SESIZARE
Subsemnatul(a)________________________________________ identificat(a) cu B.I./ C.I.
seria ____ nr.__________, CNP [_]_]_]_]_]_]_]_]_]_]_]_]_], varsta _____ ani, domiciliat(a) in
jud. ________________, loc. ________________________, str. _________________________
nr. ____, bl. _____, sc. _____, et. ____, ap. _____, angajat(a)/fost(a) angajat(a) in perioada
de la _____________________________ pana la _______________________________
la angajator______________________________________ cu sediul in loc.
_______________________________ str. ________________________ nr. ___, bl. ___
reprezentata prin __________________________________.
Punct de lucru ( repere):______________________________________________________
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Numar de telefon la care pot fi contactat(a) pentru informatii suplimentare
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Prin prezenta va relatez urmatoarele:
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Imi asum si sustin cele relatate in prezenta sesizare.
Declar ca am fost informat(a) ca datele cu caracter personal sunt prelucrate in scopul si pentru indeplinirea
atributiilor legale ale Inspectoratului Teritorial de Munca Prahova si sunt de acord, in mod expres si fara
echivoc, cu aceasta prelucrare.
Am luat la cunostinta ca informatiile din cererea depusa si din actele anexate la aceasta, vor fi prelucrate de ITM
Prahova cu respectarea prevederilor Regulamentului (UE) 2016/679 privind protectia persoanelor fizice in ceea
ce priveste prelucrarea datelor cu caracter personal, si libera circulatie a acestor date.
Data:______________ Semnatura_____________________