检查笔录 时间_______年_______月_______日_______时_______分_______年_______月_______日_______时_______分 地点_______________________________________________________________ 复查员姓名、单位___________________________________________________ 侦查人员姓名、单位_________________________________________________ ___________________________________________________________________ 检察人员姓名、单位_________________________________________________ 被检查人诉讼身份、姓名、性别、年龄、住址 ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 见证人姓名、住址、单位_____________________________________________ ___________________________________________________________________ 检查目的___________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 检查过程及结果_____________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 侦查员:______________ 检查人:______________ 见证人:______________
记录人:______________