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\ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 ce ucznia}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid8463082 /s\'b3uchacza*, kt\'f3rego dotyczy wniosek o zwolnienie z ww. op\'b3at }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 :

\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ltrpar\ql \fi-360\li1080\ri0\sl360\slmult1\widctlpar
\jclisttab\tx0\wrapdefault\faauto\ls2\rin0\lin1080\itap0\pararsid225149 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 Imi\'ea}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8463082 (-ona) i nazwisko }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462\charrsid3964856 .................................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8463082 .............................................................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \ltrpar\ql \fi-360\li1080\ri0\sl360\slmult1\widctlpar
\jclisttab\tx1080\wrapdefault\faauto\ls2\rin0\lin1080\itap0\pararsid225149 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 Data i miejsce urodzenia .........................................................................................}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8463082 .}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5572194 \hich\af0\dbch\af0\loch\f0 3.\tab}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5572194 PESEL\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85
\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8463082 \'85}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5572194\charrsid3964856 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 \hich\af0\dbch\af0\loch\f0 4.\tab}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 Imiona rodzic\'f3w .................
.....................................................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5572194 .............................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8463082 ...}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5572194 .}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5572194 \hich\af0\dbch\af0\loch\f0 5.\tab}}\pard \ltrpar\ql \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080\wrapdefault\faauto\ls2\rin0\lin1080\itap0\pararsid8198606 {\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid5572194 Miejsce}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid225149  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14378622\charrsid3964856 zameldowania}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10370049 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85ul
\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14378622 
\par }\pard \ltrpar\ql \li720\ri0\widctlpar\wrapdefault\faauto\rin0\lin720\itap0\pararsid8198606 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10370049 \tab \tab \tab \tab \tab }{\rtlch\fcs1 \af0 \ltrch\fcs0 \super\insrsid10370049 (kod, miejscowo\'9c\'e6)}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10370049\charrsid10370049 
\par }\pard \ltrpar\ql \li720\ri0\sb120\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin720\itap0\pararsid8198606 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10370049 nr domu \'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\super\insrsid10370049\charrsid10370049  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10370049 \'85\'85...................................tel. \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85.
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 \hich\af0\dbch\af0\loch\f0 6.\tab}}\pard \ltrpar\ql \fi-357\li1077\ri0\sl360\slmult1\widctlpar
\jclisttab\tx1080\wrapdefault\faauto\ls2\rin0\lin1077\itap0\pararsid8198606 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 Miejsce zamieszkania }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10370049 (gdy jest inne ni\'bf ,miejsce zameldowania)}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12073260 \'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13632851 
\par }\pard \ltrpar\ql \li720\ri0\widctlpar\wrapdefault\faauto\rin0\lin720\itap0\pararsid12073260 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12073260 \tab \tab \tab \tab \tab \tab \tab \tab \tab \tab }{\rtlch\fcs1 \af0 \ltrch\fcs0 \super\insrsid12073260 
(kod, miejscowo\'9c\'e6)}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12073260\charrsid3964856 
\par }\pard \ltrpar\ql \li720\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin720\itap0\pararsid225149 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 ul. ..............................}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid13632851\charrsid3964856 .......................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 nr domu ..................................... tel. ...........}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13632851\charrsid3964856 ....}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8075484 ..}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13632851\charrsid3964856 ....}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5572194 \hich\af0\dbch\af0\loch\f0 7.\tab}}\pard \ltrpar\ql \fi-360\li1080\ri0\sl360\slmult1\widctlpar\jclisttab\tx1080\wrapdefault\faauto\ls2\rin0\lin1080\itap0\pararsid225149 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5572194 Nazwa }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10370049 i siedziba }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5572194 szko\'b3y, klasa, }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 rok nauki}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8075484 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  .................................................}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid5572194 ............................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8075484 .....................................................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5572194 ..}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462\charrsid3964856 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 \hich\af0\dbch\af0\loch\f0 8.\tab}Adres szko\'b3y ............................................................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8075484 ul. }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 .....................................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8075484 ..}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 .......}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462 
\par }\pard \ltrpar\ql \li720\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin720\itap0\pararsid8075484 {\rtlch\fcs1 \af0 \ltrch\fcs0 \super\insrsid8075484 \tab \tab \tab (kod, miejscowo\'9c\'e6) }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\super\insrsid8075484\charrsid8075484 
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid12073260 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid12073260 II. Uzasadnienie wniosku}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12073260\charrsid12073260 \'85\'85\'85
\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid9582333\charrsid12073260 
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid3964856 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 ................................................................
.........................................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9582333\charrsid3964856 
.......................................................................................................................................................................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3964856\charrsid3964856 
.............................
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1668462 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3964856\charrsid3964856 ..................
..............................................................................................................................................................................................................................................................

\par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid3964856 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid3964856\charrsid3964856 III. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid12204703\charrsid3964856 Do wniosku nale
\'bfy za\'b3\'b9czy\'e6 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid12073260 nw. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid12204703\charrsid3964856 dokumenty }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid3964856\charrsid3964856 potwierdzaj\'b9ce}{\rtlch\fcs1 
\ab\af0 \ltrch\fcs0 \b\insrsid3964856\charrsid3964856 :
\par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1715996 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid12912833 1)}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid3964856\charrsid1715996  sytuacj\'ea rodzinn\'b9}{
\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid13370172  ucznia}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid1715996 , tj. za\'9cwiadczenie }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid1715996\charrsid1715996 o stanie rodzinnym}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 
\insrsid5572194  sporz\'b9dzone przez wnioskodawc\'ea }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid12912833 - }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid5572194 nale\'bfy wymieni\'e6 osoby }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid14499921 
z imienia i nazwiska wchodz\'b9ce w sk\'b3ad rodziny, stopie\'f1 pokrewie\'f1stwa, }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid12912833 ich }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid14499921 miejsce pracy, szko}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 
\insrsid12912833 \'b3\'ea w przypadku ucznia/s\'b3uchacza;}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid14499921  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9582333\charrsid1715996 
\par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid11361201 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 2)}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid12912833 w}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16394654 y}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 soko\'9c\'e6 \'9credniego dochodu netto, tj. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16394654 pomniejszonego o podatek dochodowy }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 od }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16394654 os\'f3b fizycznych, }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 o }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16394654 sk\'b3
adki na ubezpieczenie zdrowotne, ubezpieczenie spo\'b3eczne, kwot\'ea}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8198606  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16394654 aliment\'f3w \'9cwiadczonych na rzecz innych os\'f3b) }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid16394654\charrsid1384209 z mi}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16394654 esi\'b9ca poprzedzaj\'b9cego }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 miesi\'b9c, }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 \line }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid12912833 w kt\'f3rym z\'b3o\'bfono niniejszy wniosek}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 , w tym}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833  doch\'f3d wynikaj\'b9cy }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462\charrsid3964856 :
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1668462 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 a}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 ) }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid12912833 z wynagrodzenia }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 ze stosunku pracy}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 - ....................... z\'b3,}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462\charrsid3964856 
\par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid8198606 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8198606 b) }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 z dzia\'b3alno\'9cci gospodarczej wykonywanej osobi\'9c
cie, z umowy o dzie\'b3o, zlecenia, agencyjnej}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13370172  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 :
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1668462 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
 ...................................................... }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 - ......................... z\'b3,}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  ...................................................... }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 -............. ............ z\'b3, }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  ...................................................... }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 - ......................... z\'b3;}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par 3) z gospodarstwa rolnego}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3964856\charrsid3964856 (}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14499921 l}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3964856\charrsid3964856 iczba
}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  ha przeliczeniowych x stawka za {\*\xmlopen\xmlns2{\factoidname metricconverter}{\xmlattr\xmlattrns0{\xmlattrname ProductID}{\xmlattrvalue 1 ha}}}1 ha}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid12912833 {\*\xmlclose} przeliczeniowy) -\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 z\'b3;}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14499921 4) }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12912833 z emerytury/}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 renty}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10296013 *}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid14499921 /}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 renty strukturalnej}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10296013 *}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 -.............................z\'b3;
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 5) }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 z renty socjalnej-}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 
............................ z\'b3,}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par 6) }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ze \'9cwiadcze\'f1 rodzinnych, w tym z :}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par a) zasi\'b3}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ku}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  rodzinn}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ego oraz dodatk\'f3w}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462\charrsid3964856  do zasi\'b3ku rodzinnego}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 ......}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ............................ z\'b3
, }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 b) zasi\'b3ku piel\'eagnacyjnego-}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 .....}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ............................ z\'b3,}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 c) \'9cwiadczenia piel\'eagnacyjnego-}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 .}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ............................ z\'b3;}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 7) z zasi\'b3ku}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  dla bezrobotnych}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
.................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ................ z\'b3;}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 8) zasi\'b3ku sta\'b3ego}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  z pomocy spo\'b3ecznej}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462\charrsid3964856  ............................. z\'b3}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ;}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par 9) }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 z aliment\'f3w}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  ..}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ............................ z\'b3;}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462\charrsid3964856 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 10) dodatku mieszkaniowego-}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  ...}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ............................ z\'b3,}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462\charrsid3964856 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 11) innych dochod\'f3w-}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  ...}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 ............................ z\'b3;}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462\charrsid3964856 
\par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid8198606 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 12)}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788  pobieranych}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid3964856\charrsid3964856  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788  stypendi\'f3w}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  o charakterze socjalnym }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14499921 (}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3740931 wysoko\'9c\'e6 stypendium otrzymanego przez cz\'b3onka rodziny)}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9961788 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 ......................}{\rtlch\fcs1 
\af0 \ltrch\fcs0 \insrsid1861710 ............................}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 ......... z\'b3.
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid13970397 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \ul\insrsid1668462\charrsid3964856 Doch\'f3d miesi}{\rtlch\fcs1 \af0 \ltrch\fcs0 \ul\insrsid1668462\charrsid3964856 \'ea}{
\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \ul\insrsid1668462\charrsid3964856 czny w rodzinie wyni}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \ul\insrsid9961788 \'f3s\'b3}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \ul\insrsid8198606  .................z\'b3 (s\'b3ownie :}{\rtlch\fcs1 
\ab\af0 \ltrch\fcs0 \ul\insrsid9961788 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85.}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \ul\insrsid8198606 \line }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \ul\insrsid1668462\charrsid3964856 (suma ww. dochod\'f3w}{\rtlch\fcs1 \ab\af0 
\ltrch\fcs0 \ul\insrsid12211057 , tj.}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \ul\insrsid1668462\charrsid3964856  od 1-12)}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \ul\insrsid1668462 
\par }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \ul\insrsid9961788\charrsid3964856 
\par }\pard \ltrpar\qj \fi708\li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid7103873 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 Wy}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'bf}{\rtlch\fcs1 \ab\af0 
\ltrch\fcs0 \b\insrsid1668462\charrsid3964856 ej wymienione dochody nale}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'bf}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 y potwierdzi}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\b\insrsid7103873\charrsid3964856 \'e6}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid12211057 wydanym przez w\'b3a\'9cciwy podmiot, }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid8198606 np.}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid12211057  zak\'b3ad pracy, gmin\'ea, itd. }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 za}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'9c}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 
\b\insrsid1668462\charrsid3964856 wiadczeniem o wysoko}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'9c}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 ci}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid12211057 
 tych dochod\'f3w}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 ,}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid11609447\charrsid3964856  }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 odcinkiem
 pobranej emerytury/renty}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid12211057 *}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856  lub za}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'9c}{\rtlch\fcs1 \ab\af0 
\ltrch\fcs0 \b\insrsid1668462\charrsid3964856 wiadczeniem o korzystaniu ze }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'9c}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 wiadcze}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\b\insrsid1668462\charrsid3964856 \'f1 }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 pieni}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'ea\'bf}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13970397\charrsid3964856 
nych z pomocy spo\'b3ec}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid12211057 znej, za\'9c w przypadku bezrobotnych}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13970397\charrsid3964856  }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid12211057 cz\'b3onk\'f3
w rodziny}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13970397\charrsid3964856 \endash  za\'9cwiadczenie}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13370172 m}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13970397\charrsid3964856  }{\rtlch\fcs1 \ab\af0 
\ltrch\fcs0 \b\insrsid16004805\charrsid3964856 z }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13970397\charrsid3964856 urz\'eadu pracy po\'9cwiadcza}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13370172 j\'b9cym zarejestrowanie si\'ea}{\rtlch\fcs1 \ab\af0 
\ltrch\fcs0 \b\insrsid13970397\charrsid3964856  }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid12211057 osoby }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13970397\charrsid3964856 bezrobotn}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid16004805\charrsid3964856 
ej}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid3740931  lub kopii tych dokument\'f3w potwierdzonych }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid10296013 \'84}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid3740931 za zgodno\'9c\'e6 z orygina\'b3em}{\rtlch\fcs1 
\ab\af0 \ltrch\fcs0 \b\insrsid10296013 \'94 }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid3740931 przez }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid12211057 osob\'ea przyjmu}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid10233625 j\'b9c\'b9}{\rtlch\fcs1 
\ab\af0 \ltrch\fcs0 \b\insrsid12211057  }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid3740931 przedmiotowe dokumenty}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid12211057 , jako za\'b3\'b9czniki do niniejszego wniosku. }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 
\b\insrsid3740931  }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462 
\par }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid225149\charrsid3964856 
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1124931 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3964856\charrsid3964856 3. }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid13139344\charrsid3964856 Za\'9cwiadczenie}{
\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid13139344\charrsid3964856  }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid12211057\charrsid12211057 o}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12211057  ubieganiu si\'ea/nie ubieganiu}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid13139344\charrsid3964856  si\'ea}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12211057 *}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13139344\charrsid3964856  w MOPS/GOPS}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13370172 *}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid13139344\charrsid3964856  o stosowny zasi\'b3ek na pokrycie koszt\'f3w }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16394654 zakwaterowania w Bursie}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12211057  a w przypadku otrzymania takiego zasi\'b3ku w ww. za\'9c
wiadczeniu powinna by\'e6 wskazana jego wysoko\'9c\'e6. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13139344\charrsid3964856  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13139344\charrsid1124931 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid3737820 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 IV. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'8c}{\rtlch\fcs1 \ab\af0 
\ltrch\fcs0 \b\insrsid15867191 wiadomy (-}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 a}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid15867191 )}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856  odpowiedzialno}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'9c}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 ci karnej za podanie }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid12211057 w niniejszym wniosku }{\rtlch\fcs1 \ab\af0 
\ltrch\fcs0 \b\insrsid1668462\charrsid3964856 nieprawdziwych danych o}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'9c}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 wiadczam, }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\b\insrsid1668462\charrsid3964856 \'bf}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 e:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 - powy\'bfsze dane s\'b9 prawdziwe,
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13370172 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10233625  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15867191 zapozna\'b3em(-}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 am}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid15867191 )}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856  si\'ea z warunkami }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12211057 wynikaj\'b9cymi }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid285142 z Zarz\'b9dzenia nr     /200}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10233625 6 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid225149 Prezydenta Miasta Suwa\'b3k z dnia}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1715996           }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15867191  }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid1715996          }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid225149  20}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3737820 0}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3740931 6}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid225149  r. }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid355304\charrsid3964856  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid285142 okre\'9claj\'b9cego m.in. warunki cz\'ea\'9cciowego lub ca\'b3kowitego zwalniania z op\'b3at za zakwaterowanie w Bursie, }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid1668462\charrsid3964856  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1715996 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13370172 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10233625  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 niezw\'b3ocznie powiadomi\'ea }{\rtlch\fcs1 \af0 \ltrch\fcs0 \expnd-1\expndtw-8\insrsid285142 
Wydzia\'b3 O\'9cwiaty, Wychowania i Sportu}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid285142\charrsid3964856  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid285142 Urz\'ea}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 d}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid285142 u Miejskiego }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15867191 \line }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid285142 w Suwa\'b3kach }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 o ustaniu przyczyn, kt\'f3re stanowi\'b9 podstaw
\'ea}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid225149  zwolnienia z op\'b3at za }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16394654 zakwaterowanie}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 .
\par 
\par }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 V. Wyra}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'bf}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 am zgod}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\b\insrsid1668462\charrsid3964856 \'ea }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 na przetwarzanie }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid285142 przez Urz\'b9d Miejski }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid10233625 
w Suwa\'b3kach }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 danych osobowych zawartych we wniosku, zgodnie z ustaw}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 \'b9 }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 
\b\insrsid1668462\charrsid3964856 z dnia 29 sierpnia 1997 r. o ochronie danych osobowych (Dz. U. z 2002 r. Nr 101, poz. 926 ).
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1668462 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16670436\charrsid3964856 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 Do wniosku za\'b3\'b9czam}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16670436\charrsid3964856  nast\'eapuj\'b9ce dokumenty}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 :
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ltrpar\ql \fi-360\li1080\ri0\sl360\slmult1\widctlpar
\jclisttab\tx1080\wrapdefault\faauto\ls4\rin0\lin1080\itap0\pararsid3740931 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 ..............................................................................................
.............................,
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 \hich\af0\dbch\af0\loch\f0 2.\tab}...........................................................................................................................,
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 \hich\af0\dbch\af0\loch\f0 3.\tab}...........................................................................................................................,
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 \hich\af0\dbch\af0\loch\f0 4.\tab}...........................................................................................................................,}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2313254 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3740931\charrsid3964856 \hich\af0\dbch\af0\loch\f0 5.\tab}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3740931\charrsid3964856 
...........................................................................................................................,
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3740931\charrsid3964856 \hich\af0\dbch\af0\loch\f0 6.\tab}...........................................................................................................................,
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3740931\charrsid3964856 \hich\af0\dbch\af0\loch\f0 7.\tab}...........................................................................................................................,
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3740931\charrsid3964856 \hich\af0\dbch\af0\loch\f0 8.\tab}...........................................................................................................................,}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3740931 \tab \tab }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3740931\charrsid3964856 
\par }\pard \ltrpar\ql \li0\ri0\sl480\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1124931 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 Suwa\'b3ki , d}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1124931 nia }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid1668462\charrsid3964856  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1124931 ..\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1668462 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid225149\charrsid3964856 
\par }{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid1668462\charrsid3964856 (podpis wnioskodawcy)
\par 
\par }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 VI. Opinia dyrektora }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid16394654 Bursy Szkolnej}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid1668462\charrsid3964856 
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1668462 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 ...........................
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\par ........................................................................................................................................
\par ........................................................................................................................................
\par ........................................................................................................................................
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1668462 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1668462\charrsid3964856 
\par Suwa\'b3ki, dnia................................................
\par }\pard \ltrpar\ql \li0\ri0\sl480\slmult1\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1668462 {\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid1668462\charrsid3964856 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid1668462 {\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid1124931\charrsid3964856  }{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid1668462\charrsid3964856 (piecz\'ea\'e6
 i podpis dyrektora)}{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid1668462\charrsid1124931 
\par }}