rl 'V '] u{--1 }- Avsägelse av förtroendeuppdrag Undertecknad önskar bli entledigad från uppdrag, enligt följande: E..r.sai.to.r.~. . L... k~/.t~r.r.:./i.rn~d.:v.n . . . B.o.u~~. . st~. . . . . . . . . . . . . . .. I Uppdrag: .. Ev. datum: ........................................................................................................................................... .. Namn: ...S.i.Y.!1.0..l] ........ S..~~~Y..r/~JSan. ························································································ .-.- Personnummer: .......................................................................... Adress: ... f.:.~(J0.:!.fJ.aJco:?.... Postadress: ...7~7.:.0..... 5..~ E..l............................................................................. . . . .S..kw.tU.f.··········:··············.................................. . l Telefonnr: .. 07.:.2. 5.Y..fr.~.Zel. ...........:. r I l~ Datum: .................... ./..................... 20 ....... /. ....... .. ~····························-························ Underskrift ..... Skickas/lämnas till expeditionen ~""' •
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