Редактирование: Документ:Приказ от 11.04.2018 № 298 Департамент здравоохранения города Севастополя

{{Правовой акт
|вид документа=приказ
|государственный регистрационный номер=RU94000201800248 от 19.04.2018
|дата индексирования=2019-07-12 21:24:37
|дата принятия=2018-04-11 00:00:00
|дата регистрации=2018-04-19 00:00:00
|информация об опубликовании=Официальный сайт Правительства Севастополя http:// sevastopol.gov.ru / от 16.04.2018
|количество редакций=1
|наименование=Об утверждении форм заявлений, используемых в процессе лицензирования деятельности по обороту наркотических средств, психотропных веществ  и их прекурсоров, культивированию наркосодержащих растений
|наличие текста документа=содержит текст
|номер документа=298
|номер регистрации=RU94000201800248
|подчинение=Севастополь
|принявший орган=Департамент здравоохранения города Севастополя
|раздел=Федеральный регистр - акты субъектов РФ
|редакция=Редакция №1 от 11.04.2018
|реквизиты документа=ПРИКАЗ от 11.04.2018 № 298 Департамент здравоохранения города Севастополя
|рубрики правового классификатора=140.010.000 Здравоохранение (см. также 200.160.040)
140.010.020 Управление в сфере здравоохранения (см. также 010.150.040, 020.010.040, 020.010.050)
|статус действия=Действующий
|статус нормативности=Нормативный
|статус соответствия законодательству=Соответствует ФЗ
|субъект рф=Севастополь
|тип документа=Основной

}}
{{Импорт/pravo.minjust.ru
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" width="65" height="75" alt=""/></p></td><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:153.8pt"><p style="font-size:14pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p></td></tr></table><p style="font-size:14pt; line-height:150%; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">ПРАВИТЕЛЬСТВО СЕВАСТОПОЛЯ</span></p><p style="font-size:14pt; line-height:150%; margin-right:0pt; text-align:center; text-indent:0pt"><img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAoMAAAAGCAYAAAC4jJTMAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjwv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAABCSURBVGhD7daxDQAxDAMx77/0p0n1kRcQeAA7DaD59QEAUG8tjQEA6LKWxgAAdFlLYwAAukiSJElv6TkCANDlNnMA0RxlRNPOS8gAAAAASUVORK5CYII=" width="643" height="6" alt="" style="margin-left:-0.1pt; margin-top:23.9pt; position:absolute; z-index:1"/><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">ДЕПАРТАМЕНТ ЗДРАВООХРАНЕНИЯ ГОРОДА СЕВАСТОПОЛЯ</span></p><p style="font-size:10pt; line-height:150%; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">П Р И К А З</span></p><p style="background-color:#ffffff; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">«</span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">11</span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">» </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">04</span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">.2018</span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">    </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">                            </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> № </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">298</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-size:16pt; font-weight:bold">Об утверждении форм заявлений, используемых в процессе лицензирования деятельности по обороту наркотических средств, психотропных веществ </span><br/><span style="font-size:16pt; font-weight:bold">и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-indent:42.55pt"><span>Во исполнение статьи 12 Федерального закона от 04.05.2011 № 99-ФЗ </span><br/><span>«О лицензировании отдельных видов деятельности», в соответствии </span><br/><span>с требованиями Федерального закона от 21.11.2011 № 323-ФЗ «Об основах охраны здоровья граждан в Российской Федерации», постановления Правительства Российской Федерации от 22.12.2011 № 1085 «О лицензировании деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений», руководствуясь приказом Министерства здравоохранения Российской Федерации от 10.11.2017 № 908н</span><span></span><span>«Об утверждении Административного регламента по предоставлению органами исполнительной власти субъектов Российской Федерации государственной услуги по лицензированию деятельности по обороту наркотических средств и психотропных веществ (за исключением деятельности, осуществляемой организациями оптовой торговли лекарственными средствами и аптечными организациями, подведомственными федеральным органам исполнительной власти)», постановлением Правител</span><span>ьства Севастополя от 17.03.2015 </span><span>№ 182-ПП «Об утверждении положения о Департаменте здравоохранения города Севастополя»,</span></p><p style="margin-right:0pt; text-indent:0pt"><span> </span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span>ПРИКАЗЫВАЮ:</span></p><p style="margin-right:0pt; text-indent:0pt"><span> </span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1. Утвердить следующие формы заявлений, предоставляемых соискателями лицензий и лицензиатами при обращении в сектор лицензирования Управления по лекарственному обеспечению и лицензированию медицинской и фармацевтической деятельности Департамента здравоохранения города Севастополя:</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.1. заявление о предоставлении лицензии на осуществление деятельности по обороту наркотических средств, психотропных веществ </span><br/><span>и их прекурсоров, культивированию наркосодержащих растений </span><br/><span>в соответствии с Приложением № 1;</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.2. заявление о переоформлении лицензии на осуществление деятельности по обороту наркотических средств, психотропных веществ </span><br/><span>и их прекурсоров, культивированию наркосодержащих растений </span><br/><span>в соответствии с Приложением № 2 в связи с:</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.2.1. реорганизацией юридического лица в форме преобразования;</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.2.2. реорганизацией юридического лица в форме слияния (при условии наличия у каждого участвующего в слиянии юридического лица на дату государственной регистрации правопреемника реорганизованных юридических лиц лицензии на один и тот же вид деятельности);</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.2.3. изменением наименования юридического лица;</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.2.4. изменением адреса места нахождения юридического лица;</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.2.5. изменением адреса(ов) места осуществления юридическим лицом лицензируемого вида деятельности (в случае изменения адресности (индекса, наименования населенного пункта, переименования улицы, изменения номера дома и т.п., но сохранения самого места осуществления);</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.2.7. прекращением деятельности по одному адресу или нескольким адресам мест осуществления деятельности, указанным в лицензии;</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.2.8. прекращением деятельности выполняемых работ и оказываемых услуг, составляющих лицензируемый вид деятельности по указанным адресам;</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.3. заявление о переоформлении лицензии на осуществление деятельности по обороту наркотических средств, психотропных веществ </span><br/><span>и их прекурсоров, культивированию наркосодержащих растений </span><br/><span>в соответствии с Приложением № 3 в связи с:</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.3.1 изменением адресов мест осуществления юридическим лицом лицензируемого вида деятельности (адрес(а) мест(а) осуществления лицензируемой деятельности, не указанный(ые) в лицензии);</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.3.2. изменением перечня выполняемых работ, оказываемых услуг, составляющих лицензируемый вид деятельности, ранее не указанных </span><br/><span>в лицензии;</span></p><p style="margin-right:0pt; text-indent:35.45pt"><span>1.4. </span><span>заявление о предоставлении дубликата/копии лицензии </span><br/><span>на осуществление </span><span>деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span><span></span><span>в соответствии с Приложением № 4</span><span>;</span></p><p style="background-color:#ffffff; margin-bottom:0pt; margin-right:0pt; margin-top:0pt; text-indent:35.45pt"><span>1.5. </span><span>заявление о прекращении деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений в соответствии с Приложением № 5.</span></p><ol start="2" type="1" style="margin:0pt; padding-left:0pt"><li style="background-color:#ffffff; font-family:Arial; font-size:12pt; list-style-position:inside; margin:0pt; text-indent:35.45pt"><span style="font:7.0pt &#39;Times New Roman&#39;">              </span><span style="font-family:Arial; font-size:12pt">Признать утратившими силу следующие приказы Департамента здравоохранения города Севастополя:</span></li></ol><p style="background-color:#ffffff; margin:0pt; text-indent:35.45pt"><span><span>2.1.</span></span><span style="font:7.0pt &#39;Times New Roman&#39;">           </span><span>приказ от 15.04.2016 № 441 «О порядке лицензирования деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений»;</span></p><p style="background-color:#ffffff; margin:0pt; text-indent:35.45pt"><span><span>2.2.</span></span><span style="font:7.0pt &#39;Times New Roman&#39;">           </span><span>приказ от 12.02.2018 № 121 «О внесении изменений в приказ Департамента здравоохранения города Севастополя от 15.04.2016 № 441 </span><br/><span>«О порядке лицензирования деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений».</span></p><ol start="3" type="1" style="margin:0pt; padding-left:0pt"><li style="background-color:#ffffff; font-family:Arial; font-size:12pt; list-style-position:inside; margin:0pt; text-indent:35.45pt"><span style="font:7.0pt &#39;Times New Roman&#39;">              </span><span style="font-family:Arial; font-size:12pt">Главному внештатному специалисту пресс-секретарю           Снегирёвой В.А. опубликовать настоящий приказ на официальном портале органов государственной власти </span><span style="font-family:Arial; font-size:12pt">sevastopol</span><span style="font-family:Arial; font-size:12pt">.</span><span style="font-family:Arial; font-size:12pt">gov</span><span style="font-family:Arial; font-size:12pt">.</span><span style="font-family:Arial; font-size:12pt">ru</span><span style="font-family:Arial; font-size:12pt">.</span></li><li style="background-color:#ffffff; font-family:Arial; font-size:12pt; list-style-position:inside; margin:0pt; text-indent:35.45pt"><span style="font:7.0pt &#39;Times New Roman&#39;">              </span><span style="font-family:Arial; font-size:12pt">Данный приказ вступает в силу по истечении десяти дней после дня его официального опубликования.</span></li><li style="background-color:#ffffff; font-family:Arial; font-size:12pt; list-style-position:inside; margin:0pt; text-indent:35.45pt"><span style="font:7.0pt &#39;Times New Roman&#39;">              </span><span style="font-family:Arial; font-size:12pt">Контроль за исполнением настоящего приказа возложить на заместителя директора Департамента здравоохранения города Севастополя Михневича Д.В.</span></li></ol><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span>Директор Департамента                                                                    А.Ю. Бахлыков</span></p><p style="margin-right:0pt; text-align:left; text-indent:269.35pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:269.35pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-left:241pt; margin-right:0pt; text-align:right; text-indent:0pt"><span style="font-size:16pt; font-weight:bold">Приложение № 1</span></p><p style="margin-left:241pt; margin-right:0pt; text-align:right; text-indent:0pt"><span style="font-size:16pt; font-weight:bold">к приказу Департамента здравоохранения города Севастополя</span></p><p style="margin-left:241pt; margin-right:0pt; text-align:right; text-indent:0pt"><span style="font-size:16pt; font-weight:bold">от 11.04.2018 № 298</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:474.9pt"><tr><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:145.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">Регистрационный номер:</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:167.9pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:48.25pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:right; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">от</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td></tr></table><p style="margin-bottom:12pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">                                                     (заполняется лицензирующим органом)</span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt"><tr><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:239.25pt"><p style="line-height:12pt; margin-bottom:12pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:239.3pt"><p style="line-height:12pt; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="line-height:14pt; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">В Департамент здравоохранения</span></p><p style="line-height:14pt; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">города Севастополя</span></p><p style="line-height:12pt; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td></tr></table><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:13pt; font-weight:bold">ЗАЯВЛЕНИЕ</span></p><p style="margin-right:0pt; text-align:center; text-indent:35.4pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">о предоставлении лицензии на осуществление</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:494.45pt"><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">1.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Организационно-правовая форма</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">2.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Полное наименование юридического лица</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">3.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сокращенное наименование (в случае, если имеется)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">4.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Фирменное наименование (в случае, если имеется)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:12.6pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">5.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес места нахождения юридического лица </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:12.6pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">6.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Государственный регистрационный номер записи о создании юридического лица</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:12.6pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">7.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Данные документа, подтверждающего факт внесения сведений о юридическом лице в единый государственный реестр юридических лиц, с указанием адреса места нахождения органа, осуществившего государственную регистрацию</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан ______________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(орган, выдавший документ)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи _________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Бланк: серия ______ № ________________</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес ______________________________</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p></td></tr><tr style="height:12.6pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">8.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Идентификационный номер налогоплательщика</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="color:#808080; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:12.6pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">9.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Данные документа о постановке соискателя лицензии на учет в налоговом органе</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан ______________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(орган, выдавший документ)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи _________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Бланк: серия ______ № ________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">10.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес(а) места осуществления лицензируемого вида деятельности</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Перечень заявляемых работ, оказываемых услуг, составляющих деятельность по обороту наркотических средств, </span><span style="font-family:&#39;Times New Roman&#39;">психотропных веществ и их прекурсоров, культивированию наркосодержащих растений </span></p></td></tr><tr><td rowspan="3" style="border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><a href="consultantplus://offline/main?base=LAW;n=114224;fld=134;dst=100038"><span style="color:#0000ff; font-family:&#39;Times New Roman&#39;; text-decoration:underline">&lt;*&gt;</span></a></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><a href="consultantplus://offline/main?base=LAW;n=114224;fld=134;dst=100038"><span style="color:#0000ff; font-family:&#39;Times New Roman&#39;; text-decoration:underline">&lt;*&gt;</span></a></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><a href="consultantplus://offline/main?base=LAW;n=114224;fld=134;dst=100038"><span style="color:#0000ff; font-family:&#39;Times New Roman&#39;; text-decoration:underline">&lt;*&gt;</span></a></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">11.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о наличии лицензии на осуществление медицинской деятельности (в случае, если соискателем лицензии является медицинская организация)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан ______________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование органа (организации), выдавшего документ)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи _________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">№ __________________________________</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">12.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о помещениях для осуществления деятельности по обороту наркотических средств, принадлежащих заявителю на праве собственности или ином законном основании, права на которые зарегистрированы в Едином государственном реестре прав на недвижимое имущество и сделок с ним</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан ______________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование органа (организации), выдавшего документ)</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи _________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">№ __________________________________</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">13.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о наличии заключений органа по контролю за оборотом наркотических средств и психотропных веществ, предусмотренных абзацем третьим пункта 3 статьи 10 Федерального закона от 08.01.1998 №3-ФЗ</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан ______________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование органа (организации), выдавшего документ)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи _________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">№ __________________________________</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">14.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о наличии заключений органа по контролю за оборотом наркотических средств и психотропных веществ, предусмотренных абзацем пятым пункта 3 статьи 10 Федерального закона от 08.01.1998 №3-ФЗ</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан ______________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование органа (организации), выдавшего документ)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи _________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">№ __________________________________</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">15.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о наличии заключений органа по контролю за оборотом наркотических средств и психотропных веществ, предусмотренных абзацем третьим пункта 7 статьи 30 Федерального закона от 08.01.1998 №3-ФЗ</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан ______________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование органа (организации), выдавшего документ)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи _________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">№ __________________________________</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">16.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Контактный телефон соискателя лицензии</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">17.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес электронной почты (в случае, если имеется)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">18.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Реквизиты документа, подтверждающего факт уплаты государственной пошлины за предоставление лицензии, либо иные сведения, подтверждающие факт уплаты указанной государственной пошлины </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">19.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Форма получения лицензии </span></p><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">(* - нужное указать)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:32.65pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">* На бумажном носителе лично</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:32.65pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">* На бумажном носителе направить </span><span style="font-family:&#39;Times New Roman&#39;">заказным почтовым отправлением с уведомлением о вручении</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:25.35pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">20.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:241pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Информирование по вопросам лицензирования (указать в случае, если заявителю необходимо направлять указанные сведения в электронной форме)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding:2.75pt; vertical-align:top; width:228.1pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">Направлять / не направлять</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">          (нужное указать)</span></p></td></tr></table><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt"> </span></p><p style="margin-right:0pt; text-indent:0pt"><a href="consultantplus://offline/main?base=LAW;n=114224;fld=134;dst=100038"><span style="color:#0000ff; font-family:&#39;Times New Roman&#39;; font-size:9pt; text-decoration:underline">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt"> вставить выполняемые работы и оказываемые услуги для каждого адреса места осуществления, выбрав их и скопировав из Справочника РАБОТ И УСЛУГ, СОСТАВЛЯЮЩИХ ДЕЯТЕЛЬНОСТЬ ПО ОБОРОТУ НАРКОТИЧЕСКИХ СРЕДСТВ, ПСИХОТРОПНЫХ ВЕЩЕСТВ И ИХ ПРЕКУРСОРОВ, КУЛЬТИВИРОВАНИЮ НАРКОСОДЕРЖАЩИХ РАСТЕНИЙ; (при заявлении работ (оказании услуг), предусмотренных пунктами 2, 3, 11, 15, 16, 23, 27, 28, 39, 43, 44, 55 вышеуказанного СПРАВОЧНИКА - с указанием конкретных наркотических средств и психотропных веществ, внесенных в списки I - III перечня).</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt"><span style="font-family:&#39;Times New Roman&#39;">К заявлению о предоставлении лицензии на осуществление деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений прилагается </span><a style="color:#000000" href="#Par228"><span style="font-family:&#39;Times New Roman&#39;">опись</span></a><span style="font-family:&#39;Times New Roman&#39;"> документов согласно приложению № 1.</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">В лице _______________________________________________________________________,</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt">(ФИО, должность руководителя постоянно действующего исполнительного органа юридического лица или иного лица, имеющего право действовать от имени этого юридического лица)</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">действующего на основании_____________________________________________________, </span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt">              </span><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt">(документ, подтверждающий полномочия)</span><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt">              </span></p><p style="line-height:12pt; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="line-height:12pt; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">просит предоставить лицензию на осуществление деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений.</span></p><p style="line-height:12pt; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="line-height:12pt; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="line-height:12pt; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt"><tr><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:232.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">&quot;____&quot; __________ 201___г.</span></p></td><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:246.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">_____________________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">                                        (подпись)</span></p></td></tr></table><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">       М.П.</span></p><p style="margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:255.15pt; margin-right:0pt; text-align:right; text-indent:0pt"><span style="font-size:16pt; font-weight:bold">Приложение № 1</span></p><p style="margin-left:255.15pt; margin-right:0pt; text-align:right; text-indent:0pt"><span style="font-size:16pt; font-weight:bold">к заявлению о предоставлении лицензии на осуществление деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">Опись документов</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Настоящим удостоверяется, что соискатель лицензии _______________________________________________________________________________</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование соискателя лицензии)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">представил в лицензирующий орган </span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:12.5pt; font-weight:bold; text-decoration:underline">Департамент здравоохранения города Севастополя</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование лицензирующего органа)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">нижеследующие документы для предоставления лицензии на осуществление деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:485.75pt"><tr style="height:18pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">№ п/п</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Наименование документа</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Кол-во </span><br/><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">листов</span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">1.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Заявление &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:60pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">2.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Копии документов, которые подтверждают наличие у соискателя лицензии на праве собственности или на ином законном сновании соответствующих установленным требованиям и необходимых для осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений помещений, земельных участков, права на которые не зарегистрированы в Едином государственном реестре прав на недвижимое имущество и сделок с ним&lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:60pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">3.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Копии документов, которые подтверждают наличие у соискателя лицензии на праве собственности или на ином законном основании соответствующих установленным требованиям и необходимых для осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений помещений, земельных участков, права на которые зарегистрированы в Едином государственном реестре прав на недвижимое имущество и сделок с ним &lt;**&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:48pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">4.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Копии документов, которые подтверждают наличие у соискателя лицензии на праве собственности или на ином законном основании соответствующих установленным требованиям и необходимых для осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений оборудования &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:48pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">5.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Копия сертификата специалиста, подтверждающего соответствующую профессиональную подготовку руководителя юридического лица или руководителя соответствующего подразделения юридического лица при осуществлении оборота наркотических средств и психотропных веществ, внесенных в списки I - III перечня, прекурсоров, внесенных в список I перечня, и культивирования наркосодержащих растений&lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:66pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">6.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Копии справок, выданных государственными или муниципальными учреждениями здравоохранения в установленном законодательством Российской Федерации порядке, об отсутствии у работников, которые в соответствии со своими служебными обязанностями должны иметь доступ к наркотическим средствам, психотропным веществам, а также прекурсорам, внесенным в список I и таблицу I списка IV перечня, или культивируемым наркосодержащим растениям, заболеваний наркоманией, токсикоманией, хроническим алкоголизмом &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:60pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">7.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Копия заключения органов по контролю за оборотом наркотических средств и психотропных веществ о соответствии объектов и помещений, в которых осуществляются деятельность, связанная с оборотом наркотических средств, психотропных веществ и внесенных в Список I прекурсоров, и (или) культивирование наркосодержащих растений, установленным требованиям к оснащению этих объектов и помещений инженерно-техническими средствами охраны &lt;**&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:84pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">8.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Копия заключения органов по контролю за оборотом наркотических средств и психотропных веществ об отсутствии у работников, которые в соответствии со своими служебными обязанностями должны иметь доступ к наркотическим средствам, психотропным веществам, внесенным в Список I прекурсорам или культивируемым наркосодержащим растениям, непогашенной или неснятой судимости за преступление средней тяжести, тяжкое, особо тяжкое преступление или преступление, связанное с незаконным оборотом наркотических средств, психотропных веществ, их прекурсоров либо с незаконным культивированием наркосодержащих растений, в том числе за преступление, совершенное за пределами Российской Федерации &lt;**&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:66pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">9.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Копия заключения органов по контролю за оборотом наркотических средств и психотропных веществ об отсутствии у работников, которые в силу своих служебных обязанностей получат доступ непосредственно к прекурсорам, непогашенной или неснятой судимости за преступление средней тяжести, тяжкое и особо тяжкое преступление или преступление, связанное с незаконным оборотом наркотических средств, психотропных веществ и их прекурсоров либо с незаконным культивированием наркосодержащих растений, в том числе совершенное за пределами Российской Федерации &lt;**&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:36pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">10.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Копии документов об образовании лиц, осуществляющих деятельность по обороту наркотических средств и психотропных веществ, внесенных в списки I - III перечня, прекурсоров, внесенных в список I перечня, а также о квалификации фармацевтических и медицинских работников &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:22.8pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">11.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Копия лицензии на осуществление медицинской деятельности (в случае, если соискателем лицензии является медицинская организация)</span><span style="font-family:&#39;Times New Roman&#39;"></span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">&lt;**&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">12.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:404pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Доверенность</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:53.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr></table><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">    --------------------------------</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">    </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-weight:bold">&lt;*&gt; </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Документы, которые соискатель лицензии должен представить самостоятельно.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">    </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-weight:bold">&lt;**&gt; </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Документы, которые соискатель лицензии вправе представить по собственной инициативе.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Документы сдал                                                                 Документы принял</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">соискатель лицензии/                                                        должностное лицо лицензирующего органа:</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">представитель соискателя лицензии:                              </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">_____________________________________                   _______________________________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">        (Ф.И.О., должность, подпись)                                                                  (Ф.И.О., должность, подпись)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">_____________________________________                   Дата ___________________________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">          (реквизиты доверенности)</span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">                                            Входящий № ___________________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">                                                                                             Количество листов _______________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">      М.П.            </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">                                                                                                                                                              М.П.</span></p><p style="margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">Приложение № 2</span></p><p style="margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">к приказу Департамента </span></p><p style="margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">здравоохранения города Севастополя</span></p><p style="background-color:#ffffff; margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">от 11.04.2018 № 298</span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:474.9pt"><tr><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:145.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">Регистрационный номер:</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:145.25pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:66.85pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:right; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">от</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:117.45pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td></tr></table><p style="margin-bottom:12pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">                                                     (заполняется лицензирующим органом)</span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt"><tr><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:239.25pt"><p style="line-height:12pt; margin-bottom:12pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:239.3pt"><p style="line-height:14pt; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">В Департамент здравоохранения города Севастополя</span></p><p style="line-height:12pt; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td></tr></table><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:13pt; font-weight:bold">ЗАЯВЛЕНИЕ</span></p><p style="line-height:14pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">о переоформлении лицензии на осуществление деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="line-height:12pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">Регистрационный № ________________ лицензии от «____» ________________ 201__ г.,</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">предоставленной _____________________________________________________________</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование лицензирующего органа)</span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt"><tr><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:352.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr></table><p style="margin-right:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">I. В связи с:</span></p><p style="margin-right:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> реорганизацией юридического лица в форме преобразования</span></p><p style="margin-right:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> реорганизацией юридического лица в форме слияния</span></p><p style="margin-right:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> изменением наименования юридического лица</span></p><p style="margin-right:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> изменением адреса места нахождения юридического лица</span></p><p style="margin-right:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> изменением адреса места осуществления юридическим лицом лицензируемого вида деятельности при фактически неизменном месте осуществления деятельности</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:481.7pt"><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:25.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">№ п/п</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:214.95pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">Сведения о заявителе</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:127.55pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Сведения о лицензиате/лицензиатах</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:113.4pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Новые сведения о лицензиате или его правопреемнике</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">1.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Организационно-правовая форма</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:127.55pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">2.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Полное наименование юридического лица</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:127.55pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">3.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Сокращенное наименование (в случае, если имеется)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:127.55pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">4.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Фирменное наименование (в случае, если имеется)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:127.55pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">5.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Адрес места нахождения юридического лица</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:127.55pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">6.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес(а) мест осуществления лицензируемого вида деятельности</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Выполняемые работы, оказываемые услуги, составляющие </span><span style="font-family:&#39;Times New Roman&#39;">деятельность по обороту наркотических средств, психотропных веществ и их </span><span style="font-family:&#39;Times New Roman&#39;">прекурсоров, культивированию наркосодержащих растений </span><span style="font-family:&#39;Times New Roman&#39;">(указываются в приложении № 1 к заявлению)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:127.55pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">**</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">**</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">7.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Государственный регистрационный номер </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:127.55pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">8.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Данные документа, подтверждающего факт внесения сведений о юридическом лице в единый государственный реестр юридических лиц</span><span style="font-family:&#39;Times New Roman&#39;">,</span><span style="font-family:&#39;Times New Roman&#39;"> с указанием адреса места нахождения органа, осуществившего государственную регистрацию</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:127.55pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан _____________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(орган, выдавший документ)</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи _______</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Бланк: серия _______</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">№ ________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес _____________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Courier New&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан ___________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(орган, выдавший документ)</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи _____</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Бланк: серия _____</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">№ ______________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес __________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Courier New&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">9.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Идентификационный номер налогоплательщика</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:127.55pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#7f7f7f; font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#7f7f7f; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">10.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Данные документа о постановке лицензиата на учет в налоговом органе</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:127.55pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан _____________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(орган выдавший документ)</span></p><p style="font-size:5pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:5pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи: _______</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Бланк: </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Серия ___ №________</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:113.4pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан __________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(орган выдавший документ)</span></p><p style="font-size:5pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:5pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи: _____</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Бланк: </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Серия ___ №_____</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">11.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Сведения о распорядительном документе, на основании которого произошло изменение адреса места осуществления деятельности</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:240.95pt"><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">______________________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">                          </span><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(орган, принявший решение)</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Реквизиты документа ___________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">12.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Данные документа, подтверждающего факт внесения изменений в сведения о юридическом лице в единый государственный реестр юридических лиц</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:240.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан ________________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(орган выдавший документ)</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи: __________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Бланк: </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Серия ___________ №___________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">13.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Реквизиты документа, подтверждающего факт уплаты государственной пошлины за переоформление лицензии, либо иные сведения, подтверждающие факт уплаты указанной государственной пошлины </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:240.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#7f7f7f; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">14.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Контактный телефон лицензиата</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:240.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">15.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Адрес электронной почты (в случае, если имеется)</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:240.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">16.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Форма получения лицензии </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:240.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:23pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">* На бумажном носителе лично</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:23pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">* На бумажном носителе направить </span><span style="font-family:&#39;Times New Roman&#39;">заказным почтовым отправлением с уведомлением о вручении</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:25.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">17.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:214.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Информирование по вопросам лицензирования (указать в случае, если заявителю необходимо направлять указанные сведения в электронной форме) </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:240.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Направлять / не направлять </span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:8pt; font-style:italic">               (нужное указать)</span></p></td></tr><!--[if !supportMisalignedColumns]><tr style="height:0pt"><td style="width:25.8pt; border:none"></td><td style="width:214.95pt; border:none"></td><td style="width:127.55pt; border:none"></td><td style="width:113.4pt; border:none"></td></tr><![endif]--></table><p style="margin-right:0pt; text-align:left"><span style="font-family:&#39;Times New Roman&#39;; font-size:9pt">-------------------------------------------------------</span></p><p style="margin-right:0pt; text-align:left"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">* Нужное указать.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">          **Допускается заполнение данных в приложении, о чем делается соответствующая отметка в ячейке </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">II. В связи с:</span></p><p style="margin-right:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> прекращением деятельности по одному адресу или нескольким адресам мест осуществления деятельности, указанным в лицензии</span></p><p style="margin-right:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> прекращением деятельности выполняемых работ и оказываемых услуг, составляющих лицензируемый вид деятельности по указанным адресам</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:481.7pt"><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:31.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">№ п/п</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:187.7pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">Сведения о заявителе</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:262.2pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">Сведения о лицензиате или его правопреемнике</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">1.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Организационно-правовая форма</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">2.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Полное наименование юридического лица</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">3.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Сокращенное наименование (в случае, если имеется)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">4.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Фирменное наименование (в случае, если имеется)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:10pt; line-height:normal; margin-bottom:12pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">5.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Адрес места нахождения юридического лица</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:10pt; line-height:normal; margin-bottom:12pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td></tr><tr style="height:27.85pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">6.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Государственный регистрационный номер </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:12pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:24.05pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">7.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Идентификационный номер налогоплательщика</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:12pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">8.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Контактный телефон лицензиата</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:10pt; line-height:normal; margin-bottom:12pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">9.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Адрес электронной почты (в случае, если имеется)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:10pt; line-height:normal; margin-bottom:12pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">10.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Форма получения лицензии </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:23pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">* На бумажном носителе лично</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:23pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">* На бумажном носителе направить </span><span style="font-family:&#39;Times New Roman&#39;">заказным почтовым отправлением с уведомлением о вручении</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">11.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Информирование по вопросам лицензирования (указать в случае, если заявителю необходимо направлять указанные сведения в электронной форме) </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Направлять / не направлять </span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:8pt; font-style:italic">               </span><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">(нужное указать)</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">12.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Реквизиты документа, подтверждающего факт уплаты государственной пошлины за переоформление лицензии, либо иные сведения, подтверждающие факт уплаты указанной государственной пошлины</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">13.</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:449.9pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> прекращением деятельности по одному адресу или нескольким адресам мест осуществления деятельности, указанным в лицензии</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">13.1</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес(а) мест осуществления лицензируемого вида деятельности, по которым лицензиат прекращает деятельность.</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выполняемые работы, оказываемые услуги, составляющие деятельность по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________________________________________________________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(адрес места осуществления лицензируемого вида деятельности)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________________________________________________________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(указать работы и услуги согласно </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DF17K3F0M"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">приложению</span></a><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> к Положению о лицензировании деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений, утвержденному Постановлением Правительства Российской Федерации от 22.12.2011 № 1085)</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">13.2</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата фактического прекращения деятельности по одному адресу или нескольким адресам мест осуществления деятельности, указанным в лицензии</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">14.</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:449.9pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> прекращением деятельности по выполнению работ, оказанию услуг, составляющих лицензируемый вид деятельности и указанных в лицензии</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">14.1</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выполняемые работы, оказываемые услуги, которые лицензиат прекращает исполнять при осуществлении деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений.</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес(а) мест осуществления лицензируемого вида деятельности</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________________________________________________________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(указать работы и услуги согласно </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DF17K3F0M"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">приложению</span></a><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> к Положению о лицензировании деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений, утвержденному Постановлением Правительства Российской Федерации от 22.12.2011 № 1085)</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________________________________________________________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(адрес места осуществления лицензируемого вида деятельности)</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">14.2</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:187.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата фактического прекращения лицензиатом выполнения указанных в лицензии работ, услуг</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:262.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><!--[if !supportMisalignedColumns]><tr style="height:0pt"><td style="width:31.8pt; border:none"></td><td style="width:187.7pt; border:none"></td><td style="width:262.2pt; border:none"></td></tr><![endif]--></table><p style="margin-right:0pt; text-align:left"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">--------------------------------------------------</span></p><p style="margin-right:0pt; text-align:left"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">* Нужное указать.</span></p><p style="margin-right:0pt; text-align:left"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt"><span style="font-family:&#39;Times New Roman&#39;">К заявлению о переоформлении лицензии на осуществление деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений прилагаются перечень осуществляемых работ (услуг), составляющих деятельность по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений согласно приложению № 1, а также </span><a style="color:#000000" href="#Par228"><span style="font-family:&#39;Times New Roman&#39;">опись</span></a><span style="font-family:&#39;Times New Roman&#39;"> документов согласно приложению № 2.</span></p><p style="margin-right:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">_____________________________________________________________________________</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(Ф.И.О. руководителя постоянно действующего исполнительного органа юридического лица или иного лица, имеющего право действовать от имени этого юридического лица)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">&quot;____&quot; _______________ 20____ г.                                                     _______________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">                                                                                                                                                       (Подпись)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">                                                                                                            М.П.</span></p><p style="background-color:#ffffff; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="background-color:#ffffff; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="background-color:#ffffff; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="background-color:#ffffff; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="background-color:#ffffff; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="background-color:#ffffff; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="background-color:#ffffff; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="background-color:#ffffff; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:right; text-indent:0pt"><span style="font-size:16pt; font-weight:bold">Приложение № 1</span><br/><span style="font-size:16pt; font-weight:bold">к заявлению о переоформлении лицензии на осуществление деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="margin-left:255.15pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">Перечень осуществляемых работ (услуг), составляющих деятельность по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:488.8pt"><tr style="height:31.2pt"><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:33.75pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">№ п/п</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:221.15pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Адрес места осуществления деятельности</span></p></td><td colspan="3" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:212.65pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Фактически осуществляемые виды работ и услуг </span></p></td><td style="vertical-align:top"></td></tr><tr><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:33.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td colspan="3" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:9pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:27pt"><span style="font-family:Arial; font-size:9pt"> </span></p></td><td style="vertical-align:top"></td></tr><tr><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:33.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td colspan="3" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:9pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:27pt"><span style="font-family:Arial; font-size:9pt"> </span></p></td><td style="vertical-align:top"></td></tr><tr><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:33.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td colspan="3" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:9pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:27pt"><span style="font-family:Arial; font-size:9pt"> </span></p></td><td style="vertical-align:top"></td></tr><tr><td style="border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; vertical-align:top"></td><td colspan="2" style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:219.65pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">Должность руководителя постоянно действующего исполнительного органа юридического лица или иного лица, имеющего право действовать от имени юридического лица </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:114.9pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:14.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:134.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="vertical-align:top"></td><td colspan="2" style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:219.65pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td><td colspan="2" style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:114.9pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(подпись)</span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:14.2pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td><td colspan="2" style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:134.65pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(И.О.Фамилия) </span></p></td></tr><!--[if !supportMisalignedColumns]><tr style="height:0pt"><td style="width:5.4pt; border:none"></td><td style="width:28.35pt; border:none"></td><td style="width:191.3pt; border:none"></td><td style="width:29.85pt; border:none"></td><td style="width:85.05pt; border:none"></td><td style="width:14.2pt; border:none"></td><td style="width:113.4pt; border:none"></td><td style="width:21.25pt; border:none"></td></tr><![endif]--></table><p style="margin-right:0pt; margin-top:12pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">                                                                           М.П.</span></p><p style="margin-left:411.1pt; margin-right:0pt; margin-top:12pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:212.65pt; margin-right:0pt; text-align:right; text-indent:0pt"><span style="font-size:16pt; font-weight:bold">Приложение № 2</span><br/><span style="font-size:16pt; font-weight:bold">к заявлению о переоформлении лицензии на осуществление деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="margin-left:212.65pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">Опись документов</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Настоящим удостоверяется, что лицензиат (правопреемник)</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">_____________________________________________________________________________</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование лицензиата)</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">представил в лицензирующий орган</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold; text-decoration:underline">Департамент здравоохранения города Севастополя</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование лицензирующего органа)</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">нижеследующие документы для переоформления лицензии на осуществление деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений (</span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-style:italic">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-style:italic"> нужное указать</span><span style="font-family:&#39;Times New Roman&#39;">)</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:7.1pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">I. В связи с:</span></p><p style="margin-right:0pt; text-align:left; text-indent:7.1pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> реорганизацией юридического лица в форме преобразования</span></p><p style="margin-right:0pt; text-align:left; text-indent:7.1pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> реорганизацией юридического лица в форме слияния</span></p><p style="margin-right:0pt; text-align:left; text-indent:7.1pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> изменением наименования юридического лица</span></p><p style="margin-right:0pt; text-align:left; text-indent:7.1pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> изменением адреса места нахождения юридического лица</span></p><p style="margin-right:0pt; text-indent:7.1pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> изменением адреса места осуществления юридическим лицом лицензируемого вида деятельности при фактически неизменном месте осуществления деятельности</span></p><p style="margin-right:0pt; text-indent:7.1pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-indent:7.1pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">II. В связи с:</span></p><p style="margin-right:0pt; text-indent:7.1pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> прекращением деятельности по одному адресу или нескольким адресам мест осуществления деятельности, указанным в лицензии</span></p><p style="margin-right:0pt; text-indent:7.1pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> прекращением деятельности выполняемых работ и оказываемых услуг, составляющих лицензируемый вид деятельности по указанным адресам</span></p><p style="margin-right:0pt; text-align:left; text-indent:7.1pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:453.45pt"><tr style="height:18pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:33.75pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">№ п/п</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:359.25pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Наименование документа</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:60.45pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Кол-во листов</span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:33.75pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">1</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:359.25pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Заявление о переоформлении лицензии &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:60.45pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:33.75pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">2</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:359.25pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Оригинал действующей лицензии &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:60.45pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:33.75pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">3</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:359.25pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копия документа, подтверждающего оплату государственной пошлины за переоформление лицензирующим органом лицензии**</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:60.45pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:33.75pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">4</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:359.25pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Доверенность</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:60.45pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p></td></tr></table><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">    --------------------------------</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">    </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-weight:bold">&lt;*&gt; </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Документы, которые лицензиат должен представить самостоятельно.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">    </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-weight:bold">&lt;**&gt; </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Документы, которые лицензиат вправе представить по собственной инициативе.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Документы сдал                                                              Документы принял должностное</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">лицензиат/ представитель лицензиата:                        лицо лицензирующего органа:</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">___________________________________                    ______________________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">            (Ф.И.О., должность, подпись)                                                             (Ф.И.О., должность, подпись)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">___________________________________                   Дата ____________________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">           </span><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(реквизиты доверенности)</span><span style="font-family:&#39;Times New Roman&#39;">                                         Входящий № _____________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">                                                                                         Количество листов ________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">   М.П.                                                                                                                               М.П.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">Приложение № 3</span></p><p style="margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">к приказу Департамента</span></p><p style="margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">здравоохранения города Севастополя </span></p><p style="margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">от 11.04.2018 № 298</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:467.8pt"><tr><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:145.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">Регистрационный номер:</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:138.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:66.85pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:right; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">от</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:117.45pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td></tr></table><p style="margin-bottom:12pt; margin-left:85.05pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">       (заполняется лицензирующим органом)</span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt"><tr><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:239.25pt"><p style="line-height:12pt; margin-bottom:12pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:239.3pt"><p style="line-height:12pt; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p><p style="line-height:14pt; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">В Департамент здравоохранения города Севастополя</span></p><p style="line-height:12pt; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> </span></p></td></tr></table><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:13pt; font-weight:bold">ЗАЯВЛЕНИЕ</span></p><p style="line-height:14pt; margin-bottom:12pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">о переоформлении лицензии на осуществление деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">Регистрационный № __________________ лицензии от «______» ____________ 201__ г.,</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">предоставленной ___________________________________________________________ </span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование лицензирующего органа)</span></p><p style="margin-right:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">В связи с:</span></p><p style="margin-right:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> изменением адресов мест осуществления лицензируемого вида деятельности</span></p><p style="margin-right:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> изменением перечня выполняемых работ, оказываемых услуг, составляющих лицензируемый вид деятельности, ранее не указанных в лицензии</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:467.55pt"><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:31.8pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">№ п/п</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:223.1pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">Сведения о заявителе</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:middle; width:212.65pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">Сведения о лицензиате или его правопреемнике</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">1.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Организационно-правовая форма</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">2.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Полное наименование юридического лица</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">3.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Сокращенное наименование (в случае, </span><span style="font-family:&#39;Times New Roman&#39;">если имеется)</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">4.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Фирменное наименование (в случае, если имеется)</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">5.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Адрес места нахождения юридического лица</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td></tr><tr style="height:27.85pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">6.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Государственный регистрационный номер </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:24.05pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">7.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Идентификационный номер налогоплательщика</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:14.7pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">8.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Контактный телефон лицензиата</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">9.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">Адрес электронной почты (в случае, если имеется)</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; margin-top:6pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">10.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Реквизиты документа, подтверждающего факт уплаты государственной пошлины за переоформление лицензии, либо иные сведения, подтверждающие факт уплаты указанной государственной пошлины</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:23pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">11.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Форма получения лицензии </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:23pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">* На бумажном носителе лично</span></p><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:23pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">* На бумажном носителе направить </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">заказным почтовым отправлением с уведомлением о вручении</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">12.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Информирование по вопросам лицензирования (указать в случае, если заявителю необходимо направлять указанные сведения в электронной форме) </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:11pt">Направлять / не направлять </span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:8pt; font-style:italic">               </span><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">(нужное указать)</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">13.</span></p></td><td colspan="3" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:435.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> изменением адресов мест осуществления лицензируемого вида деятельности</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">13.1</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о новых адресах мест осуществления лицензируемого вида деятельности</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о новых работах (услугах), которые лицензиат намерен выполнять при осуществлении деятельности по обороту наркотичес-ких средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений (при выполнении работ (оказании услуг), предусмотренных </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DF16K3F8M"><span style="font-family:&#39;Times New Roman&#39;">пунктами 2</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DF16K3FBM"><span style="font-family:&#39;Times New Roman&#39;">3</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1FK3F9M"><span style="font-family:&#39;Times New Roman&#39;">11</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1FK3FDM"><span style="font-family:&#39;Times New Roman&#39;">15</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1FK3FCM"><span style="font-family:&#39;Times New Roman&#39;">16</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1EK3FBM"><span style="font-family:&#39;Times New Roman&#39;">23</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1EK3FFM"><span style="font-family:&#39;Times New Roman&#39;">27</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1EK3FEM"><span style="font-family:&#39;Times New Roman&#39;">28</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1DK3F1M"><span style="font-family:&#39;Times New Roman&#39;">39</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1CK3FBM"><span style="font-family:&#39;Times New Roman&#39;">43</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1CK3FAM"><span style="font-family:&#39;Times New Roman&#39;">44</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1BK3FDM"><span style="font-family:&#39;Times New Roman&#39;">55</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1AK3FBM"><span style="font-family:&#39;Times New Roman&#39;">63</span></a><span style="font-family:&#39;Times New Roman&#39;"> приложения к Положению о лицензировании деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений, утвержденного Постановлением Правительства Российской Федерации </span><span style="font-family:&#39;Times New Roman&#39;">от 22.12.2011 № 1085 - с указанием конкретных наркотических средств и психотропных веществ, внесенных в </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF48F37305DB376F33416AB4250BED9A2B1244DA18K3FEM"><span style="font-family:&#39;Times New Roman&#39;">списки I</span></a><span style="font-family:&#39;Times New Roman&#39;"> - </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF48F37305DB376F33416AB4250BED9A2B1244DC1EK3FCM"><span style="font-family:&#39;Times New Roman&#39;">III</span></a><span style="font-family:&#39;Times New Roman&#39;"> перечня)</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________________________________________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(адрес места осуществления лицензируемого вида деятельности)</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">________________________________________________________________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(Указать работы и услуги согласно </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DF17K3F0M"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">приложению</span></a><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> к Положению о лицензировании деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений, утвержденному Постановлением Правительства Российской Федерации от 22.12.2011 № 1085)</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">13.2</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о наличии лицензии на осуществление медицинской деятельности с указанием нового адреса осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений (для медицинских организаций)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:27pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выдан ___________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование органа (организации), выдавшего документ)</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата выдачи ______________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">№ _______________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Новый(ые) адрес(а) осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений: ________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">_________________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">13.3</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о документах, подтверждающих наличие у лицензиата на праве собственности или на ином законном основании соответствующих установленным требованиям и необходимых для осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений помещений и земельных участков, права на которые зарегистрированы в Едином государственном реестре прав на недвижимое имущество и сделок с ним</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Реквизиты документов: ____________</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">13.4</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о наличии заключений органа по контролю за оборотом наркотических средств и психотропных веществ, предусмотренных </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EF9DF4DF27305DB376F33416AB4250BED9A2B1244DA1CK3FBM"><span style="font-family:&#39;Times New Roman&#39;">абзацем</span></a><span style="color:#0000ff; font-family:&#39;Times New Roman&#39;"></span><span style="font-family:&#39;Times New Roman&#39;">третьим пункта 3 статьи 10 Федерального Закона от 08.01.1998 № 3-ФЗ</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Реквизиты заключения органов по контролю за оборотом наркотических средств и психотропных веществ о соответствии объектов и помещений, в которых осуществляются деятельность, связанная с оборотом наркотических средств, психотропных веществ и внесенных в </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF48F37305DB376F33416AB4250BED9A2B1244DA18K3FEM"><span style="font-family:&#39;Times New Roman&#39;">Список I</span></a><span style="font-family:&#39;Times New Roman&#39;"> прекурсоров, и (или) культивирование наркосодержащих растений, установленным требованиям к оснащению этих объектов и помещений инженерно-техническими средствами охраны</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________________________________________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(указать № и дату выдачи заключения, наименование территориального органа Главного управления по контролю за оборотом наркотиков Министерства внутренних дел Российской Федерации, </span><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">выдавшего заключение)</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">13.5</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:223.1pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о сертификате специалиста, подтверждающем соответствующую профессиональную подготовку руководителя подразделения юридического лица, расположенного по новому адресу, при осуществлении оборота наркотических средств и психотропных веществ, внесенных в </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF48F37305DB376F33416AB4250BED9A2B1244DA18K3FEM"><span style="font-family:&#39;Times New Roman&#39;">списки I</span></a><span style="font-family:&#39;Times New Roman&#39;"> - </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF48F37305DB376F33416AB4250BED9A2B1244DC1EK3FCM"><span style="font-family:&#39;Times New Roman&#39;">III</span></a><span style="font-family:&#39;Times New Roman&#39;"> перечня</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:212.65pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Реквизиты сертификата: ____________</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">14.</span></p></td><td colspan="3" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:435.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE1CK3FEM"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold"> изменением перечня выполняемых работ, оказываемых услуг, составляющих лицензируемый вид деятельности, ранее не указанных в лицензии</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">14.1</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:250.05pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о новых работах (услугах), которые лицензиат намерен выполнять при осуществлении деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес(а) места осуществления лицензи-руемого вида деятельности, по которым лицензиат намерен выполнять новые работы (услуги) (при выполнении работ оказании услуг), предусмотренных </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DF16K3F8M"><span style="font-family:&#39;Times New Roman&#39;">пунктами 2</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DF16K3FBM"><span style="font-family:&#39;Times New Roman&#39;">3</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1FK3F9M"><span style="font-family:&#39;Times New Roman&#39;">11</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1FK3FDM"><span style="font-family:&#39;Times New Roman&#39;">15</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1FK3FCM"><span style="font-family:&#39;Times New Roman&#39;">16</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1EK3FBM"><span style="font-family:&#39;Times New Roman&#39;">23</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1EK3FFM"><span style="font-family:&#39;Times New Roman&#39;">27</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1EK3FEM"><span style="font-family:&#39;Times New Roman&#39;">28</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1DK3F1M"><span style="font-family:&#39;Times New Roman&#39;">39</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1CK3FAM"><span style="font-family:&#39;Times New Roman&#39;">44</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1BK3FDM"><span style="font-family:&#39;Times New Roman&#39;">55</span></a><span style="font-family:&#39;Times New Roman&#39;">, </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DE1AK3FBM"><span style="font-family:&#39;Times New Roman&#39;">63</span></a><span style="font-family:&#39;Times New Roman&#39;"> приложения к Положению о лицензировании деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих расте-ний, утвержденному Постановлением Правительства Российской Федерации от 22.12.2011 № 1085 с указанием конкретных наркотических средств и психотропных веществ, внесенных в </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF48F37305DB376F33416AB4250BED9A2B1244DA18K3FEM"><span style="font-family:&#39;Times New Roman&#39;">списки I</span></a><span style="font-family:&#39;Times New Roman&#39;"> - </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF48F37305DB376F33416AB4250BED9A2B1244DC1EK3FCM"><span style="font-family:&#39;Times New Roman&#39;">III</span></a><span style="font-family:&#39;Times New Roman&#39;"> перечня)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:185.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________________________________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(указать работы и услуги согласно </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF46F27305DB376F33416AB4250BED9A2B1244DF17K3F0M"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">приложению</span></a><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> к Положению о лицензировании деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений, утвержденному Постановлением Правительства Российской Федерации от 22.12.2011 № 1085)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________________________________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(адрес места осуществления лицензируемого вида деятельности)</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">14.2</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:250.05pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о документах, подтверждающих наличие у лицензиата на праве собственности или на ином законном основании соответст-вующих установленным требованиям и необходимых для осуществления деятель-ности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений помещений, права на которые зарегист-рированы в Едином государственном реестре прав на недвижимое имущество и сделок с ним, ранее не указанную в лицензии)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:185.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Реквизиты документов: ________</span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:31.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">14.3</span></p></td><td colspan="2" style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:250.05pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Сведения о наличии заключений органа по контролю за оборотом наркотических средств и психотропных веществ, предусмотренных </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EF9DF4DF27305DB376F33416AB4250BED9A2B1244DA1CK3FBM"><span style="font-family:&#39;Times New Roman&#39;">абзацем</span></a><span style="font-family:&#39;Times New Roman&#39;"> третьим пункта 3 статьи 10 </span><span style="font-family:&#39;Times New Roman&#39;">Федерального закона от 08.01.1998 № 3-ФЗ (указать при намерении выполнять работу (оказывать услугу по культивированию наркосодержащих растений), ранее не указанную в лицензии)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:185.7pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Реквизиты заключения органов по контролю за оборотом наркоти-ческих средств и психотропных веществ о </span><span style="font-family:&#39;Times New Roman&#39;">соответствии объектов и помещений, в которых осуществляются деятельность, связанная с оборотом наркоти-ческих средств, психотропных веществ и внесенных в </span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADF48F37305DB376F33416AB4250BED9A2B1244DA18K3FEM"><span style="font-family:&#39;Times New Roman&#39;">Список I</span></a><span style="font-family:&#39;Times New Roman&#39;"> прекурсоров, и (или) культивиро-вание наркосодержащих расте-ний, установленным требованиям к оснащению этих объектов и помещений инженерно-техничес-кими средствами охраны</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________________________________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(указать № и дату выдачи заключения, наименование территориального органа Главного управления по контролю за оборотом наркотиков Министерства внутренних дел Российской Федерации, выдавшего заключение)</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p></td></tr><!--[if !supportMisalignedColumns]><tr style="height:0pt"><td style="width:31.8pt; border:none"></td><td style="width:223.1pt; border:none"></td><td style="width:26.95pt; border:none"></td><td style="width:185.7pt; border:none"></td></tr><![endif]--></table><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p><p style="margin-right:0pt"><span style="font-family:&#39;Times New Roman&#39;">К заявлению о переоформлении лицензии на осуществление деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений прилагается </span><a style="color:#000000" href="#Par228"><span style="font-family:&#39;Times New Roman&#39;">опись</span></a><span style="font-family:&#39;Times New Roman&#39;"> документов согласно приложению № 1.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:5pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">_____________________________________________________________________________</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(Ф.И.О. руководителя постоянно действующего исполнительного органа юридического лица или иного лица, имеющего право действовать от имени этого юридического лица)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">&quot;____&quot; _______________ 20____ г.                                                    ______________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">                                                                                                                                                       (Подпись)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">                                                                                                       М.П.</span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:226.8pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Приложение № 1</span><br/><span style="font-family:&#39;Times New Roman&#39;">к заявлению о переоформлении лицензии на осуществление деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">Опись документов</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Настоящим удостоверяется, что лицензиат (правопреемник)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">___________________________________________________________________________</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование лицензиата)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">представил в лицензирующий орган</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold; text-decoration:underline">Департамент здравоохранения города Севастополя</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(наименование лицензирующего органа)</span></p><p style="margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">нижеследующие документы для переоформления лицензии на осуществление деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений </span><span style="font-family:&#39;Times New Roman&#39;; font-style:italic">(</span><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-style:italic">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-style:italic"> нужное указать</span><span style="font-family:&#39;Times New Roman&#39;; font-style:italic">)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">I. В связи с:</span></p><p style="margin-right:0pt; text-align:left"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> изменением адресов мест осуществления лицензируемого вида деятельности</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:463.9pt"><tr style="height:18pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">№ п/п</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Наименование документа</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Кол-во листов</span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">1.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Заявление о переоформлении лицензии &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">2.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Оригинал действующей лицензии &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:48pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">3.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копии документов, которые подтверждают наличие у лицензиата на праве собственности или на ином законном основании соответствующих установленным требованиям и необходимых для осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений оборудования &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:60pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">4.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копии документов, которые подтверждают наличие у лицензиата на праве собственности или на ином законном основании соответствующих установленным требованиям и необходимых для осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений помещений, земельных участков, права на которые не зарегистрированы в Едином государственном реестре прав на недвижимое имущество и сделок с ним &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:60pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">5.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копии документов, которые подтверждают наличие у лицензиата на праве собственности или на ином законном основании соответствующих установленным требованиям и необходимых для осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений помещений, земельных участков, права на которые зарегистрированы в Едином государственном реестре прав на недвижимое имущество и сделок с ним) &lt;**&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:54pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">6.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копия заключения органов по контролю за оборотом наркотических средств и психотропных веществ о соответствии объектов и помещений, в которых осуществляются деятельность, связанная с оборотом наркотических средств, психотропных веществ и внесенных в Список I прекурсоров, и (или) культивирование наркосодержащих растений, установленным требованиям к оснащению этих объектов и помещений инженерно-техническими средствами охраны &lt;**&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:48pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">7.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копия сертификата специалиста, подтверждающего соответствующую профессиональную подготовку руководителя подразделения юридического лица, расположенного по новому адресу, при осуществлении оборота наркотических средств и психотропных веществ, внесенных в списки I - III перечня, прекурсоров, внесенных в список I перечня, и культивирования наркосодержащих растений &lt;**&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">8.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копия лицензии на осуществление медицинской деятельности с указанием нового адреса осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений (для медицинских организаций) &lt;**&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">9.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Доверенность</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr></table><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left"><span style="font-family:&#39;Times New Roman&#39;; font-weight:bold">II. В связи с:</span></p><p style="margin-right:0pt; text-align:left"><a style="color:#000000" href="consultantplus://offline/ref=42292BBC3C6D9097106281968D3150984EFADE48FC7305DB376F33416AB4250BED9A2B1244DE18K3F0M"><span style="font-family:&#39;Times New Roman&#39;">&lt;*&gt;</span></a><span style="font-family:&#39;Times New Roman&#39;"> изменением перечня выполняемых работ, оказываемых услуг, составляющих лицензируемый вид деятельности, ранее не указанных в лицензии</span></p><p style="margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:463.9pt"><tr style="height:18pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">№ п/п</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Наименование документа</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:middle; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Кол-во листов</span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">1.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Заявление о переоформлении лицензии &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">2.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Оригинал действующей лицензии &lt;*&gt;</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:66pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">3.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копии документов, которые подтверждают наличие у лицензиата на праве собственности или на ином законном основании соответствующих установленным требованиям и необходимых для осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений оборудования &lt;*&gt; (представляется при намерении выполнять работу (оказывать услугу) по культивированию наркосодержащих растений, ранее не указанную в лицензии)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:78pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">4.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копии документов, которые подтверждают наличие у лицензиата на праве собственности или на ином законном основании соответствующих установленным требованиям и необходимых для осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений помещений, земельных участков, права на которые не зарегистрированы в Едином государственном реестре прав на недвижимое имущество и сделок с ним &lt;*&gt; (представляется при намерении выполнять работу (оказывать услугу) по культивированию наркосодержащих растений, ранеене указанную в лицензии)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:78pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">5.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копии документов, которые подтверждают наличие у лицензиата на праве собственности или на ином законном основании соответствующих установленным требованиям и необходимых для осуществления деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений помещений, земельных участков, права на которые зарегистрированы в Едином государственном реестре прав на недвижимое имущество и сделок с ним &lt;**&gt; (представляется при намерении выполнять работу (оказывать услугу) по культивированию наркосодержащих растений, ранее не указанную в лицензии)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:72pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">6.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Копия заключения органов по контролю за оборотом наркотических средств и психотропных веществ о соответствии объектов и помещений, в которых осуществляются деятельность, связанная с оборотом наркотических средств, психотропных веществ и внесенных в Список I прекурсоров, и (или) культивирование наркосодержащих растений, установленным требованиям к оснащению этих объектов и помещений инженерно-техническими средствами охраны &lt;**&gt; (представляется при намерении выполнять работу (оказывать услугу) по культивированию наркосодержащих растений, ранее не указанную в лицензии)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr style="height:12pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:27pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">7.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:387.3pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Доверенность</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:3.5pt; padding-right:3.5pt; vertical-align:top; width:49.6pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr></table><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">    --------------------------------</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">    </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-weight:bold">&lt;*&gt; </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Документы, которые лицензиат должен представить самостоятельно.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">    </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-weight:bold">&lt;**&gt; </span><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Документы, которые лицензиат вправе представить по собственной инициативе.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Документы сдал                                                              Документы принял должностное</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">лицензиат/ представитель лицензиата:                        лицо лицензирующего органа:</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">__________________________________                     ________________________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">            (Ф.И.О., должность, подпись)                                                             (Ф.И.О., должность, подпись)</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">_________________________________                      Дата _____________________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">           </span><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(реквизиты доверенности)</span><span style="font-family:&#39;Times New Roman&#39;">                                       Входящий № ______________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">                                                                               Количество листов _____________________</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">   М.П.                                                                                                                        М.П.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:248.1pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">Приложение № 4</span></p><p style="margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">к приказу Департамента </span></p><p style="margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">здравоохранения города Севастополя </span></p><p style="background-color:#ffffff; margin-right:0pt; text-align:right; text-indent:248.1pt"><span style="font-size:16pt; font-weight:bold">от 11.04.2018 № 298</span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin:18pt 0pt 12pt 255.15pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">В Департамент здравоохранения города Севастополя</span></p><p style="margin-left:248.1pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">Полное наименование заявителя</span></p><p style="margin-left:295.7pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Исх. № _____________________</span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt"><tr><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:23.25pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">от «</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:19.85pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:12.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">»</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:111.8pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr></table><p style="margin-right:0pt; margin-top:36pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">ЗАЯВЛЕНИЕ</span></p><p style="margin-bottom:12pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">о предоставлении дубликата/копии лицензии на осуществление </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">деятельности по обороту наркотических средств, психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; margin-right:0pt; orphans:0; padding-top:1pt; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">(полное наименование юридического лица)</span></p><p style="margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><div style="border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; clear:both; margin:0pt"><p style="margin:0pt 0.05pt 0pt 0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">(место нахождения юридического лица)</span></p><p style="margin:0pt 0.05pt 0pt 0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:1pt"> </span></p></div><p style="margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; margin-right:0pt; orphans:0; padding-top:1pt; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">(государственный регистрационный номер записи о создании юридического лица)</span></p><p style="margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><div style="border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; clear:both; margin:0pt"><p style="margin:0pt 0.05pt 0pt 0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">(идентификационный номер налогоплательщика)</span></p><p style="margin:0pt 0.05pt 0pt 0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic"> </span></p></div><p style="margin-right:0pt; orphans:0; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">просит предоставить дубликат/копию лицензии на осуществление деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений, выданной</span></p><p style="margin-right:0pt; orphans:0; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; margin-right:0pt; orphans:0; padding-top:1pt; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">(наименование лицензирующего органа)</span></p><p style="margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">Номер и дата регистрации лицензии </span></p><p style="margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; margin-right:0pt; orphans:0; padding-top:1pt; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:1pt"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:467.8pt"><tr><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:215.45pt"><p style="font-size:13.5pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:13.5pt"> </span></p><p style="font-size:13.5pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:13.5pt">Руководитель юридического лица</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:99.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:14.2pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:justify; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:138.95pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:215.45pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:99.2pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(подпись)</span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:14.2pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:top; width:138.95pt"><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(Ф.И.О.)</span></p></td></tr></table><p style="margin-left:191.35pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">                                         М.П.</span></p><p style="margin-left:191.35pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:191.35pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:191.35pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; margin-right:0pt; orphans:0; padding-top:1pt; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:1pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">&lt;*&gt; За предоставление дубликата лицензии уплачивается государственная пошлина в соответствии со ст. 333.33 Налогового кодекса Российской Федерации.</span></p><p style="margin-right:0pt; text-align:left; text-indent:248.1pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:248.1pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:248.1pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:248.1pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">Приложение № 5</span></p><p style="margin-right:0pt; text-align:left; text-indent:248.1pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">к приказу Департамента</span></p><p style="margin-right:0pt; text-align:left; text-indent:248.1pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">здравоохранения города Севастополя </span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:248.1pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt">от __________ № __________</span></p><p style="background-color:#ffffff; margin-right:0pt; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:101.7%"><tr><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:60.18%"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-weight:bold">Регистрационный номер: __________________________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">                                          (заполняется лицензирующим органом</span><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">)</span></p><p style="font-size:9pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:9pt; font-weight:bold"> </span></p></td><td style="padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:39.82%"><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-weight:bold">от ____________________________</span></p><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-weight:bold"> </span></p><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt; font-weight:bold"> </span></p><p style="font-size:14pt; line-height:normal; margin-bottom:0pt; margin-left:5.35pt; margin-right:0pt; text-align:center; text-indent:-5.35pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">В Департамент здравоохранения города Севастополя</span></p><p style="font-size:14pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="color:#000000; font-family:Arial; font-size:14pt"> </span></p></td></tr></table><p style="margin-right:0pt; page-break-after:avoid; page-break-inside:avoid; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">ЗАЯВЛЕНИЕ</span></p><p style="margin-right:0pt; page-break-after:avoid; page-break-inside:avoid; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">о прекращении </span><span style="font-family:&#39;Times New Roman&#39;; font-size:14pt; font-weight:bold">деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Регистрационный № _________________________ лицензии от «</span><span style="font-family:&#39;Times New Roman&#39;">____» __________ 20___г.</span><span style="color:#000000; font-family:&#39;Times New Roman&#39;">, </span></p><p style="margin-left:0pt; margin-right:0pt; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">предоставленной ________________________________________________________________</span></p><p style="margin-left:0pt; margin-right:0pt; text-align:center; text-indent:35.4pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">(наименование лицензирующего органа)</span></p><p style="margin-left:0pt; margin-right:0pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:469.25pt"><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">1.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Организационно-правовая форма и полное наименование юридического лица</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">2.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Сокращенное наименование юридического лица (в случае, если имеется)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">3.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Фирменное наименование юридического лица (в случае, если имеется)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">4.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адрес</span><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> места нахождения юридического лица (с указанием почтового индекса)</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">5.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Государственный регистрационный номер записи о создании юридического лица</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">6.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Данные документа, подтверждающего факт внесения сведений о юридическом лице в единый государственный реестр юридических лиц</span><span style="font-family:&#39;Times New Roman&#39;">, с указанием адреса места нахождения органа, осуществившего государственную регистрацию</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Выдан ____________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">                 </span><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">(орган, выдавший документ)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Дата выдачи _______________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Бланк: серия ________ № ____________</span></p><p style="font-size:10pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:10pt"> </span></p><p style="font-size:11pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Адрес_______________________________________________________________________</span></p><p style="font-size:8pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:8pt"> </span></p></td></tr><tr style="height:4.15pt"><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">7.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Идентификационный номер налогоплательщика</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">8.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Данные документа о постановке юридического лица на учет в налоговом органе</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Выдан ___________________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-style:italic">                  </span><span style="color:#000000; font-family:&#39;Times New Roman&#39;; font-size:10pt; font-style:italic">(орган, выдавший документ)</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Дата выдачи _______________________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">Бланк: серия _________ № ___________</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">9.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Адреса(а) мест осуществления лицензируемого вида деятельности. </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Выполняемые работы, оказываемые услуги, составляющие </span><span style="font-family:&#39;Times New Roman&#39;">деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">10.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Дата фактического прекращения</span><span style="font-family:&#39;Times New Roman&#39;"> деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">11.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Номер телефона, (в случае, если имеется), адрес электронной почты </span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:left; text-indent:36pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr><tr><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:28.35pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">12.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:219.75pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">Форма получения </span><span style="font-family:&#39;Times New Roman&#39;">юридическим лицом</span><span style="font-family:&#39;Times New Roman&#39;"> уведомления о решении лицензирующего органа</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; border-left-color:#000000; border-left-style:solid; border-left-width:0.75pt; border-right-color:#000000; border-right-style:solid; border-right-width:0.75pt; border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; padding-left:5.4pt; padding-right:5.4pt; vertical-align:top; width:221.15pt"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:23pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">* На бумажном носителе лично</span></p><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; text-align:justify; text-indent:23pt"><span style="color:#000000; font-family:&#39;Times New Roman&#39;">* На бумажном носителе направить </span><span style="font-family:&#39;Times New Roman&#39;">заказным почтовым отправлением с уведомлением о вручении</span></p></td></tr></table><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">--------------------------------</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">&lt;*&gt; Нужное указать.</span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-right:0pt; text-align:left; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;">              </span><span style="font-family:&#39;Times New Roman&#39;">,</span></p><p style="border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; margin-bottom:12pt; margin-right:0pt; padding-top:1pt; text-align:center; text-indent:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(Ф.И.О. руководителя постоянно действующего исполнительного органа юридического лица или иного лица, имеющего право действовать от имени этого юридического лица)</span></p><table cellspacing="0" cellpadding="0" style="border-collapse:collapse; margin-left:0pt; width:100%"><tr><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:1.7%"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">“</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:4.56%"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:2.56%"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">”</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:15.92%"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:3.7%"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:right; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">20</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:3.7%"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td><td style="padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:36.38%"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-left:2.85pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">г.</span></p></td><td style="border-bottom-color:#000000; border-bottom-style:solid; border-bottom-width:0.75pt; padding-left:1.4pt; padding-right:1.4pt; vertical-align:bottom; width:31.46%"><p style="font-size:12pt; line-height:normal; margin-bottom:0pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p></td></tr></table><p style="margin-left:340.2pt; margin-right:0pt; orphans:0; text-align:center; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:10pt">(подпись)</span></p><p style="margin-left:318.95pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;">М.П.</span></p><p style="margin-left:318.95pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:318.95pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="margin-left:318.95pt; margin-right:0pt; orphans:0; text-align:left; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;"> </span></p><p style="border-top-color:#000000; border-top-style:solid; border-top-width:0.75pt; margin-right:0pt; orphans:0; padding-top:1pt; text-indent:0pt; widows:0"><span style="font-family:&#39;Times New Roman&#39;; font-size:1pt"> </span></p><p style="background-color:#ffffff; margin-right:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt">Лицензиат, имеющий намерение прекратить деятельность по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений, обязан представить или направить в лицензирующий орган заказным почтовым отправлением с уведомлением о вручении заявление о прекращении деятельности по обороту наркотических средств и психотропных веществ и их прекурсоров, культивированию наркосодержащих растений не позднее чем за пятнадцать календарных дней до дня фактического прекращения лицензируемого вида деятельности (часть 14 статьи 20 Федерального закона от 04.05.2011 № 99-ФЗ «О лицензировании отдельных видов деятельности»).</span></p><p style="background-color:#ffffff; margin-right:0pt"><span style="font-family:&#39;Times New Roman&#39;; font-size:11pt"> </span></p><p><span> </span></p></div>
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