签订日期：__________________________________
签订地点：__________________________________ 甲方(委托人)：____________________代表人：________________________
身份证号码：________________________联系电话：______________________
住所：__________________________________________________________
乙方(被委托人)：___________________代表人：________________________
营业执照号码：_______________________联系电话：______________________
住所：___________________________________________________________....
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