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刑事附带民事起诉状

发布时间:2010-12-29 16:05:09


附带民事诉讼原告人:         性别    民族        出生年月日               

籍贯                 现住址                                 

联系电话                             

附带民事诉讼被告人:         性别    民族        出生年月日               

籍贯                 现住址                                 

联系电话                             

诉讼请求:

                                                      

                                                                       

                                                                       

                                                                       

                                                                       

事实与理由:

                                                                       

                                                                       

                                                                       

证据和证据来源:(证人的姓名和住址)

                                                                       

                                                                       

                                   此致

                             *****区人民法院

附:本刑事附带民事起诉状副本   份

                                   

附带民事诉讼原告人              

                                             年   月   日

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