______公安局
                                         延长侦察羁押期限通知书
                                         （存 根）
                                         ___________________________________________
                                        字[    ]     号
                                         案件名称：_________________________________
                                         案件编号：_________________________________
                                         犯罪嫌疑人：______ 性别：______年龄：______
                                         住址：_____________________________________
                                         单位及职业：_______________________________
                                         逮捕时间：_________________________________
                                         重新计算原因：_____________________________
                                         重新计算时间_______________________________
                                         送往单位：_________________________________
                                         批准人：___________________________________
                                         批准时间：_________________________________
                                         办案人：___________________________________
                                         办案单位：_________________________________
                                         填发时间：_________________________________
                                         填发人：___________________________________