Mu s 09-CT/TC

CNG HA X HI CH NGHA VIT NAM

c lp - T do - Hnh phc
----------------

HP NG HY B
HP NG TNG CHO
Ti y ban nhn dn qun (huyn)..thnh ph
H Ch Minh (Trng hp vic chng thc c thc hin ngoi tr s th ghi a im
thc hin chng thc v y ban nhn dn qun (huyn), chng ti gm c:
Bn tng cho (sau y gi l Bn A):
ng (B):..................................................................................................................
Sinh ngy:................................................................................................................
Chng minh nhn dn s:.......................cp ngy..................................................
ti.............................................................................................................................
H khu thng tr (trng hp khng c h khu thng tr th ghi ng k tm tr):.....
.................................................................................................................................
Hoc c th chn mt trong cc ch th sau:
1. Ch th l v chng:

ng : .......................................................................................................................
Sinh ngy:................................................................................................................
Chng minh nhn dn s:.......................cp ngy..................................................
ti.............................................................................................................................
H khu thng tr: ...............................................................................................
.................................................................................................................................
Cng v l b: .........................................................................................................
Sinh ngy:................................................................................................................
Chng minh nhn dn s:.......................cp ngy..................................................
ti.............................................................................................................................
H khu thng tr:................................................................................................
.................................................................................................................................
(Trng hp v chng c h khu thng tr khc nhau, th ghi h khu thng tr ca tng
ngi).
2. Ch th l h gia nh:

H v tn ch h: ....................................................................................................
Sinh ngy:................................................................................................................
Chng minh nhn dn s:.......................cp ngy..................................................
ti.............................................................................................................................
H khu thng tr:................................................................................................
.................................................................................................................................
Mu ny c ban hnh km theo Quyt nh s
ca y ban nhn dn thnh ph H Ch Minh.

123/2005/Q-UBND ngy 15 thng 7 nm 2005

Mu s 09-CT/TC

Cc thnh vin ca h gia nh:

- H v tn:..............................................................................................................
Sinh ngy:................................................................................................................
Chng minh nhn dn s:.......................cp ngy..................................................
ti.............................................................................................................................
H khu thng tr:................................................................................................
.................................................................................................................................
* Trong trng hp cc ch th nu trn c i din th ghi:

H v tn ngi i din:........................................................................................
Sinh ngy:................................................................................................................
Chng minh nhn dn s:.......................cp ngy..................................................
ti.............................................................................................................................
H khu thng tr:................................................................................................
.................................................................................................................................
Theo giy y quyn (trng hp i din theo y quyn) s: ..
ngy .do ..lp.
3.. Ch th l t chc:

Tn t chc: ............................................................................................................
Tr s: .....................................................................................................................
Quyt nh thnh lp s:.........................................ngy........thng ......nm.........
do ....................................................................................................................cp.
Giy chng nhn ng k kinh doanh s:.................ngy......thng.......nm.........
do ....................................................................................................................cp.
S Fax: ...............................................S in thoi:..............................................
H v tn ngi i din: .......................................................................................
Chc v: .................................................................................................................
Sinh ngy:...............................................................................................................
Chng minh nhn dn s:.......................cp ngy..................................................
ti.............................................................................................................................
Theo giy y quyn (trng hp i din theo y quyn) s: ..
ngy .do ..lp.
Bn c tng cho (sau y gi l Bn B):
(Chn mt trong cc ch th nu trn)
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................
....................................................................................................................................................

Mu ny c ban hnh km theo Quyt nh s

ca y ban nhn dn thnh ph H Ch Minh.

123/2005/Q-UBND ngy 15 thng 7 nm 2005

Mu s 09-CT/TC

Nguyn trc y hai bn A v B c k Hp ng tng cho c .

..... chng nhn (chng thc) ngy
.., s ...., quyn s ... Theo , Bn A tng
cho
Bn
B
ti
sn
l

Nay hai bn ng hy b Hp ng nu trn vi cc ni dung sau y:

IU 1
NI DUNG THA THUN HY B
Ghi c th ni dung tha thun lin quan n vic hy b Hp ng tng cho ti sn
nh l do ca vic hy b Hp ng, giao li ti sn tng cho (thi hn, phng thc), yu
cu bi thng thit hi (nu c)...

...............................................................................................................................
...............................................................................................................................
...............................................................................................................................
...............................................................................................................................
...............................................................................................................................
IU 2
VIC NP L PH CHNG THC
L ph chng thc Hp ng ny do Bn.....chu trch nhim np.
IU 3
PHNG THC GII QUYT TRANH CHP
Trong qu trnh thc hin Hp ng m pht sinh tranh chp, cc bn
cng thng lng trn nguyn tc tn trng quyn li ca nhau; trong trng
hp khng thng lng c, th mt trong hai bn c quyn khi kin yu
cu ta n c thm quyn gii quyt theo quy nh ca php lut.
IU 4
CAM OAN CA CC BN
Bn A v bn B chu trch nhim trc php lut v nhng li cam oan
sau y:
1. Vic giao kt Hp ng ny hon ton t nguyn, khng b la di
hoc p buc;
Mu ny c ban hnh km theo Quyt nh s
ca y ban nhn dn thnh ph H Ch Minh.

123/2005/Q-UBND ngy 15 thng 7 nm 2005

Mu s 09-CT/TC

2. Thc hin ng v y tt c cc tha thun ghi trong Hp ng

ny;
3. Cc cam oan khc .
IU 5
IU KHON CUI CNG
1. Hai bn cng nhn hiu r quyn, ngha v v li ch hp php ca
mnh, ngha v hu qu php l ca vic giao kt Hp ng ny;
2. Hai bn c Hp ng, hiu v ng tt c cc
iu khon ghi trong Hp ng v k vo Hp ng ny trc s
c mt ca Ngi c thm quyn chng thc.
Hoc chn mt trong cc trng hp sau y:
- Hai bn c Hp ng, hiu v ng tt c cc

iu khon ghi trong Hp ng v k, im ch vo Hp

ng ny trc s c mt ca Ngi c thm quyn chng thc.
- Hai bn c Hp ng, hiu v ng tt c cc
iu khon ghi trong Hp ng v im ch vo Hp ng
ny trc s c mt ca Ngi c thm quyn chng thc.
- Hai bn nghe Ngi c thm quyn chng thc c Hp
ng, hiu v ng tt c cc iu khon ghi trong Hp
ng v k vo Hp ng ny trc s c mt ca Ngi c thm
quyn chng thc.
- Hai bn nghe Ngi c thm quyn chng thc c Hp
ng, hiu v ng tt c cc iu khon ghi trong Hp
ng v k, im ch vo Hp ng ny trc s c mt ca
Ngi c thm quyn chng thc.
Hai bn nghe Ngi c thm quyn chng thc c
Hp ng, hiu v ng tt c cc iu khon ghi trong
Hp ng v im ch vo Hp ng ny trc s c mt ca
Ngi c thm quyn chng thc.
Hai bn nghe ngi lm chng c Hp ng, hiu v ng tt
c cc iu khon ghi trong Hp ng v k vo Hp ng ny trc s c mt
ca Ngi c thm quyn chng thc;
Hai bn nghe ngi lm chng c Hp ng, hiu v ng tt
c cc iu khon ghi trong Hp ng v k, im ch vo Hp ng ny trc
s c mt ca Ngi c thm quyn chng thc;
Hai bn nghe ngi lm chng c Hp ng, hiu v ng tt
c cc iu khon ghi trong Hp ng v im ch vo Hp ng ny trc s
c mt ca Ngi c thm quyn chng thc;
4
Mu ny c ban hnh km theo Quyt nh s
ca y ban nhn dn thnh ph H Ch Minh.

123/2005/Q-UBND ngy 15 thng 7 nm 2005

Mu s 09-CT/TC

3. Hp ng ny c hiu lc t.....................................................................
Bn A

Bn B

(k, im ch v ghi r h tn)

(k, im ch v ghi r h tn)

LI CHNG CA NGI C THM QUYN CHNG THC

Ngy .. thng .. nm ...(bng ch....)
(Trng hp chng thc ngoi gi lm vic hoc theo ngh ca ngi yu cu
chng thc c thc hin ngoi gi lm vic, th ghi thm gi, pht v cng ghi bng ch
trong du ngoc n)

Ti y ban nhn dn qun (huyn) .... thnh ph H Ch Minh.

(Trng hp vic chng thc c thc hin ngoi tr s, th ghi a im thc hin
chng thc v y ban nhn dn)
Ti (ghi r h tn, chc v ca ngi thc hin chng thc) .,

qun (huyn) ....thnh ph H Ch

Minh.
Chng thc:
- Hp ng hy b Hp ng tng cho ny c giao kt gia Bn A
l. v Bn B l...; cc bn t nguyn tha
thun giao kt Hp ng v cam oan chu trch nhim trc php lut v ni
dung Hp ng;
- Ti thi im chng thc, cc bn giao kt Hp ng u c nng lc
hnh vi dn s ph hp theo quy nh ca php lut;
- Ni dung tha thun ca cc bn ph hp vi php lut, o c x hi;
- Cc bn giao kt c Hp ng ny, ng ton b ni dung ghi
trong Hp ng v k vo Hp ng ny trc s c mt ca ti;
Hoc c th chn mt trong cc trng hp sau y:

- Cc bn giao kt c Hp ng ny, ng ton b ni dung ghi

trong Hp ng v k, im ch vo Hp ng trc s c mt ca ti;
- Cc bn giao kt c li Hp ng ny, ng ton b ni dung ghi
trong Hp ng v im ch vo Hp ng trc s c mt ca ti;

Mu ny c ban hnh km theo Quyt nh s

ca y ban nhn dn thnh ph H Ch Minh.

123/2005/Q-UBND ngy 15 thng 7 nm 2005

Mu s 09-CT/TC

- Cc bn giao kt nghe Ngi c thm quyn chng thc c Hp ng

ny, ng ton b ni dung ghi trong Hp ng v k vo Hp ng
trc s c mt ca ti;
- Cc bn giao kt nghe Ngi c thm quyn chng thc c Hp ng
ny, ng ton b ni dung ghi trong Hp ng ny v im ch vo
Hp ng trc s c mt ca ti;
- Cc bn giao kt nghe Ngi c thm quyn chng thc c li Hp
ng ny, ng ton b ni dung ghi trong Hp ng v k, im ch
vo Hp ng trc s c mt ca ti;
Hai bn nghe ngi lm chng c Hp ng, hiu v ng tt
c cc iu khon ghi trong Hp ng v k vo Hp ng ny trc s c mt
ca ti;
Hai bn nghe ngi lm chng c Hp ng, hiu v ng tt
c cc iu khon ghi trong Hp ng v k, im ch vo Hp ng ny trc
s c mt ca ti;
- Hai bn nghe ngi lm chng c Hp ng, hiu v ng tt c
cc iu khon ghi trong Hp ng v im ch vo Hp ng ny trc s c
mt ca ti;
- Hp ng ny c lp thnh ... bn chnh (mi bn chnh gm .....
t, ..trang), cp cho :
+ Bn A .. bn chnh
+ Bn B.. bn chnh
+ Lu ti Phng T php mt bn chnh.
- S chng thc.. , quyn s ..TP/CC- ....
Ngi c thm quyn chng thc
(k, ng du v ghi r h tn, chc v)

Mu ny c ban hnh km theo Quyt nh s

ca y ban nhn dn thnh ph H Ch Minh.

123/2005/Q-UBND ngy 15 thng 7 nm 2005