申请人：_________性别：______身份证号：___________________
通信地址：______________________________联系方式___________
被申请人：_________________________________________________
法定代表人__________________职务___________________________
行政复议请求：_____________________________________________
事实与理由：_______________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
此 致
申请人：
年 月 日
行政复议申请书格式.doc
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