调查笔录(首页)

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案件名称：                 

调查地点：                  

调查时间：   年    月    日    时   分至   时    分

被调查人：      性别：    年龄：    职务：                 与本案关系：          工作单位：                                                住    址：            联系电话：                       

调 查 人：                                                

单    位：                                                

记 录 人：                                                

我们是                       粮食局的执法人员（姓名）                    ，执法证件编号是：             

我们依法向你调查                         的有关情况，请予以配合。

调查记录：问：                                                           

 答：                                                                                                                                                 

 问：                                                                         

 答：                                                                         

 问：                                                                         

 答：                                                                     

 问：                                                                                             

 答：                                                                        

 问：                                                                                             

注：被调查人应在每页调查笔录和修改处签字、盖章或摁指印。

调查笔录(末页)

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  问：                                                                      

  答：                                                                        

  问：                                                                        

  答：                                                                    

  问：                                                                        

  答：                                                                    

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  答：                                                                        

被调查人：以上笔录我已看过，与本人所述无异。              

                                 签名：                                                                                                        

调查人（签名）：                                                                                                          

注：该文书为相关执法文书的末页。