ࡱ> WYV9 Cbjbj"bS"l8&TH"2"!!!!!!!!!!!!!$z# %~E!E!`"```!`!``zWz pmZ{,o|"0H"w,&>"&`} I A D O Sd OZPIS DO ZOZNAMU UCHDZA OV ONJOM MESTSKHO BYTU Meno apriezvisko: ................................................................................................. dtum narodenia: ......................................... stav: ............................................... trval pobyt pod>a ob ianskeho preukazu: ............................................................ koreaponden n adresa: (uviese adresu aupresnie) ............................................................. .............................................................................. urodi ov usvokrovcov uprbuznch in uviese................................... Po et osb bvajcich vs asnom byte: & & & & & & & & & & & & & Ve>kose (po et izieb) s asnho bytu: & & & & & & & & & & & & & Zamestnanie uchdza a : ............................................................................................................ Vlastnk (spoluvlastnk) domu, bytu: NO* NIE* Njomnk (spolunjomnk) domu, bytu: NO* NIE* Dvod vpovede znjmu bytu vpredchdzajcom prpade, alebo dvod pre ktor bol zbytu vypratan, ak tto skuto nose nastala: & ........................................................................& & & ...................................................................................................................................................... Osobn daje rodinnch prsluankov aprsluankov domcnosti Meno apriezviskoVzeah k ~iadate>oviDtum narodeniaZamestnanie Shlasm svykonanm aetrenia vmieste s asnho bydliska: NO* NIE* Zdvodnenie ~iadosti (najm s asn bytov, rodinn a socilne pomery): ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Mm zujem obyt (napr. ve>kose, izbovitose, kategria, vaka njomnho od  do,...): ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... SHLAS SO SPRACOVANM OSOBNCH DAJOV Vzmysle 7 zkona NR SR . 428/2002 Z. z. oochrane osobnch dajov vznen neskorach predpisov /alej len zkon/ tmto vyslovujem shlas dotknutej osoby so spracvanm mojich osobnch dajov vtakom rozsahu, vakom s uveden vpripojenej ~iadosti, resp. dokumente. Pod>a 10 ods. 1 psm. d 5/ zkona tmto beriem na vedomie ashlasm stm, aby tieto osobn daje boli koprovan, skenovan alebo inak zaznamenvan na nosi e informci pre potreby prevdzkovate>a ajpod>a 10 ods. 6. ZroveH prehlasujem, ~e pri zskavan mojich osobnch dajov ma oprvnen osoba prevdzkovate>a informa nho systmu informovala ovaetkch skuto nostiach pod>a 10 zkona. Beriem na vedomie, ~e tento shlas je mo~n odvolae len psomnm odvolanm, ktor dotknut osoba doru  prevdzkovate>ovi informa nho systmu. Shlas poskytujem pre prevdzkovate>a informa nho systmu: Mestsk bytov podnik, Doln 49/21, 967 01 Kremnica na dobu neur it. Po ukon en pvodnho elu spracvania bude prevdzkovate> osobn daje spracvae vnevyhnutnom rozsahu vslade sustanovenm 6 ods. 3 psm. a/ zkona, alebo ich vslade sustanovenm 6 ods. 3 psm. b/ zlikviduje, ke sa stan nepotrebnmi. VKremnici, dHa ............................... ..................................................... Podpis ~iadate>a estne vyhlasujem, ~e daje vtejto ~iadosti s pravdiv asom si vedom prvnych nsledkov nepravdivch dajov. VKremnici, dHa ............................... ..................................................... Podpis ~iadate>a Prlohy k~iadosti: 1) Potvrdenie o prjme 2) Potvrdenie Mestskho radu vKremnici 3) estn vyhlsenie POTVRDENIE MESTSKHO RADU VKREMNICI, ~e uchdza  m vo i Mestu Kremnica vyrovnan vaetky dlhy anevysporiadan zvzky /komunlny odpad, daH znehnute>nosti, .../ Meno apriezvisko: .................................................... Trval pobyt pod>a ob ianskeho preukazu: ................................................................................. Stanovisko Mestskho radu vKremnici: ................................................................................................. .................................................................................................................................................................... .................................................................................................................................................................... .................................................................................................................................................................... VKremnici, dHa .......................................... ........................................................ pe iatka podpis  E ST N VY H L SE N IE Pod>a 39 zkona . 71/1967 Zb. osprvnom konan vznen neskorach predpisov Podpsan () ................................................................................................................................ Dtum narodenia................................................. slo OP .......................................................... trvale bytom ................................................................................................................................. vy h l asuj e m na svoj u  e se, ~e : - nevlastnm ja ani man~el/ man~elka byt ani rodinn dom, ~iadny byt od innosti zkona . 182/1993 Zb. oprevode vlastnctva bytov v znen neskorach predpisov sme neodkpili ani neodpredali; - nemm ja ani man~el/ man~elka vo i organizcim zriadench mestom Kremnica dlhy a nevyrovnan zvzky, ~e sa nevedie vo i nm sdny spor ani exeku n konanie; - ja ani man~el/ man~elka sme neboli v minulosti njomcami bytu, ktor sme znehodnotili, poakodili, ani sme vminulosti protiprvne neobsadili byt; - nm nebol vminulosti vypovedan njom bytu pod>a 711 ods. 1 psm. c), d), g) Ob ianskeho zkonnka Tieto daje s pravdiv apln. Som si vedom() prvnych nsledkov nepravdivho estnho vyhlsenia, najm, ~e uvedenm nepravdivho daju: sa m~em dopustie priestupku pod>a 21 ods. 1 psm. f) zkona . 372/1990 Zb. opriestupkoch vznen neskorach predpisov. VKremnici, dHa ....................................................... ........................................................ podpis fyzickej osoby Osved ujem, ~e estn vyhlsenie spsal (a) apodpsal (a) .............................................................................................r. . ................................................... V ................................., dHa ....................................... ............................................. 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