CONCEJO DE ARTICA

ARTIKAKO KONTZEJUA
Ayuntamiento de Berrioplano
Berriobeitiko Udala
(Navarra –Nafarroa)

INSTANCIA GENERAL / ESKABIDE OROKORRA
__________________________________________________________________(e)k /
con DNI nº ______________________________________________ NAN zk. duenak /
con domicilio en __________________________________________________ kalean /
nº ________ zk.an / piso _______ solairuan / municipio _________________________
herrian bizi eta / teléfono _____________________________________ tel. zk. duenak

EXPONE / ZERA AZALTZEN DUT:
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SOLICITA / ZERA ESKATZEN DUT:
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Artica, a _____ de ___________________de __________
Artikan, ________(e)ko ________________aren ____(e)an
Firma/ Sinadura:
SRA. PRESIDENTA DEL CONCEJO DE ARTIKA
ARTIKAKO KONTZEJUKO PRESIDENTE JAUNARI.

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