简易纠纷调解协议书

2020-03-02 13:43:24 来源：范文大全收藏下载本文

简易纠纷调解协议书

编号：_______________

当事人（自然人姓名、性别、年龄、民族、职业、单位或住址，法人及社会组织的名称、地址、法定代表人姓名和职务）：

________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 纠纷简要情况：__________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 经调解，自愿达成如下协议：______________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 履行协议的方式、地点、期限：____________________________________________ ________________________________________________________________________ ________________________________________________________________________ 当事人（签名或盖章）:_______________________________________________ 调解员（签名或盖章）:_______________________________________________

调解日期：年月日

简易纠纷调解协议书

玉环经济开发区人民调解委员会

年月日