7/28/2019 M28_So yeu ly lich

1/2

M u 28(Ban hnh km theo Quyt nh s 617/Q-UBND-HC

ngy 28 thng 6 nm 2013 ca Ch tch UBND tnh ng Thp)

CNG HO X HI CH NGHA VIT NAMc lp - T do - Hnh phc

S YU L LCH

I. S lc l lch:- H v tn: .B danh: ................................- Ngy, thng, nm sinh: ..Nam/N: ................................- Ni sinh: ....................................................................................................................- Dn tc: ......................................................Quc tch: ...............................................- Thng tr ti: ...........................................................................................................

- Ngh nghip:.- n v cng tc hin nay (nu l cn b, cng chc)................................

II. Qu trnh o to, bi dng chuyn mn, nghip v:Tn trng hoc c

s o to, bidng

Chuyn ngnho to, bi dng

T thng, nmn thng, nm

Hnh thc oto, bi dng

Vnbng,

chng ch

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Ghi ch: Hnh thc o to, bi dng bao gm: Chnh qui, ti chc, chuyn tu, ..Vn bng bao gm: Tin s, thc s, bc s, dc s, c nhn, k s, cao ng, trung cp, ..

III. Qu trnh lm vic:

T thng, nmn thng, nm

lm nhng cng vic g (k c hp ng lao ng) trong c quan, n v, tchc no, u.

nh4 x 6

7/28/2019 M28_So yeu ly lich

2/2

M u 28(Ban hnh km theo Quyt nh s 617/Q-UBND-HC

ngy 28 thng 6 nm 2013 ca Ch tch UBND tnh ng Thp)

IV. Khen thng:

Thng, nm Ni dung v hnh thc khen thngCp quyt

nh

V. K lut:Thng, nm L do v hnh thc k lut

Cp quytnh

Ngi khaiTi xin cam oan v nhng li

khai trong bn l lch ny l ngs tht v chu trch nhim trcphp lut.............., ngy... thng ...nm........

(K tn, ghi r h tn)

XC NHNBn l lch ny do...t khai ti ...............................................................l ng s tht.

UBND/C QUAN....(C quan nu ngi t khai l CB, CC,VC)

..............., ngy .....thng .... nm ........(K tn, ghi r h tn v ng du)