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‫ﺍﻋﺘﺮﺍﺽ ﺑﺎﺯﻳﮕﺮﺍﻥ ﺑﺎﺯﺍﺭ ﺑﺮﻕ ﺍﻳﺮﺍﻥ ﺑﻪ ﺻﻮﺭﺗﺤﺴﺎﺏﻫﺎﻱ ﺻﺎﺩﺭﻩ‬

                  ‫ﻓﺮﻡ ﺍﻋﺘﺮﺍﺽ ﺷﻤﺎﺭﻩ )‪ (3‬ﺟﻬﺖ ﺍﺭﺟﺎﻉ ﺑﻪ ﻣﻌﺎﻭﻧﺖ ﻓﻨﻲ ﻭ ﻫﻤﺎﻫﻨﮕﻲ‬

         ‫ﺷﻤﺎﺭﻩ ‪:‬‬                                                          ‫ﺍﺯ‪ :‬ﺷﺮﻛﺖ ‪ /‬ﺳﺎﺯﻣﺎﻥ ‪:‬‬
         ‫ﺗﺎﺭﻳﺦ ‪:‬‬
                  ‫ﺑﻪ ‪ :‬ﺷﺮﻛﺖ ﻣﺪﻳﺮﻳﺖ ﺷﺒﻜﻪ ﺑﺮﻕ ﺍﻳﺮﺍﻥ – ﻣﻌﺎﻭﻧﺖ ﻓﻨﻲ ﻭ ﻫﻤﺎﻫﻨﮕﻲ‬
‫ﺷﻤﺎﺭﻩ ﻓﺎﻛﺲ ‪:‬‬
                  ‫ﺷﻤﺎﺭﻩ ﺗﻤﺎﺱ ﻣﺴﺘﻘﻴﻢ ‪:‬‬                                     ‫ﭘﺴﺖ ﺍﻟﻜﺘﺮﻭﻧﻴﻜﻲ ‪: Email‬‬

                                        ‫‪ -1‬ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻣﻮﺍﺭﺩ ﺯﻳﺮ ﻋﻨﻮﺍﻥ ﺍﻋﺘﺮﺍﺽ ﺧﻮﺩ ﺭﺍ ﻣﺸﺨﺺ ﻛﻨﻴﺪ‪.‬‬

‫ﺏ ‪ -‬ﺍﻃﻼﻋﺎﺕ ﻣﺮﺑﻮﻁ ﺑﻪ ﺧﺮﻳﺪﺍﺭﺍﻥ ﺍﻧﺮژﻱ‬          ‫ﺍﻟﻒ ‪ -‬ﺍﻃﻼﻋﺎﺕ ﻣﺮﺑﻮﻁ ﺑﻪ ﻓﺮﻭﺷﻨﺪﮔﺎﻥ ﺍﻧﺮژﻱ‬

                  ‫ﻣﻴﺰﺍﻥ ﺍﻧﺮژﻱ ﻣﺼﺮﻓﻲ‬                              ‫ﻣﻴﺰﺍﻥ ﺗﻮﻟﻴﺪ ﺍﻧﺮژﻱ ﻭﺍﺣﺪﻫﺎﻱ ﻧﻴﺮﻭﮔﺎﻫﻲ‬
                   ‫ﻣﻴﺰﺍﻥ ﺗﺒﺎﺩﻝ ﻣﺎﻫﻴﺎﻧﻪ‬                                              ‫ﻣﻴﺰﺍﻥ ﺍﻧﺮژﻱ ﺭﺍﻛﺘﻴﻮ‬

                                            ‫ﻛﺴﺮ ﺩﺭﺁﻣﺪ ﺧﺪﻣﺎﺕ ﺍﻧﺘﻘﺎﻝ ﻧﺎﺷﻲ ﺍﺯ ﻧﻮﺍﻗﺺ ﻟﻮﺍﺯﻡ ﻭ ﻛﻨﺘﻮﺭﻫﺎﻱ‬

                                                                          ‫ﺳﻨﺠﺶ ﺍﻧﺮژﻱ‬

‫ﺩﺭ ﺻﻮﺭﺗﻴﻜﻪ ﺍﻋﺘﺮﺍﺽ ﺷﻤﺎ ﻫﻴﭻ ﻳﻚ ﺍﺯ ﻣﻮﺍﺭﺩ ﺫﻛﺮ ﺷﺪﻩ ﺩﺭ ﻓﻮﻕ ﺭﺍ ﺷﺎﻣﻞ ﻧﺸﻮﺩ‪ ،‬ﻋﻨﻮﺍﻥ ﺍﻋﺘﺮﺍﺽ ﺧﻮﺩ ﺭﺍ ﺑﻴﺎﻥ ﻧﻤﺎﻳﻴﺪ‪.‬‬

                                            ‫‪ -2‬ﻣـﻮﺭﺩ ﺍﻋﺘﺮﺍﺽ ﺧﻮﺩ ﺭﺍ ﺑﻄﻮﺭ ﻣﺨﺘﺼﺮ ﺷﺮﺡ ﺩﻫﻴﺪ‪.‬‬

           ‫‪ -3‬ﻣﺪﺍﺭﻛﻲ ﺭﺍ ﻛﻪ ﺟﻬﺖ ﺗﺎﻳﻴﺪ ﺍﺩﻋﺎﻫﺎﻱ ﻣﻄﺮﺡ ﺷﺪﻩ ﺑﻪ ﻫﻤﺮﺍﻩ ﻓﺮﻡ ﺍﻋﺘﺮﺍﺽ ﺿﻤﻴﻤﻪ ﻧﻤﻮﺩﻩ ﺍﻳﺪ ﺑﻪ ﺗﺮﺗﻴﺐ ﺫﻛﺮ ﻧﻤﺎﻳﻴﺪ‪.‬‬

‫ﺍﻳﻨﺠﺎﻧﺐ ‪.................‬ﺑﻪ ﻧﻤﺎﻳﻨﺪﮔﻲ ﺍﺯ ﺷﺮﻛﺖ‪ /‬ﻣﻮﺳﺴﻪ ‪ .................‬ﺍﻋﺘﺮﺍﺽ ﻛﺘﺒﻲ ﺧﻮﺩ ﺭﺍ ﻧﺴﺒﺖ ﺑـﻪ ﻋﻨـﻮﺍﻥ ﺍﻋﺘـﺮﺍﺽ‬
‫ﻣﺸﺨﺺ ﺷﺪﻩ ﺩﺭ ﺍﻳﻦ ﻓﺮﻡ‪،‬ﺍﻋﻼﻡ ﺩﺍﺷﺘﻪ ﻭ ﺍﺯ ﻣﻌﺎﻭﻧﺖ ﻣﺤﺘﺮﻡ ﻓﻨﻲ ﻭ ﻫﻤﺎﻫﻨﮕﻲ ﺗﻘﺎﺿﺎﻱ ﭘﻴﮕﻴﺮﻱ ﻭ ﺍﻗﺪﺍﻣﺎﺕ ﻻﺯﻡ ﺩﺭ ﺍﻳﻦ ﺯﻣﻴﻨﻪ ﺭﺍ‬

                                                                                                                 ‫ﺩﺍﺭﻡ‪.‬‬

                                                                               ‫ﺗﺎﺭﻳﺦ ﻭ ﺍﻣﻀﺎء‬
                                       ‫ﺍﻳﻦ ﻗﺴﻤﺖ ﺗﻮﺳﻂ ﺑﺮﺭﺳﻲ ﻛﻨﻨﺪﻩ ﺍﻋﺘﺮﺍﺽ ﺗﻜﻤﻴﻞ ﻣﻲﮔﺮﺩﺩ‪.‬‬
                  ‫ﺍﺯ‪ :‬ﺷﺮﻛﺖ ﻣﺪﻳﺮﻳﺖ ﺷﺒﻜﻪ ﺑﺮﻕ ﺍﻳﺮﺍﻥ – ﻣﻌﺎﻭﻧﺖ ﻓﻨﻲ ﻭ ﻫﻤﺎﻫﻨﮕﻲ – ﺩﻓﺘﺮ ﺳﻨﺠﺶ ﻭ ﭘﺎﻳﺶ ﺍﻧﺮژﻱ‬

                    ‫ﺑﻪ ‪ :‬ﺷﺮﻛﺖ ﻣﺪﻳﺮﻳﺖ ﺷﺒﻜﻪ ﺑﺮﻕ ﺍﻳﺮﺍﻥ – ﻣﻌﺎﻭﻧﺖ ﺑﺎﺯﺍﺭ ﺑﺮﻕ – ﺩﻓﺘﺮ ﻣﻄﺎﻟﻌﺎﺕ ﺍﻗﺘﺼﺎﺩﻱ ﻭ ﺗﻮﺳﻌﻪ ﺑﺎﺯﺍﺭ ﺑﺮﻕ‬
                                      ‫ﻧﺘﻴﺠﻪ ﺑﺮﺭﺳﻲ ﺍﻋﺘﺮﺍﺽ ﺟﻬﺖ ﺍﻃﻼﻉ ﻭ ﺍﻗﺪﺍﻣﺎﺕ ﺑﻌﺪﻱ ﺑﻪ ﺷﺮﺡ ﺫﻳﻞ ﺑﻪ ﺍﻃﻼﻉ ﻣﻲﺭﺳﺪ‪.‬‬

‫ﻣﺪﻳﺮ ﺗﺎﺋﻴﺪ ﻛﻨﻨﺪﻩ‬                        ‫ﻛﺎﺭﺷﻨﺎﺱ ﺑﺮﺭﺳﻲ ﻛﻨﻨﺪﻩ‬                       ‫ﺍﻋﺘﺮﺍﺽ ﻣﻮﺭﺩ ﺗﺎﺋﻴﺪ ﻧﻴﺴﺖ‬
‫ﺗﺎﺭﻳﺦ ﻭ ﺍﻣﻀﺎء‬                              ‫ﺗﺎﺭﻳﺦ ﻭ ﺍﻣﻀﺎء‬                           ‫ﺍﻋﺘﺮﺍﺽ ﻣﻮﺭﺩ ﺗﺎﺋﻴﺪ ﺍﺳﺖ‬
                                                                          ‫ﺑﺨﺸﻲ ﺍﺯ ﺍﻋﺘﺮﺍﺽ ﻣﻮﺭﺩ ﺗﺎﺋﻴﺪ ﺍﺳﺖ‬

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