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The document ceased to be valid since February 10, 2015 according to the Order of the Ministry of Natural Resources and Environmental Protection of the Russian Federation and Federal Forestry Agency of the Russian Federation of December 26, 2014 No. 481

It is registered

Ministry of Justice

Russian Federation

On August 27, 2013 No. 29787

ORDER OF FEDERAL FORESTRY AGENCY OF THE RUSSIAN FEDERATION

of July 10, 2013 No. 191

About approval of the application form about provision of the license

According to article 5 of the Federal Law of May 4, 2011 No. 99-FZ "About licensing of separate types of activity" (The Russian Federation Code, 2011, No. 19, Art. 2716; No. 30 (p. I), Art. 4590; No. 43, Art. 5971, No. 48, Art. 6728; 2012, No. 26, Art. 3446; No. 31, Art. 4322; 2013, No. 9, the Art. 874) and Regulations on licensing of activities for suppression of the fires in settlements, on production facilities and infrastructure facilities, on suppression of wildfires, the approved order of the Government of the Russian Federation of January 31, 2012 No. 69 (The Russian Federation Code, 2012, to No. 7, of the Art. 854), I order:

1. Approve the Application form about provision of the license (for the individual entrepreneur) according to appendix No. 1.

2. Approve the Application form about provision of the license (for the legal entity) according to appendix No. 2.

3. Declare invalid the order of Federal Forestry Agency of February 15, 2012 No. 49 "About approval of the application form about provision of the license" (registration No. 23693 is registered by the Ministry of Justice of the Russian Federation on April 3, 2012; Bulletin of regulations of federal executive bodies, 2012, No. 23).

The deputy minister - the head

V. Lebedev

Appendix № 1

 
"__" _________ 20__ г.
                    Заявление о предоставлении лицензии
(для индивидуального предпринимателя)
   -----------------------------------------------------------------------¬
Я, ¦ ¦
L-----------------------------------------------------------------------
(фамилия, имя, отчество индивидуального предпринимателя,
--------------------------------------------------------------------------¬
¦ ¦
L--------------------------------------------------------------------------
данные документа, удостоверяющего его личность)
-------------------------------------------------------------¬
Проживающий: ¦ ¦
L-------------------------------------------------------------
(адрес места жительства)
---------------------¬ ----------------------¬
Номер телефона: ¦ ¦ номер факса: ¦ ¦
L--------------------- L----------------------
-------------------------------------------------¬
Адрес электронной почты ¦ ¦
(в случае, если имеется) L-------------------------------------------------
-----------------------------------------¬
Адреса мест осуществления ¦ ¦
лицензируемого вида деятельности L-----------------------------------------
Основной государственный регистрационный номер (ОГРНИП)
-----T----T----T----T----T----T----T----T----T----T----T----T----T---T----¬
¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦
L----+----+----+----+----+----+----+----+----+----+----+----+----+---+-----
--------------------------------------------------------------------------¬
¦ ¦
L--------------------------------------------------------------------------
(данные документа, подтверждающие факт внесения сведений в ЕГРИП,
с указанием адреса
--------------------------------------------------------------------------¬
¦ ¦
L--------------------------------------------------------------------------
места нахождения органа, осуществившего государственную регистрацию)
-----T----T----T----T----T----T----T----T----T----T----T----¬
ИНН ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦
L----+----+----+----+----+----+----+----+----+----+----+-----
серия свидетельства _____, №_______, дата выдачи "__" ____________ 20__ г.
прошу предоставить лицензию на осуществление вида деятельности
--------------------------------------------------------------------------¬
¦ ¦
L--------------------------------------------------------------------------
(вид и состав деятельности)
Реквизиты документа, подтверждающего факт уплаты ----------------------¬
государственной пошлины за предоставление лицензии, ¦ ¦
либо иные сведения, подтверждающие факт уплаты ¦ ¦
указанной государственной пошлины L----------------------
Приложение: документы для получения лицензии согласно описи на ___ л.
При  необходимости  получить  информацию   по   вопросам  лицензирования  в
электронной форме в данной строке указывается запрашиваемая информация:
--------------------------------------------------------------------------¬
¦ ¦
L--------------------------------------------------------------------------
___________________________   _____________________________________________
(подпись, печать) (фамилия и инициалы)

Appendix №2

 
"__" _________ 20__ г.
                    Заявление о предоставлении лицензии

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