公安机关
听证报告书
案由______________________________________________________________________________________
时间_____ 年_____月_____日____时_____分 至_____ 年_____月_____日____时_____分
地点______________________________________ 举行方式______________________________________
听证主持人__________________________________
听证员______________________________________
记录员______________________________________
违法嫌疑人__________________________________
法定代理人__________________________________
委托代理人__________________________________
本案其他利害关系人__________________________
本案其他利害关系人的代理人__________________
本案办案人员________________________________
听证会基本情况_______________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
案件事实_____________________________________________________________________________________________________
处理意见和建议_______________________________________________________________________________________________
听证主持人（签名）：
_____年____月_____日
