P U N O M O Ć

kojom ja:__________________________________________________________________
( ime i prezime )

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( adresa )

ovlašćujem________________________________________________________________
( ime i prezime osobe kojoj se daje punomoć) JMBG (jedinstveni matični broj građanina)

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(Adresa)

za poduzimanje slijedećih radnji:

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Ukoliko bi opunomoćenik bio spriječen da me zastupa ovlašćujem zamjenika u osobi:

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( ime i prezime zamjenika ) JMBG ( jedinstveni matični broj građanina )

POTPIS DAVAOCA PUNOMOĆI

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ul. Butmirska cesta br. 12, 71210 Ilidža, Sarajevo, BiH,

tel/fax. 00387 33 775-649, centrala 77 56 00
www.opcinailidza.ba; e-mail press@bih.net.

OB-QMS-851-15; izd.3.; 14.11.2018. Stranica 1 od 1