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VIOLATION REPORT

Full name of reporter: …………….. ……..…..


Full name of violated person: .………………………....
Date / time of violation: ……………….……..……………………………………………………..
Date / time of finding violation:…………………………………………………………………….
I. Contents of violation (specify damages, if any ):
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II. Violated person’s opinion:
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III. Comments of direct incharge
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IV. Conclusion of solving
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Date………../………../ 2015
Recorder Person Violated Person
Signature Signature

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