Splnomocnenie

Podpísaný(á):  ....................................................................................................................

Dátum narodenia: ...............................................................................................................

Trvalé bydlisko:....................................................................................................................

týmto splnomocňujem:  

meno a priezvisko: ...............................................................................................................

rodné číslo: ...........................................................................................................................

bytom: ....................................................................................................................................

číslo OP: ................................................................................................................................

na úkon: .................................................................................................................................

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Bratislava, dňa ............................                                              
                                                                                                          
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