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行政起诉状

行政起诉状

(公民提起行政诉讼用)
      原告:_________________________________________________________
      被告:_________________________________________________________
      案由:_________________________________________________________
      诉讼请求:_____________________________________________________
      事实与理由:___________________________________________________
      _______________________________________________________________
      _______________________________________________________________
      ______________________________________________________
      证据和证据来源,证人姓名和住址:_______________________________
       
       
          此致
        _____________人民法院
       
      起诉人:          
      年   月   日          
      附:本诉状副本_______份。
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