Lisa
Kadrina Vallavolikogu
30.03.2016 määruse nr 55
juurde

Taotlus Kadrina valla eelarvest sotsiaaltoetuste 
taotlemiseks
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1. Taotleja isiku andmed:
Ees- ja perekonnanimi.......................................................................................................................
Isikukood...........................................................................................................................................
Elukoha  aadress ...............................................................................................................................
Muud kontaktandmed........................................................................................................................

2. Soovin saada järgmist sotsiaaltoetust ...........................................................................................

3. Vajan sotsiaaltoetust põhjusel, et ..................................................................................................
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4. Perekonna kuusissetulekud:
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5. Perekonna kuu väljaminekud
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6. Toetus palun kanda minu arvelduskontole nr ………………………………………………….

7. Kinnitan esitatud andmete õigsust ja olen nõus minu isikuandmete, sealhulgas delikaatsete isikuandmete kasutamise, töötlemise ja töötlemiseks edastamisega kolmandatele isikutele, kui see on vajalik taotluse menetlemiseks.

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taotleja allkiri

Lisad:
1.	ID kaardi koopia
2.	pangakonto väljavõte