CNG HA X HI CH NGHA VIT NAM

c lp - T do - Hnh phc
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BN CAM KT
Knh gi:......................................................................................
Tn c nhn/t chc: (ti/chng ti).......................................................................................
M s thu (nu c):................................................................................................................
S CMND/h chiu/KKD:............................Ngy cp:......................Ni cp:..................
a ch c tr/tr s:...............................................................................................................
Ni lm vic (nu c):.............................................................................................................
in thoi lin h:...................................................................................................................

Ti cam kt cc ni dung sau y

1...............................................................................................................................................
2...............................................................................................................................................
3...............................................................................................................................................
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5...............................................................................................................................................
(xem hng dn ghi ni dung bn di)

Ti/chng ti ngh:
1...............................................................................................................................................
2...............................................................................................................................................
3...............................................................................................................................................
Ti/chng ti hon ton chu trch nhim v tnh chnh xc ca thng tin nu trn.
., ngy thng nm....
C NHN/PHP NHN CAM KT
(K, ghi r h tn)

Hng dn ghi ni dung: Phn ny ghi r ni dung c th tha thun vit cam kt
ca c nhn hoc t chc (v d: Nu c cp c thm quyn cho php c nhn
chuyn nhng chng ti s tip tc thc hin d n, c ngha v vi khch hng v cc
bn c lin quan.).