ÓÀØÀÒÈÅÄËÏÓ ÛÒÏÌÉÓ, ãÀÍÌÒÈÄËÏÁÉÓÀ

ÃÀ ÓÏÝÉÀËÖÒÉ ÃÀÝÅÉÓ ÌÉÍÉÓÔÒÉÓ

2007 ß.9 ÀÂÅÉÓÔÏÓ № 338/Í ÁÒÞÀÍÄÁÉÈ
ÓÀÌÄÃÉÝÉÍÏ ÃÏÊÖÌÄÍÔÀÝÉÀ ×ÏÒÌÀ № IV – 100/À
Ý Í Ï Á À
ãÀÍÌÒÈÄËÏÁÉÓ ÌÃÂÏÌÀÒÄÏÁÉÓ ÛÄÓÀáÄÁ
1. ÝÍÏÁÉÓ ÂÀÌÝÄÌÉ ÃÀßÄÓÄÁÖËÄÁÉÓ ÃÀÓÀáÄËÄÁÀ ÃÀ ÌÉÓÀÌÀÒÈÉ __________________________________
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2. ÃÀßÄÓÄÁÖËÄÁÉÓ ÃÀÓÀáÄËÄÁÀ ÃÀ ÌÉÓÀÌÀÒÈÉ ÓÀÃÀÝ ÉÂÆÀÅÍÄÁÀ ÝÍÏÁÀ ____________________________
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3. ÐÀÝÉÄÍÔÉÓ ÓÀáÄËÉ ÃÀ ÂÅÀÒÉ _____________________________________________________________
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4. ÃÀÁÀÃÄÁÉÓ ÈÀÒÉÙÉ (ÒÉÝáÅÉ / ÈÅÄ / ßÄËÉ) _________________________________________________
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5. ÐÉÒÀÃÉ ÍÏÌÄÒÉ _______________________________________________________________________
(ÉÅÓÄÁÀ 16 ßÄËÓ ÌÉÙßÄÖËÉ ÐÉÒÉÓ ÛÄÌÈáÅÄÅÀÛÉ)
6. ÌÉÓÀÌÀÒÈÉ ___________________________________________________________________________
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7. ÓÀÌÖÛÀÏ ÀÃÂÉËÉ ÃÀ ÈÀÍÀÌÃÄÁÏÁÀ, (ÌÏÓßÀÅËÉÓ / ÓÔÖÃÄÍÔÉÓ ÛÄÌÈáÅÄÅÀÛÉ – ÉÌ ÓÀÓßÀÅËÏ
ÃÀßÄÓÄÁÖËÄÁÉÓ / ÓÊÏËÉÓ ÃÀÓÀáÄËÄÁÀ ÃÀ ÊËÀÓÉ / ÊÖÒÓÉ, ÓÀÃÀÝ ÉÂÉ ÓßÀÅËÏÁÓ) ___________________
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8. ÈÀÒÉÙÄÁÉ: À) ÀÌÁÖËÀÔÏÒÉÀÛÉ ÌÉÌÀÒÈÅÉÓ _________________________________________________
Á) ÓÔÀÝÉÏÍÀÒÛÉ ÂÀÂÆÀÅÍÉÓ _____________________________________________________
Â) ÓÔÀÝÉÏÍÀÒÛÉ ÌÏÈÀÅÓÄÁÉÓ ___________________________________________________
Ã) ÂÀßÄÒÉÓ __________________________________________________________________
9. ÃÀÓÊÅÍÀ ãÀÍÌÒÈÄËÏÁÉÓ ÌÃÂÏÌÀÒÄÏÁÉÓ ÛÄÓÀáÄÁ ÀÍ ÓÒÖËÉ ÃÉÀÂÍÏÆÉ (ÞÉÒÉÈÀÃÉ ÃÀÀÅÀÃÄÁÀ,
ÈÀÍÌáËÄÁÉ ÃÀÀÅÀÃÄÁÄÁÉ, ÂÀÒÈÖËÄÁÄÁÉ) ____________________________________________________
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10. ÂÃÃÀÔÀÍÉËÉ ÃÀÀÅÀÃÄÁÄÁÉ ______________________________________________________________
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11. ÌÏÊËÄ ÀÍÀÌÍÄÆÉ ______________________________________________________________________
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12. ÜÀÔÀÒÄÁÖËÉ ÃÉÀÂÍÏÓÔÉÊÖÒÉ ÂÀÌÏÊÅËÄÅÄÁÉ ÃÀ ÊÏÍÓÖËÔÀÝÉÄÁÉ _____________________________
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13. ÀÅÀÃÌÚÏ×ÏÁÉÓ ÌÉÌÃÉÍÀÒÄÏÁÀ __________________________________________________________
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14. ÜÀÔÀÒÄÁÖËÉ ÌÊÖÒÍÀËÏÁÀ _____________________________________________________________
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15. ÌÃÂÏÌÀÒÄÏÁÀ ÓÔÀÝÉÏÍÀÒÛÉ ÂÀÂÆÀÅÍÉÓÀÓ _________________________________________________
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16. ÌÃÂÏÌÀÒÄÏÁÀ ÓÔÀÝÉÏÍÀÒÉÃÀÍ ÂÀßÄÒÉÓÀÓ ________________________________________________
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17. ÓÀÌÊÖÒÍÀËÏ ÃÀ ÛÒÏÌÉÈÉ ÒÄÊÏÌÄÍÃÀÝÉÄÁÉ ______________________________________________
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18. ÌÊÖÒÍÀËÉ ÄØÉÌÉ _____________________________________________________________________
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19. ÃÀßÄÓÄÁÖËÄÁÉÓ áÀËÌÞÙÅÀÍÄËÉÓ / áÄËÌÞÙÅÀÍÄËÉÓ
ÌÏÀÃÂÉËÉÓ áÄËÌÏßÄÒÀ ____________________________________________________________

20. ÝÍÏÁÉÓ ÂÀÝÄÌÉÓ ÈÀÒÉÙÉ „___________“ „______________________“

ÁÄàÃÉÓ ÀÃÂÉËÉ .