XXX市场监督管理局约谈记录

　　时? 间:____________年_________月_________日_________时_________分至____________年_________月_________日_________时_________分___第_________次
　　地点:______________________________________________________________________________________________________
　　约谈人:_________________________________________________________、__________________________________________
　　被约谈人:_________________________________________________________________________________________________
　　联系电话:___________________________________________________邮政编码：_________________________________
　　住址：________________________________________________________________________________________________
　　工作单位:___________________________________________________职务：_______________________________________
　　_____________________________________________________________________________________________________________
　　_____________________________________________________________________________________________________________
　　_____________________________________________________________________________________________________________
　　_____________________________________________________________________________________________________________
　　_____________________________________________________________________________________________________________
　　_____________________________________________________________________________________________________________
　　被约谈人(签名或者盖章):________________________________________________年____________月____________日
　　约谈人(签名或者盖章):__________________________________________________年____________月____________日
　　_______________________________________________________________________年____________月____________日
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　　（续页）
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