聲請變更送達處所狀

Application for Changing the Address for Service of Process

股別：

Section:

告訴

貴署 年度 字第 號聲請人告發

涉嫌

一案，茲以 住 居 所送達處所

遷移至 縣變更為 市 鄉鎮市區 村里 鄰 路街 段 巷 弄 ００號之 樓 室。嗣後如有應送達聲請人

之訴訟文件，請按新址送達。

requested for prosecution of the crime of reported the crime of suspected of committing the crime of The Case year zhi No. of your Office,which

the Applicant

, the domicile/residence/place for service of process has changed to Rm- , F, No. , Alley ,Lane , Section , Road/Street, Neighborhood Village,

Township/City/District, County/City.

Any litigation documents for the attention of the Applicant shall be served to the new address.

此 致

福建連江地方檢察署公鑒

TO

Fuchien Lienchiang District Prosecutors Office

： （簽名蓋章）

Applicant: (Signature/Stamp)

國民身分證統一編號/護照號碼/居留證號

National ID No./Passport No./Alien Resident Certificate No.

住 址：

Address:

電 話：

Tel.:

中 華 民 國 年 月 日

Date: (mm)/ (dd), (yyyy)