（首页） 共 页
案由：______________________________________
调查机关：__________________________________
承办人：____________________________________
调查时间：__________________________________
当事人情况：________________________________
经调查认定的主要违法事实：
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
处理意见：
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________
承办人签名：______（盖章）
_______年_______月______日
