Privind deplasarea de la domiciliu la locul de munca si invers
Subsemnatul(a) _________________________________ care ma legitimez cu____ seria ______nr.________________________CNP___________________________ grupa sanguina_______data nasterii_______________in loc.__________________ judetul_________________si domiciliul actual in str._________________________ nr.___ap._____localitatea__________________________jud__________________ studii ___________________angajat la societatea _______________________ avind marca_______________calificarea_________________________in functia de _____________________________declar pe proprie raspundere ca deplasarea de la domiciliul actual la locul de munca o efectuez pe urmatorul traseu: ___________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ _____________________________________________________________ folosind urmatoarele mijloace de transport :_________________________________ ___________________________________________________________________ timpul total al deplasarii fiind in medie de ______ore si _______ minute. Deasemenea la deplasarea de la locul de munca la domiciliu folosesc urmatorul traseu:______________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ _____________________________________________________________ folosind urmatoarele mijloace de transport__________________________________ ___________________________________________________________________ timpul total al deplasarii fiind in medie de _____ore si _____minute. data: