxxxx xxxxxxxxxxxxx xxxxxx xxxxxxxxx a xxxxx xxx xxxxxxx xxxxxxxx xxxxxxxxxx zákonem.
Xxxxxxx xx xxxxxxxxx xxx xxxxxxx ..........................................................................................................................
(xxxxx xx xxxxx xxxxxx)
vedeného xxx .........................................................................................................................................................
(uvede se xxxxxxx xxxxxxxx věci)
X xxxxx xxxxxx xxxx xxx xxxxxxx xxxxx xxxxxxx k xxxxxxxxxx xxxxxxxxxx do xxxxxx utajení ............................. xxxxxx, x xx x oblasti .....................................
V ........................................ xxx .............................
Xxxxxxx xxxxxxx Xxxxxxx xxxxx
Jméno x xxxxxxxx: Xxxxx a xxxxxxxx:
Xxxxxx: Xxxxx xxxxxxxx:
Xxxxx xxxxxxx: Xxxxx xxxxxxxxx:
Xxxxxx:
Příloha č. 11 k vyhlášce x. 527/2005 Xx.
Xxxxxx x xxxxxx xxxxxxx x xxxxxxxxxxxx xxxxxxxxxxxx xxxxxxx osoby
Xxxxx x xxxxxx xxxxxxx x xxxxxxxxxxxx xxxxxxxxxxxx xxxxxxx xxxxx xxx:
Xxxxx x xxxxxxxx:
Datum xxxxxxxx:
Xxxxx xxxxxxxx:
Xxxxxxxxxx výkonu xxxxxxx xxxxxxxx:
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Xxxxxxxxx xxxxxxxxxx xxxxxx xxxxxxx xxxxxxxx:
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Xxxxxxxxx xxxxx
Xxxxxxxx xxxxxxxx:
Xxxxx x xxxxxxxx:
Xxxxxx:
Xxxxx xxxxxxx:
X ................................. dne .............................
......................................................
Xxxxxx xxxxxxx xxxxx
Příloha x. 12 x xxxxxxxx x. 527/2005 Xx.
XXXXXXXX
X xxxxxxx xxxxx x xxxxx xxxxxxx podávané podle xxxxxx č. 412/2005 Sb., x xxxxxxx xxxxxxxxxxx xxxxxxxxx x x xxxxxxxxxxxx xxxxxxxxxxxx, x xxxxxxxx xxxxxxx Xxxxxxxx xxxxxxxxxxxxx xxxxx, Adresa xxxxxxxx xxxxxx x Adresa xxx účely xxxxxxxxxx, xxxxxxxxx pouze xxxxx.
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Xxxxx narození (xxxxx)
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Xxxxxx trvalého pobytu xxxxxx xxxxxxxxxxx xx xxxxxxxxxx 10 let
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opakovatelně
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Číslo xxxxxxx (xxxx evidenční)
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Číslo xxxxxxxxxx
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Stát
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číselník
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Prohlašuji, xx xxxx údaje xxxxx/x xxxxx x xxxxxxxx Xxxxx x podpis
Adresa xxx xxxxx xxxxxxxxxx
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Xxxxxx xxxxxxxxxx/xxxxxxxx xxxxxx
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Číslo
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Vydal
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Datum xxxxxx
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Xxxxxxxx xxxxxxxx (xxxxxxxxx xxxxxxxxxx činnost)
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Zaměstnán xx
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Xxxxxxxxxx, xx xxxx údaje xxxxx/x xxxxx x xxxxxxxx Datum x xxxxxx
Xxxxx předchozích zaměstnavatelů xx xxxxxxxxxx 10 xxx x xxxxxxxx xxxx vzniku x xxxxxxxx xxxxxxxxxxxxxxxx xxxxxx xxxx služebního xxxxxx
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Číslo xxxxxxxx knížky
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Xxxxxxxxxx, xx xxxx údaje xxxxx/x xxxxx x xxxxxxxx Xxxxx x podpis
Podnikatelská xxxxxxx x xxxxxxxxxx 10 xxxxxx
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Xxxxxxxxx poměry
Finance
(bankovní účty)
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Druh
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Xxxxxxxxxx, že xxxx xxxxx xxxxx/x úplně x xxxxxxxx Datum x xxxxxx
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Prohlašuji, xx jsem xxxxx xxxxx/x úplně x xxxxxxxx Xxxxx a xxxxxx
Xxxxxxx xxxxxx
(Xxxxxx všechna xxxxxxx xxxxxxx, xxxxx xxxxx Xxx xxxx xxxxxx x posledních 10-xx xxxxxx, x xx bez xxxxxx xx výsledek xxxxxx xx případné xxxxxxxxx xxxxxx a xxxxxxxxx xx x xxxxxxxxxxx xxxxxx.)
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Xxxxx ukončení trestního xxxxxxx
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Xxxxxxx stíhání xxxx (xxxxxxx značka, xxxxx xxxxxxx)
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Xxxxxxxx xxxxxx xxxxxxxxxx x xxxxxxxxxx 10 xxxxxx
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Xxxxx xxxxxxxx xxxxxx xxxxxxxxxx
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Xxxxxxxx vyjádření
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Osobní, významné xxxxxxxxxxxx xxxxxxxx xx xxxxxxxx příslušníky xxxxxxxxxxx xxxxx Xxxxxxxx xxxx xxxx Organizace Severoatlantické xxxxxxx, xx xxxxxxxx xxxxxx Xxxxx republiky xxxxxxxx x xxxxxxxxx x x xxxxxx xxxxxxxx xxxxxxxxxxx žijícími x Xxxxx republice
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Ano
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Ne
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Podrobné xxxxxxxxx
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X xxxxxxx xx xxx
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Xxxxxxxxxx, xx xxxx xxxxx uvedl/a xxxxx x xxxxxxxx Xxxxx x podpis
Příslušnost, kontakty x xxxxx xx xxxxxx x xxxxxxxx xxxxxxxxxxxx služby xxxx xxxx nebo xx xxxx xxxxxx x xxxxxxx zpravodajství a xx složky xxxxxxx x §14 xxxx. 3 xxxx. x) xxxxxx č. 412/2005 Xx., x xxxxxxxxxx 10 xxxxxx
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Xxxxxxx xxxxxx xxxx xxxxxxxxxxxx xxxxx, uvedené v xxxxxx xxxxxxxxxxx oblast xxxxxxxxxx xxxxx a xxxxxxx alkoholu v xxxxxxxxxx 10 xxxxxx
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X xxxxxxx xx xxx xxxxxxxxxxxx
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Xxxxxxxx xxxxxxxxx
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X xxxxxxx xx xxx xxxxxxxxxxxx
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Xxxxxxxxxxx xxxxxxxx
Xxxxxxx hazardní hry (x xxxxxxx kladné xxxxxxxx xxxxxxxx rozveďte)
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Ano
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Ne
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Podrobné xxxxxxxxx
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X xxxxxxx xx xxx
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Xxxxx xxxxxxxxxx xx xxxxxxxx xxxx xxxxxxxxxxxxxx xxxxxxx, alkoholu x xxxxx xxxxxxxxxxxxx hráčství x xxxxxxxxxx 10 xxxxxx
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X xxxxxxx xx ano
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Podrobný xxxxxxxxx
Xxxxxxx xxxxxx xxxxxx. Doporučujeme Xxx následující xxxxxxx: xxxxxx, škola x xxxxxxxx xx zaměstnání, xxxxxxxxxx xxxxxxxxxxxxx, xxxxxxxxxx x rodinný xxxxx, xxxxxxxxxx, způsob xxxxxxx xxxxxxx xxxx, tělesné x xxxxxxx xxxxxx. X případě, xx xxxx xxxxxxxxx platného xxxxxxx, xxxxxx xxxxx xxxxxxxxxx na xxxxxx xx xxxxxx předchozí xxxxxxx.
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Xxxxxxxxxx, xx xxxx xxxxx uvedl/a úplně x xxxxxxxx Datum x xxxxxx
Xxxxxxx x. 13 x xxxxxxxx x. 527/2005 Xx.
XXXXXXX XXXXXXXXXXXX XXXX
Xxxx. přihr. 49
150 06 Xxxxx 56
____________________________________________________________________________________
DOKLAD
x bezpečnostní způsobilosti xxxxxxx osoby
ČÍSLO:
Xxxxx a xxxxxxxx
Xxxxx xxxxxxxx
Xxxxx xxxxxxxx Xxxxx číslo
Xxxxx x xxxx xxxxxxxx
Státní xxxxxxxxx
Xxxxx xxxxxx Xxxxxxxx xx Xxxxxxxx xx
Xxxxxx xxxxxxxxxxx xxxxxxxx Xxxxx úředního xxxxxxx
Xxxxxxxxx xxxxxxxxxxxxxx xxxxx Xxxxxxxxx xxxxxxxxxxxxxx úřadu
Informace
Xxxxxx xxxxxxx x. 527/2005 Xx. xxxxx xxxxxxxxx xxxx 1.1.2006.
Xx xxx xxxxxxxx xxxxxx xxxxxxx xxxxx xxxxx xx xxxxxxxxx.
Právní xxxxxxx x. 527/2005 Xx. byl xxxxxx xxxxxxx xxxxxxxxx č. 363/2011 Sb. x xxxxxxxxx xx 1.1.2012.
Znění xxxxxxxxxxxx xxxxxxxx norem xxxxxx xxxxxxxx xxxxxxxx x xxxxxxxx xxxx xxxxxxxxxxxxx, xxxxx xx xxxx netýká derogační xxxxx shora xxxxxxxxx xxxxxxxx xxxxxxxx.