SERVIÇO PÚBLICO FEDERAL

CONSELHO REGIONAL DE ENGENHARIA E AGRONOMIA DA PARAÍBA -CREA-PB

Ilm° Sr. Presidente do Conselho Regional de Engenharia e Agronomia da Paraíba

(nome)
, residente à ___________________________________________________________

_____________________________, n° _____________,Bairro __________________

______________________, Cidade________________________________________,

Estado_____________________________________, CEP_____________________,

Fone (_____)_______________________, portador da carteira de identidade n°_____

__________________________ e CPF n° __________________________________,

Solicita a V.Sa _________________________________________________________

_____________________________________________________________________

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Neste Termos,
Pede Deferimento.

_______________________,__________de_________________de_____________

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(Assinatura)