‫ﺗﺻﺭﻳﺢ ﺷﺭﻓﻲ‬

‫__________________________________________________________________________‬ ‫ﺃﻧﺎ ﺍﻟﻣﻣﺿﻲ ﺃﺳﻔﻠﻪ ﺍﻟﺳﻳﺩ )ﺓ(‬

‫ﻣﻐﺭﺑﻲ )ﺓ( ﺍﻟﺟﻧﺳﻳﺔ ﺑﻁﺎﻗﺗﻪ )ﻫﺎ( ﺍﻟﻭﻁﻧﻳﺔ ﺭﻗﻡ____________________________________________________________‬

‫ﺍﻟﻘﺎﻁﻥ )ﺓ( ﺏ ______________________________________________________________________________________‬

‫‪ ‬ﺍﻛﺎﺩﻳﺭ‬ ‫‪ ‬ﻓﺎﺱ‬ ‫ﻣﻭﻅﻑ ﺑﻔﺭﻭﻉ ﺍﻟﻣﻣﻠﻛﺔ ﺍﻟﻣﻐﺭﺑﻳﺔ ‪  :‬ﺍﻟﺩﺍﺭ ﺍﻟﺑﻳﺿﺎء‬

‫ﻣﺳﺟﻝ ﺑﺎﻟﺗﺎﻣﻳﻥ ﺍﻟﺻﺣﻲ ﻟﺩﻯ ﺍﻟﻣﺟﻣﻭﻋﺔ ﺍﻟﻌﺭﺑﻳﺔ ﻟﻠﺗﺎﻣﻳﻥ ﺗﺣﺕ ﺭﻗﻡ ‪__________________________ :‬‬

‫ﺃﺻﺭﺡ ﺑﻣﺎ ﻳﻠﻲ ‪:‬‬

‫ﺍﻟﻔﺻــﻝ ﺍﻷﻭﻝ‪ :‬ﺃﻧﻧﻲ ﺃﺗﻣﺗﻊ ﺑﺻﺣﺔ ﺟﻳﺩﺓ ﻭ ﻻ ﺃﻋﺎﻧﻲ ﻣﻥ ﺃﻱ ﻣﺭﺽ ﻣﻌﺩ – ﻭ ﺃﻥ ﺟﻣﻳﻊ ﺍﻟﺑﻳﺎﻧﺎﺕ ﻭ ﺍﻟﻣﻌﻠﻭﻣﺎﺕ ﺍﻟﺗﻲ‬
‫ﺃﺩﻟﻳﺕ ﺑﻬﺎ ﻟﻠﻣﺅﺳﺳﺔ ﺍﻟﻣﺷﻐﻠﺔ )ﺍﻟﻣﺟﻣﻭﻋﺔ ﺍﻟﻌﺭﺑﻳﺔ ﻟﻠﺗﺎﻣﻳﻥ ( ‪ -‬ﺻﺣﻳﺣﺔ ﻭ ﻣﻭﺛﻭﻗﺔ – ﻭ ﺃﻧﻲ ﺃﺗﻌﻬﺩ ﺑﺎﻟﺣﺿﻭﺭ ﺇﻟﻰ ﻣﻘﺭ‬
‫ﺍﻟﻌﻣﻝ ﻓﻭﺭ ﺍﻻﻓﺗﺗﺎﺡ ﺍﻟﺭﺳﻣﻲ ﻟﻠﻔﺭﻉ ‪ ,‬ﻭ ﻓﻲ ﺣﺎﻟﺔ ﺗﻐﻳﺑﻲ ﺑﺩﻭﻥ ﻣﺑﺭﺭ ﻗﺎﻧﻭﻧﻲ ﺃﻭ ﻋﺫﺭ ﻣﻘﺑﻭﻝ ‪ ,‬ﻓﺎﻥ ﻋﻘﺩ ﺍﻟﻌﻣﻝ ﺍﻟﺫﻱ‬
‫ﻳﺭﺑﻁﻧﻲ ﺑﺎﻟﻣﺅﺳﺳﺔ ﻳﺗﻡ ﺇﻟﻐﺎﺋﻪ ‪ ,‬ﻭ ﺃﻋﻁﻲ ﻟﻠﻣﺅﺳﺳﺔ ﺍﻟﻣﺷﻐﻠﺔ ﺍﻟﺣﻖ ﺑﺗﻌﻭﻳﺿﻲ ﺑﻣﻭﻅﻑ ﺁﺧﺭ ﻣﻥ ﻻﺋﺣﺔ ﺍﻻﻧﺗﻅﺎﺭ ﺩﻭﻥ‬
‫ﺃﻱ ﺍﻋﺗﺭﺍﺽ ﻣﻧﻲ ‪..‬ﻭ ﺩﻟﻙ ﺣﺳﺏ ﻣﻘﺗﺿﻳﺎﺕ ﺍﻟﻘﺎﻧﻭﻥ ﺍﻷﺳﺎﺳﻲ ﻟﻠﻣﺟﻣﻭﻋﺔ‪.‬‬
‫ﺍﻟﻔﺻـﻝ ﺍﻟﺛﺎﻧﻲ‪ :‬ﺃﺻﺭﺡ ﺃﻧﻧﻲ ﺃﺩﻳﺕ ﻣﺻﺎﺭﻳﻑ ﺍﻹﺭﺳﺎﻝ ﺍﻟﺑﺭﻳﺩﻱ ﻟﻣﺅﺳﺳﺔ ﺍﻟﺑﺭﻳﺩ ﻭ ﺍﻟﺷﺣﻥ ﺍﻟﺩﻭﻟﻲ ﺑﺩﺑﻲ ﺑﺗﺎﺭﻳﺦ ‪:‬‬
‫____________________________________________________‬

‫ﺍﻟﻔﺻـﻝ ﺍﻟﺛﺎﻟﺙ‪ :‬ﻧﻌﻡ‪ ,‬ﺃﻭﺍﻓﻖ ﻋﻠﻰ ﺍﻧﻪ ﻓﻲ ﺣﺎﻟﺔ ﻋﺩﻡ ﺍﻟﺗﺣﺎﻗﻲ ﺑﺎﻟﻌﻣﻝ ﻓﻲ ﺍﻟﻳﻭﻡ ﺍﻟﻣﺣﺩﺩ ﺑﻘﺭﺍﺭ ﺍﻟﺗﻌﻳﻳﻥ ﺩﻭﻥ ﻣﺑﺭﺭ ﻗﺎﻧﻭﻧﻲ‬
‫ﻓﺎﻧﻪ ﻻ ﻳﺣﻖ ﻟﻲ ﺍﻟﻣﻁﺎﻟﺑﺔ ﺑﺗﻌﻭﻳﺿﻲ ﻭ ﺍﺳﺗﺭﺟﺎﻉ ﻣﺻﺎﺭﻳﻑ ﺍﻹﺭﺳﺎﻝ ﺍﻟﺑﺭﻳﺩﻱ ﻣﻥ ﺇﺩﺍﺭﺓ ﺍﻟﻔﺭﻉ ﺑﺎﻟﻣﻐﺭﺏ ‪.‬‬

‫ﺑﺗﺎﺭﻳﺦ ‪:‬‬ ‫ﺍﻟﺗﻭﻗﻳﻊ ‪:‬‬ ‫ﺍﻻﺳﻡ ﺍﻟﻛﺎﻣﻝ ‪:‬‬

‫‪-------------------/----------------/2020‬‬ ‫‪----------------------------------------------------------‬‬ ‫‪---------------------------------------------------------‬‬

‫ﺗﺻﺣﻳﺢ ﺍﻹﻣﺿﺎء ﻣﻥ ﻁﺭﻑ ﺍﻟﺳﻠﻁﺔ ﺍﻟﻣﺣﻠﻳﺔ‬