事故调查询问笔录.doc

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1、第页  共页 事故调查询问笔录时间：年月日    时   分至      年    月    日    时    分 地  点：                                          被询问人：             性别：               出生日期：               部门：             职务（岗位）：            本工种工龄：            联系方式：                                                           询问人：            

2、     单位及职务：                                记录人：                 单位及职务：                                 问：我们是三川徳青工程机械有限公司质量安全部、制造部的工作人员，现在向你询问                 事故的有关问题，请你如实回答。 答：                                                                 问：                                                    

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5、                                                                                                               被询问人签名：              第  页  共  页 事故调查询问笔录                                                                                                                                                

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