SPLNOMOCNENIE
Podpísaný/á ............................................................................................................
Narodený/á .............................................................................................................
Bytom .....................................................................................................................
Číslo OP ................................................. rodné číslo ............................................
splnomocňujem
Meno priezvisko .....................................................................................................
Narodený/á .............................................................................................................
Bytom ......................................................................................................................
Číslo OP ................................................. rodné číslo ............................................
K .............................................................................................................................
.................................................................................................................................
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podpis
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SPLNOMOCNENIE