CEREREpentru înscrierea modificărilor actului constitutiv şi/sau statutului*)

*) Inclusiv schimbarea sediului persoanei juridice fără scop patrimonial. __________________________________________________________________________| 1. Persoana împuternicită pentru efectuarea procedurii: || - Numele/Denumirea ..................................................... || - Domiciliul/Sediul .................................................... ||__________________________________________________________________________| __________________________________________________________________________| 2. Denumirea persoanei juridice fără scop patrimonial .................. ||__________________________________________________________________________| __________________________________________________________________________| 3. Sediul: || - judeţul .............................................................. || - localitatea .......................................................... || - adresa ............................................................... || - telefon .............................................................. || - fax .................................................................. || - e-mail ............................................................... ||__________________________________________________________________________| __________________________________________________________________________| 4. Modificarea se referă la ............................................ ||__________________________________________________________________________| __________________________________________________________________________| 5. Actul modificator: actul adiţional autentificat de ...... sub nr. ... || din data de .................. ||__________________________________________________________________________| __________________________________________________________________________| 6. Temeiul juridic al cererii: Ordonanţa Guvernului nr. 26/2000 ||__________________________________________________________________________| __________________________________________________________________________| 7. Înscrisuri doveditoare: || - Actul adiţional ............. exemplare || - Alte acte ............................ ||__________________________________________________________________________| __________________________________________________________________________| 8. Taxa judiciară de timbru ............. lei, conform ................. ||__________________________________________________________________________| __________________________________________________________________________| 9. Timbru judiciar .................. lei ||__________________________________________________________________________| __________________________________________________________________________| 10. Data || 11. Semnatura ||__________________________________________________________________________|