IME I PREZIME: __________________________

ADRESA:________________________________
OIB:_____________________________________

OPĆINSKI SUD U SESVETAMA

Na posl. broj: __________________________

Za potrebe predmeta – broj gornji, u prilogu ovog dopisa dostavljam: ___________

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________.

U Sesvetama, _______________________

Potpis:

______________________