1._/ _/ _/
2._____________________________________________________________________________________________________________________________
(Jabrlanuvchi shaxs hisobga olingan joy)
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2._/ _/ _/ _/ _/
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3._____________________________________________________________________________________________________________________________
(Ma’muriy ishning yoki bayonnomaning tartib raqami)
3.1. Ma’muriy ish yoki bayonnoma tuzilgan/ish qo‘zg‘atilgan sana;
“____” ___________ _______yil.
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3. _/ _/ _/ _/
_/ _/ _/ _/
_/ _/ _/ _/
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4._____________________________________________________________________________________________________________________________
(Jabrlanuvchi shaxsni hisobga olgan xodimning F.I.O. va lavozimi)
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5. Jabrlanuvchi zarar ko‘rgan holat: MJtKning ________-moddasi, ______-qismi
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6. Jabrlanuvchiga yetkazilgan zarar;“1” — ma’naviy; ;“2” — jismoniy;“3” — mulkiy;
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6. / _/
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7. Jabrlanuvchiga yetkazilgan zarar miqdori: _________________so‘m.
_______________chet el valyuta.
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8. Jabrlanuvchi shaxsning, familiyasi __________________________________
ismi _____________________, otasining ismi ___________________________
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9. Jabrlanuvchi tug‘ilgan sana; “____” _____________ ________ yil.
9.1 Jabrlanuvchining yoshi; “1” — �o‘dak; “2” — 6 yoshgacha bo‘lgan bola;“3” — 7 — 13 yosh; “4” — 14-15 yosh; “5” — 16-17 yosh; “6” — 18 — 24 yosh; “7” — 25 — 30 yosh ; “8” — 31 — 49 yosh ; “9” — 50 — 59 yosh;“10” — 60 yosh va undan katta.
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