Příloha č. 7
Soupis škod na polních porostech
Jméno, příjmení ...........................................................
Rodné číslo (vyplňuje pouze fyzická osoba) ................................
Název právnické osoby .....................................................
IČO .......................................................................
Datum ....................
Podpis poškozeného subjektu (razítko)
+-------+----------------+---------+-------------+--------------+----------+-------------+
| Poř. | | Číslo | | | Hraboši, | Výměra |
| číslo | Katastr. území | parcely | Výměra v ha | Druh plodiny | sucho, | poškozeného |
| | | | | | kroupy * | porostu |
+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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+-------+----------------+---------+-------------+--------------+----------+-------------+
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* - nehodící se škrtněte
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