政府示范
合同预览图

国家赔偿申请书(最高法院2016版)

204次浏览 1次下载 共2页 发布日期:2016-09-28
免费模版
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.1//EN" "http://www.w3.org/TR/xhtml11/DTD/xhtml11.dtd"><html xmlns="http://www.w3.org/1999/xhtml"><head><meta http-equiv="Content-Type" content="application/xhtml+xml; charset=utf-8" /><title></title><style type="text/css">body{ font-family:'Times New Roman'; font-size:1em; } p {padding:0;margin-top:5pt;margin-right:0;margin-bottom:5pt;margin-left:0;} ul, ol{ margin-top: 0; margin-bottom: 0; } .Normal{page-break-inside:auto;page-break-after:auto;page-break-before:auto;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;font-size:11.0pt;font-family:SimSun;mso-fareast-font-family:宋体;mso-bidi-font-family:Arial;lang:EN-US;mso-fareast-language:EN-US;mso-ansi-language:AR-SA;} .Heading-1{page-break-inside:avoid;page-break-after:avoid;page-break-before:auto;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;color:#3B608D;font-size:14.0pt;font-family:SimSun;mso-fareast-font-family:宋体;mso-bidi-font-family:'Times New Roman';font-weight:bold;} .Default-Paragraph-Font{font-size:11.0pt;font-family:SimSun;mso-fareast-font-family:宋体;mso-bidi-font-family:Arial;lang:EN-US;mso-fareast-language:EN-US;mso-ansi-language:AR-SA;} .Normal-Table{} .Heading-1-Char{color:#3B608D;font-size:14.0pt;font-family:SimSun;mso-fareast-font-family:宋体;mso-bidi-font-family:'Times New Roman';font-weight:bold;} </style></head><body style="pagewidth:612.0pt;pageheight:792.0pt;"><div class="Section0"><div style="min-height:72pt" /> <p class="Heading-1" style="text-align:center;line-height:1.0;"><span style="color:#000000;font-size:18.0pt;font-family:SimSun;mso-fareast-font-family:宋体;mso-bidi-font-family:SimSun;font-weight:bold;">国家赔偿申请书</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;font-weight:bold;">赔偿请求人:</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">                </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(写明姓名或名称等基本情况)。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;font-weight:bold;">赔偿义务机关:</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">                </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(写明名称、住所地)。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">法定代表人:</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">                </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(写明姓名、职务)。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;font-weight:bold;">复议机关:</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">                </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(写明名称、住所地)。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">法定代表人:</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">        </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(写明姓名、职务)。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">        </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(赔偿请求人姓名或名称)因</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">        </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(申请国家赔偿的案由),申请</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">        </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(赔偿义务机关名称)</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">                </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(申请国家赔偿的具体要求)。</span></p> <p class="Normal" style="line-height:1.0;font-size: 12pt;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">&#xa0;</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;font-weight:bold;">事实与理由:</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">主要是认为赔偿义务机关及其工作人员侵权造成赔偿请求人合法权益损害的事实和根据;已经向赔偿义务机关申请国家赔偿、向复议机关申请复议,认为赔偿义务机关、复议机关作出决定错误的理由,或者逾期不作出决定的事实和证据;根据有关法律规定应当获得国家赔偿的理由)。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;font-weight:bold;">证据和证据来源,证人姓名和住址</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">)。</span></p> <p class="Normal" style="line-height:1.0;font-size: 12pt;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">&#xa0;</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">此致</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">        </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">人民法院赔偿委员会</span></p> <p class="Normal" style="line-height:1.0;font-size: 12pt;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">&#xa0;</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">附:</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">                </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(本国家赔偿申请书副本三份和有关法律文书及证明材料目录)</span></p> <p class="Normal" style="line-height:1.0;font-size: 12pt;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">&#xa0;</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">赔偿请求人</span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;text-decoration: underline;">        </span><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">(签名或盖章)</span></p> <p class="Normal" style="line-height:1.0;font-size: 12pt;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">&#xa0;</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">年    月    日</span></p> <p class="Normal" style="line-height:1.0;font-size: 12pt;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">&#xa0;</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">制作说明</span></p> <p class="Normal" style="line-height:1.0;font-size: 12pt;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">&#xa0;</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">1.本申请书样式供赔偿请求人向人民法院赔偿委员会申请作出赔偿决定时使用。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">2.赔偿请求人是自然人的,写明其姓名、性别、有效身份证件号码(包括身份证号、军官证号、护照号等)、民族、职业(或工作单位和职务)、住址、送达地址、联系电话;有别名或者曾用名,应在姓名之后用括号标明。赔偿请求人是法人的,写明其名称、住所地,并写明法定代表人的姓名和职务、联系电话。赔偿请求人是依法成立的不具备法人资格的其他组织的,写明其名称和住所地,并写明负责人姓名和职务、联系电话。赔偿请求人有法定代理人,应写明其姓名、性别、职业(或工作单位和职务)及住址、联系电话。赔偿请求人有委托代理人的,应写明其姓名、性别、职业(或工作单位和职务)及住址、联系电话。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">3.赔偿请求人依法应向复议机关申请复议的,应当写明复议机关的决定内容或逾期不作出决定的情形。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">4.国家赔偿申请书尾部的“此致×××人民法院赔偿委员会”为申请指向的人民法院赔偿委员会名称。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">5.“附有关法律文书及证明材料”根据具体情况分别列项标注。</span></p> <p class="Normal" style="line-height:1.0;"><span style="color:#000000;font-size:12.0pt;font-family:SimSun;mso-bidi-font-family:SimSun;">6.赔偿请求人提交的国家赔偿申请书用A4纸打印或书写,书写时应字迹清楚,避免使用铅笔、圆珠笔或者红色、纯蓝色墨水等易褪色不易长期保存的工具材料书写。</span></p> </div></body></html>

最新合同

相关合同

企业风控大师