Regulations on the Department of Social Development of the University. Forms: Regulations on the Department of Social Development

Document section: Sample Documents, Position

TYPICAL POSITION

ABOUT CUSTOMS SOCIAL DEVELOPMENT DEPARTMENT

I. General provisions

2. If it is impossible or inexpedient to create a Department, its tasks and functions are performed by the Customs Logistics Department.

3. The general management of the Department is carried out by the head of customs and (or) the deputy head of customs for logistics. Methodical management of the activities of the Department is carried out by the Main Directorate of Logistics Support of the Federal Customs Service of Russia.

4. The department in its activities is guided by the Constitution Russian Federation, federal constitutional laws, the Customs Code of the Russian Federation, others federal laws, decrees and orders of the President of the Russian Federation, decrees and orders of the Government of the Russian Federation, international treaties of the Russian Federation, regulatory legal acts of the Ministry of Economic Development of Russia, the Ministry of Finance of Russia and the Bank of Russia, other regulatory legal acts in the field of customs, legal acts of the Federal Customs Service of Russia and the regional customs administration as well as these Regulations.

5. The department solves the tasks assigned to it both directly and with the participation structural divisions customs, in cooperation with the territorial authorities of other federal bodies executive authorities, executive authorities of the constituent entities of the Russian Federation, local governments, public associations and other organizations and individuals.

6. The activities of the Department are carried out on the basis of current and long-term planning.

7. Responsibilities and other issues of activity officials Departments are regulated by job descriptions (job regulations) approved in accordance with the established procedure.

8. The staffing of the Department is approved by the head of customs.

II. Main tasks

9. Studying the problems of social security of officials and customs workers, collecting, summarizing and analyzing the necessary statistical data, forecasting the development of social processes in the structural divisions of customs.

10. Submission of proposals for implementation to the management of customs social policy FTS of Russia.

11. Organization of work on the implementation of guarantees of material and social support and social protection of officials and customs workers, veterans of the customs service.

12. Organization of work on the implementation of programs social development customs authorities.

III. Main functions

13. Participation in the development of social policy and the identification of priority areas for development social base customs.

14. Development of housing programs for customs officials and participation in their implementation, determination of a reasonable need for the construction and acquisition of housing, preparation of proposals on these issues for the management of customs.

15. Organization within the powers of the Department of control over the execution of legal acts providing for social rights, benefits regulating the issues of material and welfare in relation to officials and customs workers.

16. Ensuring interaction with territorial bodies of federal executive bodies on issues within the competence of the Department.

17. Accounting for customs officials who need to improve their living conditions, control over the distribution of housing in customs.

18. Determining and substantiating the needs of customs in financing the social sphere and making appropriate proposals for consideration by the management of customs.

19. Ensuring effective use financial resources allocated for the purchase and construction of housing and other social facilities.

20. Organization of health-improving holidays for customs officials and members of their families.

21. Organization of sports and recreational activities among customs officials and members of their families.

22. Implementation of work on the selection, placement, training and education of personnel for the Customs Department.

23. Study, synthesis and dissemination of best practices in the management social work.

24. Drawing up and submission to the management of the customs of the necessary reporting information on issues within the competence of the Department.

25. Performing other functions, if such functions are provided for by the legislation of the Russian Federation, decrees and orders of the President of the Russian Federation, decrees and orders of the Government of the Russian Federation, regulatory legal acts of the Ministry of Economic Development of Russia, legal acts of the Federal Customs Service of Russia.

IV. Rights

26. To perform the assigned tasks and functions, the Department has the right to:

1) interact with other customs authorities and organizations on issues within the competence of the Department;

2) request and receive from the structural subdivisions of the customs the necessary information and documents;

3) submit for approval by the customs management draft orders, orders, contracts and other documents on the activities of the Department;

4) request, in agreement with the management of the customs, from other customs authorities and organizations under the jurisdiction of the FCS of Russia, the documents and information necessary to perform the tasks and functions assigned to the Department;

5) enjoy other rights provided for by the Customs Code of the Russian Federation and other legislative acts of the Russian Federation.

V. Final provisions

27. The department is headed by a chief appointed and dismissed by customs orders in agreement with the relevant departments of a higher customs authority.

28. Head of Department:

1) manage the activities of the Department on the basis of the principle of unity of command;

2) distributes duties between subordinate officials, ensures their observance of official discipline;

3) creates conditions for improving the professional training of officials and employees of the Department, the introduction of promising methods and methods of work;

4) organizes the development, submits for approval to the head of customs draft documents on issues within the competence of the Department;

5) ensures the implementation of programs, plans and indicators budget planning, execution of instructions of the management of customs;

6) submits, in accordance with the established procedure, submissions on the assignment of class ranks to officials of the Department;

7) submits, in accordance with the established procedure, proposals for encouraging officials and employees of the Department, for imposing disciplinary sanctions on them;

8) represent the customs in government bodies and other organizations on issues within the competence of the Department;

9) is responsible for the timely and high-quality performance of the tasks and functions assigned to the Department;

10) performs other functions, enjoys other rights and bears responsibility in accordance with the legislation of the Russian Federation.

Head of the Main Logistics Department V.F. LAGIREV

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1. General Provisions

1.1. The Social Development Department is an independent* structural subdivision of the organization.

______________________

1.2. The department of social development is created, reorganized and liquidated by order of the head of the organization.

1.3. The Social Development Department reports directly to the head of the organization.

1.4. The department of social development is headed by the head of the department, who is appointed and dismissed from his position by order of the head of the organization.

1.5. The head of the department of social development directly manages the activities of the department.

1.6. A person with higher education is appointed to the position of head of the social development department professional education and work experience in the specialty in managerial and other positions in personnel management for at least 5 years.

1.7. The duties, rights and responsibilities of each employee of the social development department are established by the job description, which is agreed with the head of the department and approved by the head of the organization.

1.8. The Department of Social Development in its activities is guided by:

Normative legal acts, other guidance and methodological materials on issues of social development;

the charter of the organization;

Orders, orders of the head of the organization (direct supervisor);

The present position.

1.9. Changes in the structure and staff of the social development department are developed by the head of the department, based on the conditions and characteristics of the organization's activities, are agreed with the immediate supervisor, as well as with the department of labor organization and wages, the personnel department, the legal department in the relevant areas of activity of the indicated structural divisions and are approved by order of the head of the organization.

2. Main tasks

The main tasks of the social development department are:

2.1. Identification and use of social reserves of labor productivity growth and production intensification.

2.2. The study of sociological and psychological problems organization of work, life and rest of workers, development of ways and methods of their solution.

2.3. Organization of work on managing the social development of the labor collective.

3. Functions

In accordance with the main tasks, the following functions are assigned to the department of social development:

3.1. Development and implementation targeted programs and social development plans based on social forecasts and modeling of social processes in accordance with the goals, strategy and personnel policy of the organization in the conditions market economy, taking into account external and internal factors of development.

3.2. Work to stabilize labor collectives, improve social structure personnel, its demographic and vocational composition, preparation of proposals for regulating the number of employees, improving their general educational and cultural and technical level, strengthening discipline and organization, creating and maintaining a favorable socio-psychological climate in the team, optimal interpersonal and intergroup relations, adaptation newly hired workers.

3.3. Studying the conditions and content of work and their impact on job satisfaction, especially among young people, developing measures to improve ergonomic, sanitary and hygienic working conditions, ensuring labor protection and safety of workers, socio-psychological support for the introduction of the process of mastering new types of complex equipment, reducing heavy and low-skilled manual labor, increasing the attractiveness, prestige and culture of work.

3.4. Participation in the examination of projects for the construction and reconstruction of industrial and non-industrial facilities in order to ensure that they take into account social requirements and standards.

3.5. Improving the system of material, socio-cultural, moral and psychological incentives to increase the labor and social activity of employees, creative attitude to work, group and individual responsibility for the results of joint activities.

3.6. Ensuring social insurance of employees, compliance with their social guarantees and civil rights, development of proposals for measures of social protection of employees of the organization within the framework of collective-contractual regulation of labor relations.

3.7. Development and implementation of measures to preserve the health and increase the content of the leisure of workers, increase the living standards of workers and their families, meet the needs for housing and household appliances, various services, social protection of certain categories of workers (pensioners, youth, women).

3.8. Advising employees on legal and financial issues, women's labor issues, developing proposals for the provision of various social benefits to employees of the organization: compensation for housing costs, education of children, provision of transport for commuting, medical care.

3.9. Conducting lectures, seminars on the study by employees of the organization of socio-psychological methods of managing social processes, providing methodological assistance to departments in the development of measures for the social development of labor collectives, coordinating their activities to identify and use social reserves of production and implement targeted integrated social programs.

4.1. The Department of Social Development, within its competence, has the right to:

4.1.1. Represent the organization in accordance with the established procedure in other organizations on issues related to production activities department of social development.

4.1.2. Require and receive from the divisions of the organization the submission of information and documents necessary for the implementation of work that is within the competence of the department of social development.

4.1.3. Conduct independent correspondence with organizations on issues within the competence of the department of social development and not requiring coordination with the head of the organization, in the prescribed manner.

4.2. The head of the social development department has the right *:

_______________________

4.2.1. Get acquainted with the draft decisions of the organization's management regarding the activities of the social development department.

4.2.2. Submit proposals for the improvement of the work related to the responsibilities provided for by this Regulation for consideration by the management of the organization.

4.2.3. Within its competence, report to the immediate supervisor about all shortcomings in the activities of the organization (structural unit, individual employees) identified in the process of fulfilling their official duties and make suggestions for their elimination.

4.2.4. Involve specialists of structural subdivisions of the organization in the performance of the duties assigned to him in cases where this is provided for by the regulations on structural subdivisions, otherwise - with the permission of the head of the organization.

4.2.5. Request personally or on behalf of the immediate supervisor from the heads of structural divisions, specialists, information and documents necessary for the performance of their duties.

4.2.6. Sign and endorse documents within their competence.

4.2.7. Submit for consideration by the head of the organization ideas on the appointment, transfer, dismissal of employees of the social development department, proposals for their encouragement or the imposition of penalties on them.

4.2.8. Require the management of the organization to assist in the performance of their duties and the exercise of rights.

5. Relationships. Connections

The department of social development interacts with structural subdivisions of the organization on issues within its competence.

6. Responsibility*

_______________________

* This section is included in the regulation on the department of social development, if job description for the head of the department of social development is not being developed.

Failure to perform (improper performance) of their official duties;

Failure to comply with the internal labor regulations, rules and regulations of labor protection and fire safety;

Misuse and incomplete use of the granted rights;

Poor performance of duties of subordinate employees;

Low performance and labor discipline of employees subordinate to him;

Causing material damage to the organization - in accordance with applicable law.

6.2. The responsibility of other employees of the social development department is established by their job descriptions.

Note. The regulation on the department of social development is drawn up in accordance with the requirements of the State Standard of the Republic of Belarus 6.38-2004 “Unified Documentation Systems. System of organizational and administrative documentation. Requirements for paperwork” (approved by the Resolution of the Committee for Standardization, Metrology and Certification under the Council of Ministers of the Republic of Belarus dated December 21, 2004 No. 69, is included in the Unified System of Organizational and Administrative Documentation (USORD), approved by order of the Department for Archives and Records Management of the Ministry of Justice of the Republic of Belarus dated May 14. 2007 No. 25).

__________________________________________________________________

(full company name, location of the enterprise)

I APPROVE Head ___________ ________________________ "___" __________ _____

POSITION

about the enterprise social development department

1. GENERAL PROVISIONS

1.2. The department was created on the basis of the order of the Head N _____ dated "__" _________ ____

1.3. Employees of the department are appointed and dismissed on the basis of the decision of the Head on the proposal of the head of the department.

1.4. Employees of the department should know and be guided in their work by the following:

the Constitution of the Russian Federation;

Legislative and regulatory legal acts, teaching materials on issues of social development;

labor law;

Goals, strategy and personnel policy enterprises;

Profile, specialization and features of the structure of the enterprise;

Sociology, psychology and physiology of labor;

Fundamentals of social planning;

Methods of psychological testing;

Methods sociological research, the study of public opinion;

The procedure and methods for developing plans and programs for the social development of the enterprise;

Fundamentals of the organization of management of the social development of the enterprise;

Social requirements and regulations;

Fundamentals of engineering and social psychology;

Methods for analyzing the implementation of social programs and determining their economic efficiency;

Forms and systems of remuneration, material and moral incentives;

Advanced domestic and overseas experience management of social processes;

Fundamentals of economics, organization of production, labor and management;

Basics of labor legislation;

Rules and norms of labor protection;

Local acts of the enterprise.

1.5. The department should have documents and materials on the following issues:

Methodical materials on the organization of social development;

The structure of the enterprise, its profile, specialization and development prospects;

The state and prospects for the development of domestic and foreign science and technology in the relevant fields of knowledge and industries;

Main technological processes production of the company's products;

Methods of organizing and planning the work of the department;

United state system office work;

Methods for the effective use of office equipment and other technical means managerial work;

Internal labor regulations;

Rules and norms of labor protection, fire safety.

2. STRUCTURE OF THE DEPARTMENT

2.1. The structure and staffing of the department is approved by the head of the enterprise.

2.2. The head of the department is in charge of the department.

2.3. The department includes (specify position):

Sociologist;

Psychologist;

- __________________________________________.

3. MAIN TASKS OF THE DEPARTMENT

3.1. The main tasks of the department are:

Implementation of sociological work at the enterprise, aimed at the formation of stable workforces, development organizational culture, the use of socio-psychological factors work motivation employees, increasing their social and creative activity, job satisfaction in order to maximize the development and use of the labor potential of each employee;

Development and implementation of measures to preserve the health and increase the content of the leisure of workers, increase the living standards of workers and their families.

4. FUNCTIONS OF THE DEPARTMENT

In accordance with the tasks assigned to it, the department performs the following functions:

4.1. Development and implementation of targeted programs and plans for social development based on social forecasts and modeling of social processes in accordance with the goals, strategy and personnel policy of the enterprise in a market economy, taking into account external and internal development factors.

4.2. Work to stabilize labor collectives, improve the social structure of personnel, its demographic and vocational composition.

4.3. Preparation of proposals for regulating the number of employees, increasing their general educational and cultural and technical level, strengthening discipline and organization, creating and maintaining a favorable socio-psychological climate in the team, optimal interpersonal and intergroup relations, and adapting newly hired employees.

4.4. The study of the conditions and content of labor and their impact on job satisfaction by employees of the enterprise.

4.5. Development of measures to improve ergonomic, sanitary and hygienic working conditions, ensure labor protection and safety of workers, socio-psychological support for the introduction of the process of mastering new types of complex equipment, reduce heavy and low-skilled manual labor, increase the attractiveness, prestige and culture of work.

4.6. Examination of projects for the construction and reconstruction of industrial and non-industrial facilities in order to ensure that they take into account social requirements and standards.

4.7. Improving the system of material, socio-cultural, moral and psychological incentives to increase the labor and social activity of employees, creative attitude to work, group and individual responsibility for the results of joint activities.

4.8. Control over the provision of social insurance for employees, observance of their social guarantees and civil rights.

4.9. Development of proposals on measures of social protection of employees of the enterprise within the framework of collective-contractual regulation of labor relations.

4.10. Development and implementation of measures to preserve the health and increase the content of the leisure of workers, increase the living standards of workers and their families, meet the needs for housing and household appliances, various services, social protection of certain categories of workers (pensioners, youth, women).

4.11. Advising employees on legal and financial issues, women's labor issues.

4.12. Development of proposals for the provision of various social benefits to employees of the enterprise; compensation for housing, children's education, transportation to work, medical care.

4.13. Ensuring the introduction of mechanization and computer technologies in their activities.

4.14. Conducting lectures, seminars on the study by employees of the enterprise of socio-psychological methods of managing social processes.

4.15. Providing methodological assistance to the structural divisions of the enterprise in the development of measures for the social development of labor collectives.

4.16. Coordination of the activities of the structural divisions of the enterprise to identify and use the social reserves of production and the implementation of targeted comprehensive social programs.

4.17. Implementation of methodological management of the activities of other structural units on social issues.

4.18. Carrying out, within the framework of its competence, conducting office work, generating and sending/receiving correspondence and other information via electronic communication channels.

4.19. Implementation of the organization of maintaining regulatory and reference information related to the functions of the department.

4.20. Ensuring, within its competence, the protection of information constituting a state secret and other information of limited distribution.

4.21. Implementation, in accordance with the legislation of the Russian Federation, of work on the acquisition, storage, accounting and use of archival documents formed in the course of the department's activities.

The assignment to the department of functions that are not related to the competence of the department is not allowed.

5. RIGHTS

The Department of Social Development, in order to solve the tasks assigned to it, has the right to:

5.1. To request, in accordance with the established procedure, from the structural divisions of the enterprise information, documents and written explanations necessary to resolve issues within the competence of the department.

5.2. Represent the interests of the enterprise within its competence in matters related to the social development of the enterprise.

5.3. Engage specialists from other structural divisions of the enterprise to resolve issues within the competence of the department.

6. INTERACTION WITH STRUCTURAL SUBDIVISIONS OF THE ENTERPRISE

6.1. In the process of production activities of the enterprise, the department constantly interacts with the following structural divisions:

(indicate structural divisions)

- ____________________________________________________________________,

- ____________________________________________________________________,

- ____________________________________________________________________.

6.2. On issues within its competence, the department provides assistance to all departments of the enterprise.

7. RESPONSIBILITY

7.1. The head of the department bears full responsibility for the quality and timeliness of the tasks and functions assigned by the Regulations to the department.

7.2. The degree of responsibility of other employees is established by job descriptions.

7.3. The head and other employees of the department are personally responsible for the compliance of the documents drawn up by them and operations with correspondence with the legislation of the Russian Federation.

8. CRITERIA FOR ASSESSING THE ACTIVITIES OF THE DEPARTMENT

8.1. Timely and high-quality implementation of the goals and objectives.

8.2. Quality performance functional responsibilities.

Head of Social Development Department

__________________________________

Agreed: legal service

____________________________

_____________/______________

/Sew and seal with the signature of an authorized person with a transcript, an indication of the position, the seal of the enterprise./

1.1. The department of social development, being an independent structural subdivision of the enterprise, is created and liquidated by order of [name of the position of the head of the enterprise].

1.2. The department reports directly to [title of the position of the head of the enterprise].

1.3. The department is headed by a chief appointed to the position by order of [name of the position of the head of the enterprise].

1.4. The head of the social development department has [the meaning of] deputy(s).

1.5. The duties of the deputy(s) are determined by the head of the social development department.

1.6. The deputy(s) and heads of structural units (bureaus, sectors, etc.) in the social development department, other employees of the department are appointed to positions and dismissed from positions by order of [name of the position of the head of the enterprise] on the proposal of the head of the social development department.

1.7. In its activities, the department is guided by:

Legislation of the Russian Federation;

the Charter of the enterprise;

By this provision;

1.8. [Enter as required].

2. Structure

2.1. structure and staffing department approves [position title of the head of the enterprise], based on the specific conditions and characteristics of the enterprise's activities on the proposal of the head of the social development department and in agreement with the [HR department].

2.2. The department of social development may include structural units (services, groups, sectors, bureaus, etc.).

For example: bureau (sector, group) of planning and accounting, bureau of pensions and social insurance, sector of medical support, bureau (sector, group) of labor sociology, housing and communal sector, sector of psychological assistance.

Note: The social development department may include individual specialists and groups performing functions for certain directions(psychology, sociology, physiology, others).

2.3. Regulations on the subdivisions of the department of social development (bureaus, sectors, groups, etc.) are approved by the head of the department, and the distribution of duties between the employees of the subdivisions is carried out by [heads of the bureau, sectors, groups; deputy head(s) of the department].

2.4. [Enter as required].

3. Tasks

The following tasks are assigned to the department of social development:

3.1. The study of the basic social needs and problems of the employees of the enterprise.

3.2. Forecasting the development of social processes in the divisions of the enterprise.

3.3. Organization of work on the implementation of guarantees of material and social support and social protection of employees of the enterprise.

3.4. Organization of work on the implementation of social programs.

3.5. [Enter as required].

4. Functions

The Social Development Department performs the following functions:

4.1. Organization and conduct of social work at the enterprise aimed at:

Formation of stable labor collectives;

Development of organizational culture;

The use of socio-psychological factors of labor motivation of employees;

Increasing the social and creative activity of employees, their job satisfaction;

Development and use of the labor potential of each employee;

- [fill in as needed].

4.2. Development and implementation of targeted programs and plans for social development based on social forecasts and modeling of social processes in accordance with the goals, strategy and personnel policy of the enterprise.

4.3. Work to stabilize labor collectives, improve the social structure of the professional and qualification composition.

4.4. Preparation of proposals for:

Optimization of the number of employees;

Raising the general educational and cultural and technical level of employees;

strengthening labor discipline and organization;

Creation and maintenance of a favorable socio-psychological climate in the team;

Adaptation of newly hired employees;

- [fill in as needed].

4.5. The study of working conditions and their impact on employee satisfaction with work.

4.6. Development of activities for:

Improvement of ergonomic, sanitary and hygienic working conditions;

Ensuring labor protection and safety of employees;

Social and psychological support for the introduction of new types of complex equipment;

Reducing heavy and low-skilled manual labor;

Increasing the attractiveness, prestige and culture of work;

- [fill in as needed].

4.7. Participation in the examination of projects for the construction and reconstruction of industrial and non-industrial facilities in order to ensure that they take into account social requirements and standards.

4.8. Participation in the organization of experiments on social aspects improvement of the economic mechanism.

4.9. Improving the system of material, socio-cultural, moral and psychological incentives to increase the labor and social activity of employees, creative attitude to work, collective and individual responsibility for the results of joint activities.

4.10. Development of proposals on measures of social protection of employees of the enterprise within the framework of collective-contractual regulation of labor relations.

4.11. Control over the provision of social insurance for employees, observance of their social guarantees and civil rights.

4.12. Development and implementation of measures for:

Preservation of health and increasing the content of leisure of employees;

Raising the standard of living of workers and their families;

Satisfying the needs for housing and household appliances, a variety of services;

Social protection of certain categories of workers (pensioners, youth, women, etc.);

- [fill in as needed].

4.13. Advising employees on legal and financial issues, labor issues, as well as developing proposals for the provision of various social benefits to employees of the enterprise:

Compensation for housing expenses;

Additional payments for the education of children;

Provision of transport for travel to and from work;

medical care;

- [fill in as needed].

4.14. The introduction of mechanization and computer technologies in the activities of sociological services, strengthening their information base.

4.15. Providing methodological assistance to departments in the development of measures for the social development of labor collectives, coordination of their activities.

4.16. Conducting lectures, seminars on the study by employees of the enterprise of socio-psychological methods of managing social processes.

4.17. [Enter as required].

5. Rights

The Social Development Department has the right to:

5.1. Request and receive from the structural divisions of the enterprise information necessary for the implementation of the activities of the department.

5.2. Give structural subdivisions and individual specialists binding instructions on issues within the competence of the department.

5.3. Conduct independent correspondence with state and municipal authorities on social and pension issues.

5.4. Participate or conduct, at its own discretion, negotiations with representatives of various organizations on issues within the competence of the department of social development.

5.5. Represent the company in accordance with the established procedure in the authorities state power, other institutions and organizations, on issues within the competence of the department.

5.6. In agreement with the head of the enterprise or his deputy for commercial matters involve experts and specialists in the social sphere for consultations, preparation of conclusions, recommendations and proposals.

5.7. [Enter as required].

6. Relationships (service relations)

6.1. The Social Development Department interacts with all divisions on the following issues:

Formation of the organizational and managerial structure of the enterprise;

Carrying out activities in the field of social protection and support for employees of the enterprise, housing, as well as health-improving, sports and socio-cultural spheres;

- [fill in as needed].

6.2. To resolve the issues specified in clause 1 of this section, the heads of structural divisions submit:

Information on the payroll number of employees;

Data on payroll funds;

- [fill in as needed].

6.3. [Enter as required].

7. Responsibility

7.1. Responsibility for the proper and timely performance by the department of the functions provided for by this regulation lies with the head of the social development department.

7.2. The head of the social development department is personally responsible for:

Organization of the activities of the department to fulfill the tasks and functions assigned to the department;

Organization in the department of prompt and high-quality preparation of documents, record keeping in accordance with applicable rules and instructions;

Observance by employees of the department of labor and production discipline;

Ensuring the safety of property located in the department, and compliance with fire safety rules;

Selection, placement and activities of department employees;

Compliance with the legislation of draft orders, instructions, regulations, resolutions and other documents endorsed (signed) by him;

- [fill in as needed].

7.3. The responsibility of the employees of the department is established by job descriptions.

7.4. [Enter as required].

Head of structural unit

[initials, last name]

[signature]

[day month Year]

Agreed:

[official with whom the regulation is agreed]

[initials, last name]

[signature]

[day month Year]

Head of the legal department

[initials, last name]

[signature]

[day month Year]