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:

C quan n v s dng CBCC:

S hiu cn b, cng chc:

S YU L LCH CN B, CNG CHC

1) H v tn khai sinh (vit ch in ).....
2)Cc tn gi ....
nh
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 h khu thng tr: ........
(S nh, ng ph, thnh ph; xm thn, x, huyn, tnh)

8) 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): ....
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)
cn s,.)

(chuyn vin cao cp,chuyn vin chnh, chuyn vin,

15.5-Ngoi ng:.15.6-Tin hc:...

(Tn ngoi ng + Tnh A,B,C,D,)

(Trnh A,B,C,.)

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

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

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)
cao nht, nm no)

(v ng, chnh quyn, on th hnh thc

23) Tnh trng sc khe:... Chiu cao:....., Cn nng:...kg, Nhm

mu:..
24) L thng binh hng: /, L con gia nh chnh sch:..
Dioxin)

(Con thng binh, con lit s, ngi nhim cht c da cam

25) S chng minh nhn dn:... Ngy cp:../../.. 26) S s BHXH:

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

27) O TO, BI DNG V CHUYN MN, NGHIP V, L LUN, CHNH TR, NGOI NG, TIN HC

Tn trng

Chuyn ngnh o to bi
dng

T thng, nm
n thng
nm

Hnh thc
o to

Vn bng, chng
ch, trnh g

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Ghi ch: Hnh thc hc: Chnh qui, ti chc, chuyn tu, bi dng./ Vn bng: Tin s, Ph tin s, Thc s, 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,

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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

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)
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- 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,?)............................................................................................................................................
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- C thn nhn (b, m, v, chng, con, anh ch em rut) nc ngoi (lm g, a ch):......................................................
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30) QUAN H GIA NH
a) V bn thn: B, M, V (chng), cc con, anh ch em rut
Quan
h

H v tn

B, m

V
chng

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Cc
con:

Anh
ch
em
rut

Nm
sinh
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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
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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

Quan
h
B, m

Anh
ch
em
rut

b) B, M, anh ch em rut (bn v hoc chng):

Nm Qu qun, ngh nghip, chc danh, chc v, n v cng tc, hc tp,
sinh
ni (trong, ngoi nc); thnh vin cc t chc chnh tr-x hi

H v tn
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31) DIN BIN QU TRNH LNG CA CN B, CNG CHC

Thng/nm:
Ngch/bc:
H s lng:
32) NHN XT, NH GI CA C QUAN, N V QUN L V S DNG CN B, CNG
CHC

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Ngi khai
Ti xin cam oan nhng
li khai trn y l ng s tht
(k tn, ghi r h tn)

.,Ngy...thngnm 20
Th trng c quan, n v qun l v s dng CBCC
(K tn, ng du)