民事再审申诉状

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申诉人:

申诉人因__________一案,对__________人民法院______年______月______日(__________)__________字第__________号民事判决(或裁定),提出申诉。

请求事项:________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

事实与理由:______________________________________________________________________________________________________

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

此致

________人民法院

申诉人:__________

____年____月____日

附:

1.原审民事判决书(或裁定书)________份;

2.证据材料________份。

TAG标签:民事 申诉状 再审