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BNH DNG.

C quan, n v c thm quyn qun l CBCC

Mu 2C-BNV/2008
S hiu cn b, cng chc: ......................................

C quan, n v s dng CBCC

S YU L LCH CN B, CNG CHC


nh mu
(4 x 6 cm)

1) H v tn khai sinh (vit ch in hoa): ..............................................................................


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 h 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, 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 ).

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: ......................................................................................................................................................
(Hnh thc cao nht, nm no)

22) K lut: ...............................................................................................................................................................


(v ng, chnh quyn, on th hnh thc cao nht, nm no)

23) Tnh trng sc khe: ..................................................... Cao: 1m ......, Cn nng: ....... (kg), Nhm mu: ........
24) L thng binh hng: ............/..........., L con gia nh chnh sch:...................................................................
1

(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
Tn trng

Chuyn ngnh o to, bi dng

T thng, nmn thng, nm

Hnh thc
o to

Vn bng, chng
ch, trnh g

Ghi ch: Hnh thc o to: Chnh qui, ti chc, chuyn tu, bi dng .../ Vn bng: TSKH, TS, ThS, C nhn, K s ...

T thng, nm
n thng, nm

28) TM TT QU TRNH CNG TC


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 (B, M, V, Chng, con, anh ch em rut) nc ngoi (lm g, a ch ...) ? .............................................
.......................................................................................................................................................................................
.......................................................................................................................................................................................
...........................................................................................................................................................................
30) QUAN H GIA NH
a) V bn thn: B, 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 ...

b) 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:
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 ........ thng........nm........


Th trng c quan, n v qun l v s dng
cn b, cng chc
(k tn, ng du)

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