海事诉前财产保全申请书

申请人:____________________________地址:______________________________

电话:______________________________传真:______________________________法定代表人:___________(姓名、职务)

被申请人:__________________________地址:______________________________

电话:______________________________传真:______________________________法定代表人:___________(姓名、职务)

请求事项:__________________________________________________________________________________________

事实和理由:__________________________________________________________________________________________

此致______海事法院

申请人:_____________

法定代表人:_________

_____年_____月_____日