LIDCMI DC DCLEKDE DC EMHLCKTIP

PC@_CT
PC@_CTE_H
E_HI
I2
CVZCD
CVZCDHCK
HCKTC
TC 2
@SEDC_KI 2 Z_HK@HZEM.
CP@_HTI 2 K² :5
HKTC_ZIKC DCLEKDE DC EMHLCKTIP.

EM BSRNEDI @HQHM DC …………….

BSMHCTE @EPT_I _CXCP DC EMOS_USCUSC , hdckthah`edi `ik DKH K² ……………, `ik

dhrc``hðk dilh`hmherhe ck ………………………………………, scõemekdi dilh`hmhi pri`csem ck
…………………………7 etcktelcktc dhni2

QÌE Z_I@CDHLCKTEM X ZCTHTI_HI2

Uuc ck vìe dc Zri`csi Pulerìshli, hktcrpikni dclekde dc emhlcktis `iktre BSEK @E_MIP
EMOS_USCUSC USH_IR, `ik dilh`hmhi ck …………………………. @cr`edi dc ……………..,
e ahk dc quc `ulpme `ik pener uke pckshðk emhlckterhe ck ockcah`hi dc me dclekdektc, peni quc
dcocrå fe`crsc pir lcksuemhdedcs edcmektedes y quc `ikshsthrå ck cm 3:% dc mis feocrcs dcm
dclekdedi.

@ILZCTCK@HE2
Cs `ilpctcktc cm Buznedi dc Zez Mctredi dc ………….

Zirquc cxhstc prucoe hkduohteomc dcm vìk`umi aelhmher cktrc mes pertcs y esì mi dhspikc cm scnukdi
 pårreai dcm ert. 34> dcm @.Z.@. (cs dc dcste`er quc me `ilpctck`he `irrcspikdcrå e mis buc`cs dc
aelhmhe ck `esi dc ki cxhsthr prucoe hkduohteomc dcm vìk`umi aelhmher y sh e me prctckshðk dc
emhlcktis sc fuohcsc e`ulumedi itres prctckshikcs ck me dclekde ert. 34> scnukdi pårreai dcm
@.Z.@.).

Zir dilh`hmher cm dclekdedi dcktri dc me `ilpctck`he tcrrhtirhem dcm Buznedi y csteomc`crmi ck cm

ert. 31: dcm @.Z.@. (cs dc rcsemter quc `irrcspikdc cm `iki`hlhckti dcm pri`csi dc emhlcktis em bucz
dcm dilh`hmhi dcm dclekdedi i dcm dclekdektc, e cmc``hðk dc èstc2 ert. 31: prhlcr pårreai dcm
@.Z.@.).
 

ASKDELCKTIP DC FC@FI2
Uuc, me dclekdektc `iktrebi letrhlikhi `ik cm dclekdedi cm dìe 54 dc Acorcri dcm ?::6.
Uuc, cm dìe 0: dc Enisti dcm ?:5:, cm dclekdedi fhzi eoekdiki dc dilh`hmhi `ikyunem uoh`edi ck
me @emmc ……………………………….. y e perthr dc dh`fe ac`fe ki `ulpmc `ik su dcocr dc privccr 
cm sis
sistck
tckhlh
hlhckt
cktii dcm fin
finer,
er, vem
vemcc dc`
dc`hr,
hr, hk
hk`ul
`ulpmc
pmc `ik su iom
iomhne
hne`hð
`hðkk dc prc
prcste
sterr emhlck
emhlcktis
tis em
dclekdektc.
Uuc, me dclekdektc ki sc ck`ucktre ck epthtud dc etckdcr e su suoshstck`he pir cster hk`epe`htede
aìsh`elcktc, pucs pedc`c dc PÌKD_ILC DC ………………….. Cs pir cmmi quc ki pucdi etckdcr 
edc`uedelcktc lhs kc`cshdedcs oåsh`es dc emhlckte`hðk, feohte`hðk, vcsthdi y eshstck`he lèdh`e.
Uuc, cm dclekdedi nize dc oucke pish`hðk c`ikðlh`e, tekti esì lås sh sc ck`ucktre treoebekdi
`ili …………………………. ck me ……………………………., uoh`ede ck me
…………………………………. K² ……….ck dikdc pcr`hoc uk hknrcsi lcksuem dc P/. 3 :::.::
 Kucvis Pimcs.
Uuc, ck vhrtud dc mi cxpucsti prc`cdcktclcktc cs quc cm dclekdektc rc`mele ck me dclekde cm
 peni pir cm dclekdedi dc uke pckshðk emhlckth`he e aevir dcm sus`rhti `ikshstcktc ck cm 3:% dc mis
feocrcs dcm dclekdedi y quc dcocrå cac`tuer èstc pir lcksuemhdedcs edcmektedes.

ASKDELCKTE@HÐK
ASKDELCKTE@HÐK BS_ÌDH@E2
Pustckti lh pcthtirhi ck mi prcvhsti ck mes shnuhcktcs kirles mcnemcs2
Ert. 4>? dcm @ðdhni @hvhm, kulcrem quc prcs`rhoc quc sc ckthckdc pir emhlcktis mi quc cs
hkdhsp
hkdhspcks
ckseom
eomcc per
peree cm sus
sustck
tckti,
ti, feo
feohte
hte`hð
`hðk,
k, vcs
vcsthd
thdii y esh
eshstc
stck`h
k`hee lèd
lèdh`e
h`e,, scn
scnòk
òk me shtue`
shtue`hðk
hðk y
 pishohmhdedcs dc me aelhmhe.
Ert. 4>0 dcm @ðdhni @hvhm, dc `uyi prhlcr pårreai sc dcsprckdc quc cm leyir dc dhc`hi`fi eõis
thckc dcrc`fi dc emhlcktis `uekdi ki sc ck`ucktre ck epthtud dc etckdcr su suoshstck`he pir `euse
dc hk`epe`hded aìsh`e dcohdelcktc `ilprioede.
Ert. 4>4 dcm @ðdhni @hvhm, quc csteomc`c ck su hk`hsi 5 quc sc dcock emhlcktis rc`ìpri`elcktc mis

`ðkyuncs.

LCDHIP Z_IOETI_HIP2
Iarcz`i cm lèrhti dc mis shnuhcktcs lcdhis prioetirhis2

Zerthde dc Letrhlikhi, dc ac`fe ……. dc …………………. dcm ……….., cxpcdhde pir me Iah`hke
dc _cnhstri dcm Cstedi @hvhm dc me Lukh`hpe
Lukh`hpemhded
mhded …………………
…………………….,
…., `ik me quc e`rcd
e`rcdhte
hte quc cm
dclekdektc cstå `esedi `ik cm dclekdedi.

@c
@crt
rtha
hah`
h`ed
edii Lè
Lèdh
dh`i
`i,, dc ac`f
ac`fee ……
…….... dc ……
…………
…………
……dc
dcmm ……
…….,., cxpc
cxpcdh
dhdi
di pirpir me Dr
Dre.
e.
………………
………… …………
…………………… ……….…. `ik
`ik @.L.
@.L.Z
Z K² ……
…………
……`i
`ikk cm `uem
`uem e`rc
e`rcddhti
hti quc
quc cs
csti
tiyy
 

hk`epe`htede aìsh`elcktc pir edimc`cr dcm PÌKD_ILC DC ……………………….. y pir ckdc quc
ki lc ck`ucktri ck epthtud dc etckdcr lh
l h suoshstck`he.
Edbukti Oimctes dc Zeni dcm dclekdedi `ik me `uem e`rcdhti su simvck`he c`ikðlh`e.

ZI_ TEKTI2
Em Buznedi, simh`hti sc shrve tckcr pir hktcrpucste me prcscktc dclekde y dermc trålhtc quc e su
keturemcze `irrcspikdc, `ikairlc e lh dcrc`fi y dc e`ucrdi e mcy.

Z_HLC_ IT_IPÌ DHNI2 Uuc dcmcni mes ae`umtedcs nckcremcs dc rcprcsckte`hðk, e quc sc rcahcrc cm
ert. 6: dcm @.Z.@. em Dr. …………………………….. `ik @.E.M. K² ………….y dc`meri cster 
hkstru
hkstruhdi
hdi e`c
e`cr`e
r`e dc sus em`em`ek`
ek`cs.
cs. Ck `uekt
`uektii em dil
dilh`h
h`hmhi
mhi dcm rcp
rcprcs
rcsckt
cktedi
edi,, rcq
rcquhs
uhshti
hti per
peree me
 prcsckte`hðk budh`hem pir eoinedi, scõemi quc sc ck`ucktre hkdh`edi ck me pertc hktridu`tirhe dc me
 prcscktc dclekde.

PCNSKDI IT_IPÌ DHNI2 Uuc eutirhzi e mis scõircs2 ……………………………… hdckthah`edi

`ik DKH
rcemhz
rcemhzer miK²
er miss …………..
e`t
e`tis y Pr.
is dc pri
pri`ur …………………………………..
`uredu
edurìe
rìe quc scek pcr
pcrthk
thkckt
cktcs `ikc DKH
cs ck cstc
cst pri K²i ……………….,
pri`cs
`csi `il
`ilii cm rcv hserpere
rcvhse r cm
cxpcdhcktc, se`er `iphes, `iphes `crthah`edes, ncsthiker y rc`incr iah`his, kithah`e`hikcs, rc`incr 
ekcxis, cktrc itris.

TC_@C_ IT_IPÌ DHNI2 Uuc edbukti mis shnuhcktcs ekcxis2

@iphe `crthah`ede dcm e`te, dc ac`fe …… dc ……………….. dcm ………, cxpcdhde pir ”………….
@cktri dc @ik`hmhe`hðk“ ck quc `ikste quc cm e`ucrdi `ik`hmhetirhi cxtrebudh`hem
cxtrebudh`hem ki sc fe pridu`hdi.
Aiti`iphe dcm DKH dcm dclekdektc.
Zerthde
Zerthde dc Letrh
Letrhlikhi
likhi dc ac`fe ……. dc ……………….dcm ……….., cxpcdhde
cxpcdhde pir me Iah`hke dc
_cnhstri dcm dc
letrhlikhem Cstedi @hvhm dc me Lukh`hpemhded ………………..………………, rcacrhde e me ukhðk
mes pertcs.
@crthah`edi Lèdh`i, dc ac`fe ……
…….. dc ………. dcm …….., cxpcdhdi pir me Dre.
………………………………. `ik @.L.Z K² ……….
Oimctes dc Zeni dcm dclekdedi dikdc sc e`rcdhte me simvck`he c`ikðlh`e dcm lhsli.

…………, …….. dc ………………… dcm ……..