行政复议举证告知书

申请人：_________________，地址：________________，电话：_____________。法定代表人：_______________

申请人：_________________姓名_____________性别_____________年龄_____________职业____________

申请人：_________________姓名_______________性别______出生年月_____________身份证(其他有效证件)号码____

申请人___________不服被申请人(名称)___________年______月______日作出的___________，于___________年__

_____________[____]号(申请人：_________________)你(你单位)______年______月______日对_________

_____________[____]号(申请人：_________________)你(你单位)______年______月______日对_________

(申请人：_________________)你(你单位)______年______月______日对_______________(被申请人的具体行政行为)不

_____________[]号申请人：_________________你(你单位)______年______月______日对_______________

申请人：___________________工作单位：___________________住址：___________________电话：________

_____________[]号(申请人：_________________)你(你单位)______年______月______日对_____________