(Z-48-sonli shakl)
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Mahsulotning sifati nomuvofiq
deb topilganligi to‘g‘risidagi ___-sonli
DALOLATNOMA
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TASDIQLAYMAN
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Mahsulotni oluvchi tashkilot rahbari
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________________________________
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(F.I.O.)
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20___ y. “___” _________________
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1. Qabul qiluvchi tashkilot nomi va manzili _________________________________________ _____________________________________________________________________________
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2. Dalolatnoma tuzilgan joy va sana ________________________________________________
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3. Dalolatnomani tuzishda ishtirok etgan shaxslar ____________________________________ _____________________________________________________________________________
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(F.I.O., lavozimi va ish joyi, guvohnoma raqami, ushbu shaxslar mahsulotni
______________________________________________________________________________
sifati bo‘yicha qabul qilish qoidalari bilan tanishtirilganliklari to‘g‘risida qayd)
______________________________________________________________________________
4. Etkazib beruvchi tashkilot nomi va manzili ______________________________________________________________________________
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5. Etkazib beruvchi tashkilot sifatsiz mahsulot jo‘natilganligi haqida xabardor qilingan sana va bu to‘g‘ridagi hujjat raqami ______________________________________________________________________________
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6. Yuk xati va jo‘natilgan mahsulot sifatini tasdiqlovchi hujjat raqami ______________________________________________________________________________
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7. Mahsulot mo‘ljallangan stansiyaga va qabul qiluvchi tashkilotga yetib kelgan sana va vaqt_____
______________________________________________________________________________
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8. Qabul qilish dalolatnomasi tuzilishidan oldin mahsulot saqlangan sharoit ______________
______________________________________________________________________________
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9. Idish (bochka, banka va boshq.) holati, plomba holati ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
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Z-48-sonli shaklning orqa tomoni
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10. Plombalar egasi (yetkazib beruvchi yoki transport tashkiloti) plomba va undagi izlarning sozligi _______________________________________________________________________ ______________________________________________________________________________
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11. Sifati to‘g‘risidagi hujjatga mos mahsulot miqdori (og‘irligi), nomi va bahosi__________
______________________________________________________________________________
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12. Namuna olinganligi va tahlil o‘tkazilgan joy to‘g‘risida ma’lumotlar
______________________________________________________________________________ ______________________________________________________________________________
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13. Sifati tekshirilayotganda tayanilgan normativ hujjatlar raqamlari ______________________________________________________________________________
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14. Mahsulot nomuvofiq deb topilishiga yoki normativ hujjatga tayanilgan holda pastroq navga tushirilishiga asoslar
______________________________________________________________________________ ______________________________________________________________________________
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15. Mahsulot sifati nomuvofiq�igini tasdiqlovchi boshqa ma’lumotlar
______________________________________________________________________________ ______________________________________________________________________________
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16. Komissiya xulosasi ___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
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17. Dalolatnomani tuzishda ishtirok etgan shaxslar imzosi _________________
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