立（撤） 案 审 批 表

案件名称：                                                

案件来源：                                                

案发时间：             案发地点：                        

当 事 人：          法定代表人（负责人）：               

地址（住址）：    联系电话：              

                                                                             案情及立（撤） 案理由：                                                 

承办人：                    

年  月  日

承办处（科、股）室意见：                                                 

负责人：                                   

年   月   日 

                                                                             审批意见：                                                                   

负责人：                                

年  月   日