______________市场监督管理局
行政处罚决定书
_____市监____〔_____〕_____号
当事人: ______________________________________________________________________
主体资格证照名称: ____________________________________________________________
统一社会信用代码（注册号）: __________________________________________________
住所(住址）: _________________________________________________________________
法定代表人（负责人、经营者）: ________________________________________________
身份证（其他有效证件）号码: __________________________________________________
联系电话:__________________________其他联系方式: _____________________________
联系地址: ____________________________________________________________________
(案件来源、调查经过及采取行政强制措施的情况) _____________________________
_______________________________________________________________________________
______________________________________________________________________________
(违反法律、法规或者规章的事实）____________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
上述事实，主要有以下证据证明:
_____________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
(当事人陈述、申辩情况，当事人陈述、申辩的采纳情况及理 由；行政处罚告知、行政处罚听证告知情况，以及复核、听证过程及意见) ___________________________________
_______________________________________________________________________________
_______________________________________________________________________________
（案件性质、自由裁量的事实和理由）_________________________________________
_______________________________________________________________________________
(行政处罚的内容和依据)____________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
(行政处罚的履行方式和期限)________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
(救济途径和期限) _________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_________市场监督管理局
(印章）
年 月 日