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(қабат, бөлме саны және басқалары)
алаңы _______ ш.м тұрғын үй салуды (беруді) сұраймын.
Отбасы құрамы ______ адам:
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20 ___ ж. «____» _______________
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(қолы)
Өтінішті қабылдаған: ________________________________________________
(Т.А.Ә., лауазымы)