Mu 2C-BNV/2008 ban hnh km theo Quyt nh s 02/2008/Q-BNV ngy

06/10/2008 ca B trng B Ni v
C quan, n v c thm quyn qun l CBCC S hiu cn b, cng chc:
C quan, n v s dng CBCC

S YU L LCH CN B, CNG CHC

1) H v tn khai sinh (vit ch in hoa): ................................................
nh mu
(4 x 6 cm)

2) Tn gi khc:......................................................................................
3) Sinh ngy: thng nm , Gii tnh (nam, n): ....................
4) Ni sinh: X , Huyn , Tnh ...........................
5) Qu qun: X . , Huyn , Tnh ...........................

6) Dn tc: , 7) Tn gio: ...............................................

8) Ni ng k b khu thng tr: ...............................................................................
(S nh, ng ph, thnh ph, xm, thn, x, huyn, tnh)
9) Ni hin nay: ..........................................................................................................
(S nh, ng ph, thnh ph, xm, thn, x, huyn, tnh)
10) Ngh nghip khi c tuyn dng: ..........................................................................
11) Ngy tuyn dng: //, C quan tuyn dng: ..............................................
12) Chc v (chc danh) hin ti: ..................................................................................
(V chnh quyn hoc ng, on th, k c chc v kim nhim)
13) Cng vic chnh c giao: .....................................................................................
14) Ngch cng chc (vin chc): , M ngch: ..........................
Bc lng:, H s:, Ngy hng://,
Ph cp chc v:, Ph cp khc:
15.1- Trnh gio dc ph thng ( tt nghip lp my/thuc h no):.....................
15.2- Trnh chuyn mn cao nht:.............................................................................
(TSKH, TS, Ths, c nhn, k s, cao ng, trung cp, s cp, chuyn ngnh)
15.3- L lun chnh tr: 15.4-Qun l nh nc:................................
(Cao cp, trung cp, s cp v tng ng) (chuyn vin cao cp, chuyn vin
chnh, chuyn vin, cn s,........)
15.5- Ngoi ng:, 15.6-Tin hc: .................................................
(Tn ngoi ng + Trnh A, B, C, D......)

(Trnh A, B, C,.......)

16) Ngy vo ng Cng sn Vit Nam://, Ngy chnh thc://

17) Ngy tham gia t chc chnh tr - x hi: ................................................................
(Ngy tham gia t chc: on, Hi,..... v lm vic g trong t chc )

2
18) Ngy nhp ng://, Ngy xut ng: // Qun hm cao nht:.........
19) Danh hiu c phong tng cao nht .......................................................................
(Anh hng lao ng, anh hng lc lng v trang; nh gio, thy thuc, ngh s nhn
dn v u t, )
20) S trng cng tc: ..................................................................................................
21) Khen thng: , 22) K lut: .....................................................
(Hnh thc cao nht, nm no)
(v ng, chnh quyn, on th hnh thc cao
nht, nm no)
23) Tnh trng sc kho: , Chiu cao:, Cn nng:.kg, Nhm mu:
24) L thng binh hng: ./, L con gia nh chnh sch: ..................................
(Con thng binh, con lit s, ngi nhim cht c
da cam Dioxin)
25) S chng minh nhn dn: ....................................................Ngy cp: //
26) S s BHXH: ...........................................................................................................
27) o to, bi dng v chuyn mn, nghip v, l lun chnh tr, ngoi ng, tin hc
Vn bng,
Chuyn ngnh o
T thng, nm - Hnh thc
Tn trng
chng ch,
to, bi dng
n thng, nm
o to
trnh g
/-/
/-/
/-/
/-/
/-/
/-/
/-/
/-/
Ghi ch: Hnh thc o to: Chnh quy, ti chc, chuyn tu, bi dng ..../ Vn bng:
TSKH, TS, Ths, C nhn, K s ............
28) Tm tt qu trnh cng tc
T thng, nm n
thng, nm

Chc danh, chc v, n v cng tc (ng, chnh quyn, on

th, t chc x hi), k c thi gian c o to, bi dng v
chuyn mn, nghip v,......

29) c im lch s bn thn:

- Khai r: b bt, b t (t ngy thng nm no n ngy thng nm no, u), khai
bo cho ai, nhng vn g? Bn thn c lm vic trong ch c (c quan, n v
no, a im, chc danh, chc v, thi gian lm vic ....)
........................................................................................................................................
........................................................................................................................................
........................................................................................................................................
- Tham gia hoc c quan h vi cc t chc chnh tr, kinh t, x hi no nc ngoi
(lm g, t chc no, t tr s u .........?):
........................................................................................................................................
........................................................................................................................................
- C thn nhn (Cha, M, V, Chng, con, anh ch em rut) nc ngoi (lm g, a
ch ........)?
........................................................................................................................................
........................................................................................................................................
........................................................................................................................................
30) Quan h gia nh
a) V bn thn: Cha, M, V (hoc chng), cc con, anh ch em rut
Mi
quan h

H v tn

Nm
sinh

Qu qun, ngh nghip, chc danh, chc

v, n v cng tc, hc tp, ni (trong,
ngoi nc); thnh vin cc t chc chnh
tr - x hi ........)

a) V bn v (hoc chng): Cha, M, anh ch em rut

Mi
quan h

H v tn

Nm
sinh

Qu qun, ngh nghip, chc danh, chc

v, n v cng tc, hc tp, ni (trong,
ngoi nc); thnh vin cc t chc chnh
tr - x hi ........)

31) Din bin qu trnh lng ca cn b, cng chc

Thng/nm
M ngch/bc
H s lng
32) Nhn xt, nh gi ca c quan, n v qun l v s dng cn b, cng chc
........................................................................................................................................
........................................................................................................................................
........................................................................................................................................
........................................................................................................................................
........................................................................................................................................
........................................................................................................................................
. Ngy thng nm
Ngi khai
Ti xin cam oan nhng li
khai trn y l ng s tht
(K tn, ghi r h tn)

Th trng c quan, n v qun l v s dng

CBCC
(K tn, ng du)