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×××工商行政管理局经济合同仲裁委员会保全措施审批表
                                        19    年    月    日

---------------------------------

|  申请人|                |单  位|                          |

|----|--------|---|-------------|

|被申请人|                |单  位|                          |

|----|--------------------------|

|  申标  |                                                    |

|  请的  |                                                    |

|  理及  |                                                    |

|  由采  |                                                    |

|  、取  |                                                    |

|  保的  |                                                    |

|  全措  |                                                    |

|  的施  |                                                    |

|----|--------------------------|

|  承办人|                                                    |

|  意  见|                                                    |

|----|--------------------------|

|  仲  裁|                                                    |

|  委员会|                                                    |

|  批  示|                                                    |

|----|--------------------------|

|  备  注|                                                    |

--------------------------------- 国家工商管理局

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