MODEL AND CONTENT of the "Event Report" form

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|Name of economic operator2 ...................... Name of economic operator/sub-unit4 .................|
|Subunit3 .......................................... Received .......................................................|
| Function ......................................................|
| Signature |
| L.S. |
| | | EVENT REPORT |
|Nr. .............dated ./......../.............. |
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| The undersigned, ................................., position...................., report the following: .........................................|
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| Semnatura |
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